~ 1 ~ International Journal of Clinical and Diagnostic Pathology 2020; 3(2): 01-05 ISSN (P): 2617-7226 ISSN (E): 2617-7234 www.patholjournal.com 2020; 3(2): 01-05 Received: 04-02-2020 Accepted: 06-03-2020 Dr. Nisha L Gyanchandani Post Graduate 3-year student, Department of Pathology, SRM Medical College Hospital and Research Center Kattankulathur, Chennai, India Dr. P Kalaivani Professor, Department of Pathology, SRM Medical College Hospital and Research Center Kattankulathur, Chennai, India Dr. G Shivashekar Professor and Head of Department of Pathology, SRM Medical College Hospital and Research Center Kattankulathur, Chennai, India Dr. Balaji Ramraj Associate Professor, Department of Community Medicine, SRM Medical College Hospital and Research Center Kattankulathur, Chennai, India Corresponding Author: Dr. P Kalaivani Professor, Department of Pathology, SRM Medical College Hospital and Research Center Kattankulathur, Chennai, India Clinicomorphological correlation of psoriasis and psoriasiform dermatitis Dr. Nisha L Gyanchandani, Dr. P Kalaivani, Dr. G Shivashekar and Dr. Balaji Ramraj DOI: https://doi.org/10.33545/pathol.2020.v3.i2a.215 Abstract Introduction: Psoriasis is a chronic inflammatory skin disorder. Psoriasiform dermatitis on other hand is a frequently encountered terminology in a variety of inflammatory dermatoses. It often poses challenges to both dermatologists and pathologists alike. Clinical features when considered alone may not be reliable to differentiate psoriasis from psoriasiform dermatitis. Aims: (a)To correlate the clinicomorphological features of psoriasis and psoriasiform dermatitis. (b)To identify determinants that may contribute to the diagnosis of psoriasis and psoriasiform dermatitis. Methods: This is a prospective study of 40 cases. Cases clinically diagnosed as psoriasis and psoriasiform dermatitis were screened microscopically and as per morphological criterias 20 cases from each entity were selected and included in the study. Detailed histopathological analysis and correlation was done. Results: The clinical features of typical scales (p= 0.0012) and Auspitz's sign (p = 0.058) morphological evidence of regular acanthosis (p= 0.0005), absent granular layer (p = 0.0001) and presence of micromunros abscess (p=0.0001) were found to be statistically highly significant contributors to the diagnosis of psoriasis in comparison to psoriasiform hyperplasia. Other morphological features like suprapapillary thinning ( p= 0.051) was also found to be morphologically significant. Vertical orientation of collagen bundles ( p = 0.002) was found to be significantly associated with diagnosis of psoriasiform hyperplasia when compared to psoriasis. Conclusion: The present study reconfirms the diagnostic accuracy of scales, Auspitz’s sign as clinically reliable signs of psoriasis. However, in their absence, morphological presence of regular acanthosis, absent granular layer and Munro microabscess may contribute to the diagnosis of psoriasis. Similarly, vertical orientation of collagen bundles points toward a diagnosis of psoriasiform dermatitis. This may help clinicians not to miss the diagnosis of clinically insignificant psoriasis in order to start early treatment and prevent the poor prognosis in these patients. Keywords: Psoriasis, psoriasiform hyperplasia, austpitzsign, scales 1. Introduction Psoriasis is a persistent inflammatory cutaneous disease which influences about 1.3%-2.2% of the total world population. Various elements are included in its etiology which includes genetic, immunological and environmental influences. The most frequently involved sites are elbows, scalp, knees and pre-sacral region [1] . Psoriasis is characterized by increased proliferation of epidermis along with abnormal differentiation and inflammation involving epidermis and dermis [2] . Clinically the disease has well established erythematous plaques covered with silvery white scales [3] . On the other hand, as that of psoriasis similar histological as well as clinical features has been possessed by the psoriasiform lesions. The various examples of psoriasiform lesions are Lichen simplex chronicus, pityriasis rosea, Pityriasis rubra pilaris, Atopic dermatitis, seborrhoeic dermatitis, as well as allergic contact dermatitis [4] . Thus, clinical and Histopathological similarities between psoriasis and psoriasiform lesions results in the diagnostic difficulties in achieving a final diagnosis. The main aim of this study is the evaluation as well as comparison of clinical and histopathological features of psoriasis and psoriasisform dermatitis to get early confirmed diagnosis and help patients to get early treatment of psoriasis in turn preventing the poor outcome in patients.