DOI: https://doi.org/10.53350/pjmhs2115123947 ORIGINAL ARTICLE P J M H S Vol. 15, No.12, DEC 2021 3947 Use Immunohistochemistry to Determine the Severity of CD34 Expression in Psoriasis that has been Histopathologically Diagnosed SAIMA BASHIR 1 , MUHAMMAD WAQAS KHAN 2 , NAJIA SOOMRO 3 , SIDRA ZAMAN 4 , KHURRAM NADEEM 5 , AYESHA GUL 6 1 Assistant Professor Histopathology, Gomal Medical College, Dera Ismail Khan KPK 2 MPhil Pathology, Khyber Teaching Hospital, Peshawar 3 Senior Lecturer Pathology, Al-Tibri Medical College and Hospital, Karachi 4 Demonstrator M. Phil Microbiology (Pathology), Avicenna Medical and Dental College, Lahore 5 Associate Professor Oral Medicine, Lahore Medical and Dental College, Lahore 6 Senior Lecturer Pathology Department, North West School of Medicine (NWSM), Peshawar Corresponding author: Najia Soomro, Email: drnajiasoomro@gmail.com, Cell: +92 333 7261643 ABSTRACT Objective: The goal of this study is to determine the degree of CD4 expression in histopathologically confirmed cases of psoriasis using immunohistochemistry. Study Design: Cross-sectional/ Descriptive study Place and Duration: Pathology Department of North West School of Medicine (NWSM), Peshawar and Avicenna Medical and Dental College, Lahore for duration of six months April 2021 to September 2021. Methods: There were 80 patients of both genders with age 18-70 years were presented in this study. Informed written consent was taken from all the patients for detailed demographics including age, sex and body mass index. Psoriasis was diagnosed by taking skin biopsy of all the patients. Histopathology slides were made from paraffin-embedded sections of the whole skin biopsy. When examined in the 40x magnification field, the cases were classified as having light staining (4-10 capillaries), moderate staining (11-20 capillaries), or strong staining (21-28 capillaries). On the basis of histopathology, psoriasis was determined to be present when the following features were observed: hyperkeratosis, acanthosis, a munro's abscess, the extension of rete ridges, and abnormalities of the dermal vasculature. SPSS 24.0 version was used to analyze. Results: Majority of the patients in or study were males 55 (68.8%) and the rest were females 25 (31.2%) with mean age 35.51+19.61 years. Mean BMI of the patients was 24.23+11.34 kg/m 2 . Frequency of moderate staining of CD34 expression was high found in 50 (62.5%) cases, mild staining in 17 (21.3%) patients and 21-28 capillaries (strong staining) in 13 (16.3%) patients. According to histopathological findings hyperkeratosis, acanthosis, a munro's abscess, the extension of rete ridges, and abnormalities of the dermal vasculature majority had moderate (11-20 capillaries) staining of CD34 expression. Conclusion: We concluded in this study that the mild staining expression of CD34 was majority seen among patients of psoriasis. Psoriasis's enhanced cutaneous vasculature has been demonstrated by this crucial angiogenesis marker. As a result, it can be used to better understand the disease's histiogenesis. Keywords: CD34 expression, Histopathology, Immunohistochemistry, Psoriasis INTRODUTION Psoriasis is a chronic inflammatory cutaneous illness with a complex but unexplained aetiology that affects approximately 2% of the world's population [1–4]. It is the most common chronic inflammatory cutaneous disorder in the world. Among the symptoms of this condition include cutaneous inflammation, hyperproliferation, and inadequate differentiation of epidermal keratinocytes [5]. Histopathologically, psoriasiform dermatitis has epidermal proliferation with regular blood vessels, which is characteristic of the condition. Psoriasis, on the other hand, is the most well-known manifestation of psoriasiform dermatitis, and other cutaneous illnesses can reveal psoriasiform epidermal hyperplasia, which can lead to uncertainty in histopathologic diagnosis [6]. A clear distinction between psoriasis and psoriatic arthritis is critical for diagnosing, prognosizing, and treating psoriatic arthritis. The use of immunohistochemistry techniques may be able to achieve this differentiation [6]. Non-psoriasis psoriasiform dermatoses (NPPD) are conditions that clinically and histopathologically resemble psoriasis but do not cause it. Seborrheic dermatitis, pityriasis rosea, pityriasis rubra pilaris (PRP), and lichen simplex chronicus are just a few of the conditions that might occur. [7] The dermatopathologist is frequently forced to make a general diagnosis despite the presence of characteristic histopathological features such as Munro's microabscesses and tortuous, dilated capillaries (psoriasis); alternating horizontal and vertical parakeratosis (pityriasis rubra pilaris); mounds of parakeratosis with extravasation of erythrocytes (pityriasis rose The Ki-67 antigen is a labile nuclear protein complex ranging in size from 345 to 395 kD. Cell cycle regulation is regulated by this protein, which is the most extensively used proliferation immunohistochemistry (IHC) marker. According to research, its expression is elevated in psoriatic lesions as compared to non-lesional skin in the disease. [8] However, there is minimal information available on the comparative expression of this marker in different kinds of psoriasis when compared to NPPD in the literature. Several conditions, such as infection, inflammation, damage, and autoimmune disorders[9], can worsen psoriasis. These variables include: It has been shown that the epidermis contains the majority of cytotoxic CD8+ T cells, whereas the dermis of people with psoriasis has the majority of CD4+ T cells [10,