Are quantitative histopathologic criteria capable of differentiating psoriasis from chronic dermatitis?

Comparison of Histopathological Findings in Psoriasis According to the Lesion Location From Biopsy

ABSTRACT

The aim of this study was to investigate whether the histopathological findings of psoriasis varied by the biopsied lesion location. Age, gender, age at disease onset, lesion locations, presence or absence of a preliminary diagnosis of psoriasis, and histopathological findings of 307 patients were recorded. The sections prepared from the patients' paraffin blocks were reexamined microscopically, the severity of the observed findings was graded, and various histopathological features were recorded. The female-to-male ratio was 1.2 to 1. Family history for psoriasis was positive in 30% of patients. A clinically preliminary diagnosis of psoriasis was present in 232 patients. The most common histopathological features included hyperkeratosis, parakeratosis, Munro/Kogoj microabscesses, suprapapillary thinning-hypogranulosis, and vascular dilation-capillary proliferation. Hyperkeratosis was least common in the trunk. A linear and moderately strong correlation was found between the histopathological findings of inflammation, capillary proliferation, and suprapapillary thinning. For the first time, the clinical and demographic features of psoriasis are evaluated and the severity of the histopathological findings is compared by the biopsied lesion location in a large number of patients.

Anti-Psoriasis Effect of Diclofenac and Celecoxib Using the Tail Model for Psoriasis

Non-steroidal anti-inflammatory drugs (NSAIDs) showed effects in some hyperproliferative dermatologic pathologies. The aim of the study is the assessment of anti-psoriasis effect of diclofenac and celecoxib using a mice tail model. The topical application of substances on the proximal mice tails was performed for two weeks. The effects on the epidermal granular layer and mean epidermal thickness (excluding the stratum corneum) were evaluated using hematoxylin–eosin staining. Orthokeratosis degree and percentual drug activity were calculated. A positive control group treated with tretinoin and two negative controls (white soft paraffin and untreated mice) were used. Orthokeratosis degree significantly increased in all the NSAIDs groups (celecoxib 1%, 2% and diclofenac 1%, 2%) and in the tretinoin 0.05% group, versus negative controls. Celecoxib 1% and 2%, tretinoin 0.05% and white soft paraffin significantly increased mean epidermal thickness, versus untreated mice. The values obtained in the case of celecoxib 2% ointment regarding the orthokeratosis degree and percentual drug activity are providing premises for further investigations regarding this effect and the mechanisms of action involved. Celecoxib 2% had the greatest percentual drug activity and is a promising substance for the anti-psoriasis topical treatment. Along with the COX-2 inhibition, celecoxib might have an anti-psoriasis effect by other independent mechanisms.

Biophysical Measurements and Ultrasonographic Findings in Chronic Dermatitis in Comparison with Uninvolved Skin

Background:

Nowadays noninvasive techniques are performed to evaluate the biophysical properties of skin in vivo.

Aims:

The aim of this study was to evaluate the biophysical and ultrasonographic properties of skin in chronic contact or atopic dermatitis to provide better insight into pathogenesis, diagnosis, and treatment response.

Materials and Methods:

The stratum corneum hydration, transepidermal water loss (TEWL), pH, erythema, melanin, sebum, friction, temperature, elasticity parameters (R0, R2, and R5), the thickness and echo-density of epidermis, dermis, and subepidermal low-echogenic band (SLEB) were measured on lesional, perilesional, and symmetrical skin of 22 chronic dermatitis patients. The average of perilesional and symmetrical skin values (control) was compared with lesional values.

Results:

Stratum corneum hydration (P<0.001), friction (P=0.02), sebum (P=0.01), and R0 (P<0.001) were significantly lower in lesion, TEWL (P=0.03), pH (P=0.001), erythema (P=0.004), and temperature (P=0.04) were significantly higher in lesion. The thickness of epidermis (P=0.002), dermis (P=0.034), and SLEB (P<0.001) were significantly higher in lesion; and the echo-density of dermis (P<0.001) and SLEB (P<0.001) was significantly lower in lesion.

Conclusion:

Chronic contact and atopic dermatitis are characterized by certain changes in biophysical and biomechanical properties of the skin. The evaluation of these parameters might be useful in the early diagnosis and assessment of treatment response.