Ann Dermatol.  2015 Feb;27(1):26-31. 10.5021/ad.2015.27.1.26.

Histopathological Findings Are Associated with the Clinical Types of Psoriasis but Not with the Corresponding Lesional Psoriasis Severity Index

• Kim BY
• Choi JW
• Kim BR
• Youn SW

• KMID: 2264833
• DOI: http://doi.org/10.5021/ad.2015.27.1.26

Abstract

BACKGROUND
The assessment of the severity of psoriasis is often subjective because of the lack of quantitative laboratory diagnostic tools. Histopathological examination is the most commonly performed procedure for psoriasis diagnosis; however, it is usually descriptive. Thus, there is currently no quantitative method of determining psoriasis severity. The clinical types of psoriasis are correlated with the severity of the disease, and a lesional severity index, such as the psoriasis severity index (PSI), could be used as a quantitative tool for assessing gross severity.
OBJECTIVE
To correlate the histopathological findings of psoriasis with the PSI.
METHODS
Psoriatic lesions in 98 patients were evaluated. The lesions were classified into the guttate, papular, small plaque, and large plaque types according to morphology, and were scored according to the PSI. Ten common histopathological features of psoriasis were evaluated for correlation with gross severity.
RESULTS
The clinical types of psoriasis showed significant correlations with the histopathological severity. However, the PSI score showed no correlation with histopathological severity.
CONCLUSION
In the future, subjective gross assessment should be modified by using objective measuring devices with detailed scales, in order to correlate the findings with the histological severity.

Keyword

Adult; Classification; Evidence-based practice; Pathology; Psoriasis

MeSH Terms

Adult
Classification
Diagnosis
Evidence-Based Practice
Humans
Pathology
Psoriasis*
Weights and Measures

Figure

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  Fig. 1 Classification of the clinical types and histopathological features of the corresponding psoriatic lesions (H&E, ×100). (A) Guttate type, (B) papular type, (C) small plaque type, and (D) large plaque type.

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  Fig. 2 Mean psoriasis severity index (PSI) scores in each clinical type of psoriasis, and comparisons according to the clinical types. Thickness and scale parameters showed statistically significant increases according to the gross morphological severity. Erythema showed no statistical significance. *p<0.05.

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  Fig. 3 Mean of histologic grades according to the clinical types of psoriasis. Most of the histologic findings showed significant change as the gross lesion size increased. *p<0.05.

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  Fig. 4 Psoriasis histopathologic score (PHS) according to the clinical types of psoriasis. Significant differences were found in different types of psoriasis (p<0.05).

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