[|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
Mimicking cigarette smoke exposure to assess cutaneous toxicity.
Prieux R et al.
Mimicking cigarette smoke exposure to assess cutaneous toxicity.
Toxicol In Vitro.
2020 Feb , 62:104664.
Cigarette smoke stands among the most toxic environmental pollutants and is composed of thousands of chemicals including polycyclic aromatic hydrocarbons (PAHs). Despite restrict cigarette smoking ban in indoor or some outdoor locations, the risk of non-smokers to be exposed to environmental cigarette smoke is not yet eliminated. Beside the well-known effects of cigarette smoke to the respiratory and cardiovascular systems, a growing literature has shown during the last 3 decades its (...)
see on pubmed
Penta-O-galloyl-β-D-glucose from Paeonia lactiflora Pall. root extract enhances the expression of skin barrier genes via EGR3.
J Ethnopharmacol.
2020 Feb 10, 248:112337.
Paeonia lactiflora Pall. has long been used to treat inflammatory skin diseases, such as psoriasis.
see on pubmed
CARD14/CARMA2sh and TANK differentially regulate poly(I:C)-induced inflammatory reaction in keratinocytes.
J. Cell. Physiol..
2020 Mar , 235, (3):1895-1902.
CARD14/CARMA2sh (CARMA2sh) is a scaffold protein whose mutations are associated with the onset of human genetic psoriasis and other inflammatory skin disorders. Here we show that the immunomodulatory adapter protein TRAF family member-associated NF-κB activator (TANK) forms a complex with CARMA2sh and MALT1 in a human keratinocytic cell line. We also show that CARMA2 and TANK are individually required to activate the nuclear factor κB (NF-κB) response following exposure to (...)
see on pubmed
on Atopic Dermatitis
Mimicking cigarette smoke exposure to assess cutaneous toxicity.
Prieux R et al.
Mimicking cigarette smoke exposure to assess cutaneous toxicity.
Toxicol In Vitro.
2020 Feb , 62:104664.
Cigarette smoke stands among the most toxic environmental pollutants and is composed of thousands of chemicals including polycyclic aromatic hydrocarbons (PAHs). Despite restrict cigarette smoking ban in indoor or some outdoor locations, the risk of non-smokers to be exposed to environmental cigarette smoke is not yet eliminated. Beside the well-known effects of cigarette smoke to the respiratory and cardiovascular systems, a growing literature has shown during the last 3 decades its (...)
see on pubmed
Sublingual Immunotherapy for Other Indications: Venom Large Local, Latex, Atopic Dermatitis, and Food.
Immunol Allergy Clin North Am.
2020 Feb , 40, (1):41-57.
There is some evidence to support the use of sublingual immunotherapy (SLIT) in food allergy, although its role is unclear. One randomized, double-blind, placebo-controlled trial supports the safe and efficacious use of dust mite SLIT in children with mild to moderate atopic dermatitis, but these data have not been confirmed. Although there are several randomized, double-blind, placebo-controlled trials to support the use of SLIT-LATEX, this product is not available in the United States and (...)
see on pubmed
The Cost-Effectiveness of Allergen Immunotherapy Compared with Pharmacotherapy for Treatment of Allergic Rhinitis and Asthma.
Immunol Allergy Clin North Am.
2020 Feb , 40, (1):69-85.
This article evaluates the cost-effectiveness of allergy immunotherapy (AIT) in the treatment of allergic rhinitis, asthma, and other allergic conditions. An extensive search of the PubMed and Medline databases (up to December 2018) was conducted. There is strong evidence in the collective literature, which included individual studies and systematic reviews, that AIT is cost-effective in the management of allergic rhinitis and asthma as compared with standard drug treatment alone. The (...)
see on pubmed
