Which histopathological feature is most characteristic of psoriasis on skin biopsy?
Solution
Correct Answer: Option A
The most characteristic histopathological feature of psoriasis on skin biopsy is parakeratosis.
- Psoriasis is a chronic inflammatory skin disorder characterized by rapid turnover of epidermal cells, leading to incomplete maturation of keratinocytes.
- This results in the retention of nuclei within the stratum corneum, a feature known as parakeratosis.
Other histological features include:
- Regular acanthosis: Thickening of the epidermis with elongation of rete ridges.
- Thinning of the suprapapillary plates: The epidermis above the dermal papillae becomes thin.
- Munro microabscesses: Collections of neutrophils in the stratum corneum.
- Dilated and tortuous capillaries in the dermal papillae, correlating with the characteristic erythematous plaques.
In contrast:
- Acantholysis (Option 2) refers to loss of cohesion between keratinocytes, typical of pemphigus vulgaris.
- Subepidermal blister (Option 3) is seen in bullous pemphigoid and other subepidermal blistering disorders.
- Spongiosis (Option 4), or intercellular edema of the epidermis, is characteristic of eczematous dermatitis.
Therefore, among the given options, parakeratosis is the hallmark of psoriasis.
Reference: Lever's Histopathology of the Skin, 11th Edition, Chapter 17: Psoriasis / Page 364-367
- Psoriasis is a chronic inflammatory skin disorder characterized by rapid turnover of epidermal cells, leading to incomplete maturation of keratinocytes.
- This results in the retention of nuclei within the stratum corneum, a feature known as parakeratosis.
Other histological features include:
- Regular acanthosis: Thickening of the epidermis with elongation of rete ridges.
- Thinning of the suprapapillary plates: The epidermis above the dermal papillae becomes thin.
- Munro microabscesses: Collections of neutrophils in the stratum corneum.
- Dilated and tortuous capillaries in the dermal papillae, correlating with the characteristic erythematous plaques.
In contrast:
- Acantholysis (Option 2) refers to loss of cohesion between keratinocytes, typical of pemphigus vulgaris.
- Subepidermal blister (Option 3) is seen in bullous pemphigoid and other subepidermal blistering disorders.
- Spongiosis (Option 4), or intercellular edema of the epidermis, is characteristic of eczematous dermatitis.
Therefore, among the given options, parakeratosis is the hallmark of psoriasis.
Reference: Lever's Histopathology of the Skin, 11th Edition, Chapter 17: Psoriasis / Page 364-367
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