[|I absolutely agree with the
statement of the value of biopsies in psoriasis.|auteur195]
[|However, the classical histopathological picture as described in the
chapter on histopathology is seen only in a minority of the biopsies taken from the psoriatic
plaque. In particular, the Munro micro abscesses and micro pustules of
kogoj can be difficult to find. Acute psoriatic papules and the margin zone of
spreading psoriatic plaques more frequently show the complete histopathological
picture as described above. Therefore, for diagnostic purposes biopsies have to
be taken from the margin zone or from psoriatic papules.|auteur197]
[|The eight major characteristics, together with micrographs, are well-described. In addition to the difficulty in distinguishing psoriasis from eczema on the palms and soles, I also do feel that erythrodermic psoriasis, with or without pustulation, also is frequently non-specific with overlap features between eczema and psoriasis. Certainly, I believe that immunohistochemistry may frequently be of more value in distinguishing psoriasis from its clinical and histological “look alikes”, eg eczema, cutaneous T-cell lymphoma, etc.|auteur215]
The typical histological appearance of psoriasis is well known (photo 40). It is characterized by:
- parakeratosis,
- presence of Munro microabscesses (photos 41 and 42),
- absence of a granular layer except on the nail, where conversely hypergranulosis exists,
- epidermal acanthosis pertaining solely to the interpapillary (rete) ridges,
- elongation and edema of the dermal papillae,
- thinning of the superjacent malpighian stratum,
- increase in the number of mitoses,
- major proliferation of the endothelial cells with hypertrophy and vasodilatation of the papillary capillarie
Pustular psoriasis is characterized by subcorneal multilocular pustules.
This typical histological appearance will only be found in clinically typical lesions (photo 43). When it comes to the palms of the hands and the soles of the feet, a spongiosis is practically always observed. Histological examination will not allow eczema to be differentiated from psoriasis in these localisations.
Thus, histological examination in psoriasis is only useful in two contexts: for securing histological evidence in an illness whose management will be reflected over the long term, and for ruling out other illnesses: parapsoriasis en plaque, lichen and so on.
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Recent publications on Psoriasis and Atopic Dermatitis
on Psoriasis
Special aspects of biologics treatment in psoriasis: management in pregnancy, lactation, surgery, renal impairment, hepatitis and tuberculosis.
J Dermatolog Treat.
2019 Nov , 30, (7):668-673.
: Biologics are modern immunomodulatory drugs, whose use in the treatment of psoriasis has led to remarkable results in psoriatic patients. The administration of these agents in special population groups, such as patients with chronic infections and renal impairment, as well as perioperative, pregnant or lactating patients, has not been thoroughly addressed, mostly because these patients are excluded from clinical studies. This report is an updated systematic overview of the use of (...)
see on pubmed
JAK-inhibitors in dermatology: current evidence and future applications.
Ciechanowicz P et al.
JAK-inhibitors in dermatology: current evidence and future applications.
J Dermatolog Treat.
2019 Nov , 30, (7):648-658.
The Janus kinase (JAK) and signal transducer and activator of transcription (STAT) pathway is a ubiquitous intracellular signaling network. Selective JAK-inhibitors have anti-inflammatory properties and have been approved in many countries for the treatment of rheumatoid arthritis (tofacitinib, baricitinib) and myelofibrosis or polycythemia vera (ruxolitinib). The aim of the publication was to summarize and critically analyze the efficacy and safety of JAK-inhibitors in skin diseases, such (...)
see on pubmed
Patient preferences for attributes of topical anti-psoriatic medicines.
Vasconcelos V et al.
Patient preferences for attributes of topical anti-psoriatic medicines.
J Dermatolog Treat.
2019 Nov , 30, (7):659-663.
Patient preferences should be considered when prescribing topical treatments to drive up adherence and improve clinical outcomes. The aim of this work was to identify the most important attributes of topical medicines for psoriasis treatment in the patients' view, and explore the sociodemographic and clinical determinants of these preferences. A questionnaire for the evaluation of the relevancy given to specific attributes of topical medicines used for psoriasis treatment was developed (...)
see on pubmed
on Atopic Dermatitis
JAK-inhibitors in dermatology: current evidence and future applications.
Ciechanowicz P et al.
JAK-inhibitors in dermatology: current evidence and future applications.
J Dermatolog Treat.
2019 Nov , 30, (7):648-658.
The Janus kinase (JAK) and signal transducer and activator of transcription (STAT) pathway is a ubiquitous intracellular signaling network. Selective JAK-inhibitors have anti-inflammatory properties and have been approved in many countries for the treatment of rheumatoid arthritis (tofacitinib, baricitinib) and myelofibrosis or polycythemia vera (ruxolitinib). The aim of the publication was to summarize and critically analyze the efficacy and safety of JAK-inhibitors in skin diseases, such (...)
see on pubmed
A case of infective endocarditis associated with atopic dermatitis perioperatively treated with dupilumab.
J Dermatolog Treat.
2019 Nov , 30, (7):674-676.
Several case reports and reviews support a relationship between atopic dermatitis (AD) and infective endocarditis (IE). Here, we present a case of severe AD suspected of causing IE. A 21-year-old man with severe AD was admitted to our hospital due to unidentified fever, syncope, and headache. He was diagnosed with IE with cerebral embolism and mitral regurgitation. Before elective cardiac surgery, he was subcutaneously administered dupilumab for 2 months to control AD. Dupilumab improved (...)
see on pubmed
Effect of cinnamamides on atopic dermatitis through regulation of IL-4 in CD4 cells.
Choi EJ et al.
Effect of cinnamamides on atopic dermatitis through regulation of IL-4 in CD4 cells.
J Enzyme Inhib Med Chem.
2019 Dec , 34, (1):613-619.
This study aimed to evaluate the effects of cinnamamides on atopic dermatitis (AD) and the mechanisms underlying these effects. To this end, the actions of two cinnamamides, (E)-3-(4-hydroxyphenyl)-N-phenylethyl acrylamide (NCT) and N-trans-coumaroyltyramine (NCPA), were determined on AD by orally administering them to mice. Oral administration of the cinnamamides ameliorated the increase in epidermal and dermal thickness as well as mast cell infiltration. Cinnamamides suppressed serum (...)
see on pubmed
