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真实世界评估“银屑病中的湿疹”:弥合皮肤科与皮肤病理科之间的差距。

Real-world evaluation of "Eczema in psoriatico": Bridging the gap between dermatology and dermatopathology.

机构信息

Department of Dermatology, Medipol Univeristy, Istanbul, Turkey.

Department of Pathology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey.

出版信息

Dermatol Ther. 2021 Jan;34(1):e14672. doi: 10.1111/dth.14672. Epub 2020 Dec 23.

Abstract

The diagnosis of psoriasis is mainly made by clinical examination but on some occasions according to the localization or duration of the lesions when spongiosis is more prominent, it can be challenging and may be considered as overlapping eczema. To evaluate the patients for "eczema in psoriatico" and to present the differences between psoriasis. Biopsy outcomes of thirty-one patients who were histologically diagnosed with psoriasis and psoriasiform dermatitis because of the erythematous and scaly plaque lesions located on hands and feet, between 2013 and 2015, were evaluated retrospectively. Histopathologic findings compatible with psoriasis and accompanied by spongiosis and spongiotic vesicles were evaluated as eczema in psoriatico and compared with psoriasis. In this study thirty-one patients, including 18 patients with eczema in psoriatico and 13 patients with psoriasis of hands and/or feet were included. Of the 31 patients, 15 (48.4%) were women and 16 (51.6%) were men, in 61.3% of cases, biopsies were taken from hands (61.1% of "eczema in psoriatico", 61.5% of psoriasis) and 38.7% from feet (38.9% of "eczema in psoriatico", 38.5% of psoriasis). There was a statistically significant difference between two groups in terms of parakeratosis severity and distribution, the presence of neutrophil and plasma in stratum corneum, the presence of granular layer loss and suprapapillar plate thinning, the shape of retes, the presence of lymphocytic exocytosis, spongiosis and spongiotic vesicles, the intensity of infiltrates in the papillar dermis and the presence of dermal edema (P < .05). Histology supports a continuum between psoriasis and eczema that share histological similarities and at the same time should be considered a separate entity, eczema in psoriatico.

摘要

银屑病的诊断主要通过临床检查,但在某些情况下,根据病变的定位或持续时间,如果海绵形成更为突出,则可能具有挑战性,并可能被认为是重叠性湿疹。为了评估“银屑病中的湿疹”患者,并介绍银屑病之间的差异。回顾性评估了 2013 年至 2015 年间因位于手部和/或足部的红斑和鳞屑斑块病变而组织学诊断为银屑病和银屑病样皮炎的 31 例患者的活检结果。评估与银屑病伴海绵形成和海绵状水疱一致的组织病理学发现,并将其评估为银屑病中的湿疹,并与银屑病进行比较。在这项研究中,包括 18 例银屑病中的湿疹和 13 例手部和/或足部银屑病患者在内的 31 例患者。31 例患者中,女性 15 例(48.4%),男性 16 例(51.6%),61.3%的病例取自手部(61.1%的“银屑病中的湿疹”,61.5%的银屑病),38.7%取自脚部(38.9%的“银屑病中的湿疹”,38.5%的银屑病)。两组在角化过度的严重程度和分布、角质层中性粒细胞和血浆的存在、颗粒层丧失和棘状板变薄、网嵴的形状、淋巴细胞外渗、海绵形成和海绵状水疱、乳头真皮浸润的强度以及真皮水肿的存在方面存在统计学显著差异(P <.05)。组织学支持银屑病和湿疹之间的连续体,它们具有组织学相似性,同时应被视为一个单独的实体,即银屑病中的湿疹。

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