Enigbokan O A, Ogun G O, Ogunbiyi A O, George A O
Department of Medicine (Dermatology unit), University of Ibadan/University College Hospital, Ibadan, Nigeria.
Department of Pathology, University of Ibadan/University College Hospital, Ibadan, Nigeria.
Ann Ib Postgrad Med. 2023 Jun;21(1):35-40.
Clinical and histopathologic observations have indicated that psoriasis is not rare in our population as previously thought. The initial rarity also led to paucity of studies on the disorder including histopathologic features in our practice setting. To date, there is no report on the histopathologic features of psoriasis indigenous to our practice environment.
To evaluate the frequency of occurrence of the various histopathologic features of psoriasis in patients from this environment and identify any peculiarities that exist in black African patients.
A cross-sectional study of patients diagnosed clinically with psoriasis at the University College Hospital, Ibadan between January 2015 and October 2016. After baseline sociodemographic data, all patients had baseline clinical examination and were offered skin biopsy after obtaining informed consent. The biopsy specimen was examined for histopathologic features of psoriasis after routine processing and staining using a pretested proforma with the frequencies of each diagnostic feature reported in percentages.
Forty-four patients with plaque psoriasis were analyzed. The mean age of the patients studied was 39.84 ± 20.97 years with a male to female ratio of which was almost equal. The most consistent epidermal changes in decreasing other of frequency were acanthosis, hypogranulosis, hyperkeratosis followed by elongation of rete ridges while dermal features were dermal infiltration by inflammatory cells, and dilatation of superficial dermal vessels. Munro's microabscesses were found in less than half of the patients biopsied. Some of the patients were found to have atypical changes.
Histopathological features of psoriasis in the study is similar to what has been previously established universally but typical features such as Munro's micro abscesses and Kogoj's spongiform pustules are less frequently seen than expected. Atypical changes such as dermal melanophages and periadnexal infiltration by inflammatory cells may also be seen.
临床和组织病理学观察表明，银屑病在我国人群中并不像之前认为的那样罕见。最初认为的罕见性也导致了对该疾病的研究匮乏，包括在我们的实际临床环境中的组织病理学特征。迄今为止，尚无关于我们实际临床环境中银屑病组织病理学特征的报告。
评估该环境中患者银屑病各种组织病理学特征的发生频率，并确定黑非洲患者中存在的任何特殊情况。
对2015年1月至2016年10月在伊巴丹大学学院医院临床诊断为银屑病的患者进行横断面研究。记录基线社会人口统计学数据后，所有患者均接受基线临床检查，并在获得知情同意后进行皮肤活检。活检标本经常规处理和染色后，使用预先测试的表格检查银屑病的组织病理学特征，每个诊断特征的频率以百分比报告。
分析了44例斑块状银屑病患者。研究患者的平均年龄为39.84±20.97岁，男女比例几乎相等。按频率递减顺序排列，最一致的表皮变化为棘层肥厚、颗粒层减少、角化过度，其次是 rete 嵴延长，而真皮特征为炎症细胞浸润和浅表真皮血管扩张。在不到一半的活检患者中发现了 Munro 微脓肿。部分患者存在非典型变化。
本研究中银屑病的组织病理学特征与之前普遍确定的特征相似，但如 Munro 微脓肿和 Kogoj 海绵状脓疱等典型特征的出现频率低于预期。也可能出现非典型变化，如真皮黑素细胞和炎症细胞的附件周围浸润。
