Analysis of dermoscopic characteristic for the differential diagnosis of palmoplantar psoriasis and palmoplantar eczema

A Cross-Sectional Study of Dermoscopy and Clinical and Histopathological Study of Acquired Palmoplantar Keratodermas: A Research Protocol

Background Acquired palmoplantar keratodermas (PPKs) pose diagnostic and therapeutic challenges due to their varied clinical presentations and overlapping features. This study aims to elucidate diagnostic criteria; assess correlations between clinical, dermoscopic, and histopathological features; and evaluate treatment outcomes for acquired PPKs, particularly palmoplantar psoriasis. Methods A prospective, cross-sectional study will be conducted at the Department of Dermatology, Venereology, and Leprosy, Acharya Vinoba Bhave Rural Hospital (AVBRH), Wardha, Maharashtra. Patients with acquired PPKs will undergo comprehensive clinical, dermoscopic, and histopathological evaluations. Treatment outcomes for palmoplantar psoriasis will be assessed following standard therapy. Statistical analysis will include descriptive statistics, diagnostic accuracy assessments, correlation analyses, and treatment outcome evaluations. Results The study is anticipated to establish reliable diagnostic criteria for acquired PPKs, identify correlations between features, and demonstrate the effectiveness of standard therapies for palmoplantar psoriasis. The findings are expected to inform evidence-based guidelines and protocols for diagnosing and managing acquired PPKs. Conclusion This study aims to advance the understanding and management of acquired PPKs by providing insights into diagnostic accuracy, correlations between features, and treatment outcomes. The study seeks to enhance patient care and outcomes for individuals affected by acquired PPKs by improving diagnostic precision and guiding therapeutic interventions.

Clinical value of dermoscopy in psoriasis

BACKGROUND

Dermoscopy is a noninvasive technique that has attracted increasing attention in the field of inflammatory skin diseases (such as psoriasis) in recent years.

OBJECTIVE

This study aimed to provide an up-to-date overview of the role of dermoscopy in the diagnosis and extra-diagnosis of psoriasis.

METHODS

This study sought to review the published literature regarding use of dermoscopy in the evaluation of psoriasis.

RESULTS

The diagnostic value of dermoscopy in psoriasis vulgaris, nail psoriasis, and other types of psoriasis was summarized from the aspects of vascular pattern, scale pattern, and other features. Meanwhile, the application value of dermoscopy in the differential diagnosis, efficacy and severity assessment, prediction and monitoring of psoriasis was discussed.

CONCLUSION

Dermoscopy has good clinical value in the diagnosis and differential diagnosis of psoriasis and shows great prospects for severity assessment and efficacy prediction monitoring.

Dermoscopy in the Diagnosis of Palmoplantar Eczema and Palmoplantar Psoriasis: A Cross-Sectional, Comparative Study from a Tertiary Care Centre in North India

Introduction

Palmoplantar hyperkeratotic lesions pose a diagnostic difficulty when differentiating clinically between palmoplantar psoriasis (PPP) and palmoplantar eczema (PPE). Dermoscopy can provide valuable clues in reaching the final diagnosis.

Objectives

To identify and compare dermoscopic findings seen in PPP and PPE.

Methods

This was a cross-sectional, comparative study carried out prospectively between March 2019 and June 2020. All adult, consenting patients visiting the dermatology outpatient department who were clinically diagnosed and histopathologically confirmed as PPP and PPE were recruited into two groups. The dermoscopic examination was done, and images were taken from the representative area. The findings were analysed by two dermatologists who were unaware of the diagnosis. The sensitivity, specificity, positive predictive value and negative predictive value of these findings were assessed.

Result

A total of 81 patients were recruited (39 patients of PPP and 42 patients of PPE). Significant findings seen in psoriatic plaques were the presence of regular vessels (84.6%, P < 0.001), with diffuse scales (87.2%) over a dull red/pink background (69.2%, P < 0.001). Dermoscopy of PPE displayed a significant presence of yellowish scales (76.2%, P < 0.001), with focal (61.9%) or absent vessels (35.7%), brown/orange-brown dots and/or globules (66.7%), yellow/yellow-orange crusts (57.1%) over a yellow/yellow-brown background (88.1%).

Conclusion

Distribution of vessels, distribution of scales and the colour of scales, presence of brown/orange-brown dots and/or globules, yellow/yellow-orange crust and background colour (dull red vs. yellow/yellow-brown) of the plaques can be useful clues in the diagnosis of PPP and PPE.

Palmoplantar Psoriasis: A Clinico-Pathologic Study on a Series of 21 Cases with Emphasis on Differential Diagnosis

Palmoplantar psoriasis (PP) is a relatively uncommon variant of psoriasis that affects palms and soles, and that frequently shares both clinical and histologic features with chronic eczema, hyperkeratotic hand dermatitis and allergic contact dermatitis. The present study aims to characterize the histologic features of PP on a series of 21 cases. The following morphological features and their distribution were included: parakeratosis, dilated vessels in papillary dermis, psoriasiform acanthosis with elongation of rete ridges, perivascular lymphocytic infiltrate, decrease/loss of granular layer, Munro's microabscesses, spongiform pustules of Kogoj, spongiosis and lymphocytic exocytosis. The main diagnostic clues and histologic differential diagnoses are also discussed.