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慢性斑块状银屑病的流行病学、临床、组织病理学和皮肤镜检查方面的见解

Insights Into the Epidemiological, Clinical, Histopathological, and Dermoscopic Aspects of Chronic Plaque Psoriasis.

作者信息

Jain Rishabh, Sangoi Ravi, Pascal Shoraf, Sharma Yagyavalkya, Variya Takodara Yash, Singh Amit Ajay, Shah Yashvee, A Prashanth, Agrawal Mohit, Wankhede Pratibha

机构信息

General Medicine, Jagadguru Sri Shivarathreeshwara Academy of Higher Education and Research, Mysore, IND.

Internal Medicine, Punyashlok Ahilyadevi Holkar Government Medical College and General Hospital, Baramati, IND.

出版信息

Cureus. 2024 Sep 22;16(9):e69912. doi: 10.7759/cureus.69912. eCollection 2024 Sep.

DOI:10.7759/cureus.69912
PMID:39439643
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11495829/
Abstract

Background Psoriasis is a persistent inflammatory condition of the skin marked by clearly demarcated red plaques adorned with silvery scales. It impacts individuals across different age ranges and presents with unique clinical, histological, and dermoscopic characteristics. This research seeks to offer an extensive assessment of the demographic, clinical, histological, and dermoscopic attributes of chronic plaque psoriasis (CPP). Methodology A total of 60 patients with CPP were included in this study. Data were collected on demographic characteristics, disease duration, clinical features, histopathological findings, and dermoscopic patterns. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York), employing descriptive statistics to summarize demographic and clinical characteristics and histopathological and dermoscopic findings. Results The study included 60 patients with CPP, predominantly aged 41-50 years (n=18, 30%), with a higher prevalence in males (n=35, 58.3%). Plaque psoriasis was the most common type observed (75%), with lesions primarily located on the scalp (n=30, 50%) and elbows (n=25, 41.7%), consistent with typical psoriasis distribution patterns. Histopathological analysis revealed acanthosis in 55 patients (91.7%) and parakeratosis in 50 patients (83.3%), indicating thickened epidermis and retention of nuclei in the stratum corneum, which are characteristic of psoriasis. Additionally, Munro's microabscesses were found in 30 patients (50%) and spongiform pustules in 10 patients (16.7%), supporting the diagnosis through classic markers. Dermoscopic evaluations identified red dots or globules in 55 patients (91.7%) and white scales in 50 patients (83.3%), essential for differentiating psoriasis from other skin conditions. Further dermoscopic findings included micro-erosions in 25 patients (41.7%), hemorrhagic spots in 15 patients (25%), and yellowish scales in 20 patients (33.3%), reflecting disease activity and inflammation. Conclusion This study underscores the importance of a multifaceted approach in diagnosing and managing CPP. The prevalence of psoriasis in middle-aged males and the common clinical presentation on the scalp and elbows are consistent with previous studies. Histopathological and dermoscopic features provide critical diagnostic support and can guide effective treatment strategies. Continued research is essential to enhance understanding and management of this prevalent dermatological condition.

摘要

背景 银屑病是一种持续性的皮肤炎症性疾病,其特征为边界清晰的红色斑块,上面覆盖着银色鳞屑。它影响着不同年龄段的个体,并具有独特的临床、组织学和皮肤镜特征。本研究旨在对慢性斑块状银屑病(CPP)的人口统计学、临床、组织学和皮肤镜特征进行全面评估。

方法 本研究共纳入60例CPP患者。收集了有关人口统计学特征、病程、临床特征、组织病理学发现和皮肤镜表现的数据。使用IBM SPSS Statistics for Windows 20版(2011年发布;IBM公司,纽约州阿蒙克)进行统计分析,采用描述性统计来总结人口统计学和临床特征以及组织病理学和皮肤镜检查结果。

结果 该研究纳入了60例CPP患者,主要年龄在41 - 50岁(n = 18,30%),男性患病率较高(n = 35,58.3%)。斑块状银屑病是最常见的类型(75%),皮损主要位于头皮(n = 30,50%)和肘部(n = 25,41.7%),与典型的银屑病分布模式一致。组织病理学分析显示,55例患者(91.7%)有棘层肥厚,50例患者(83.3%)有角化不全,表明表皮增厚且角质层细胞核残留,这是银屑病的特征。此外,30例患者(50%)发现有Munro微脓肿,10例患者(16.7%)发现有海绵状脓疱,通过这些典型标志物支持诊断。皮肤镜评估发现55例患者(91.7%)有红点或红丘疹,50例患者(83.3%)有白色鳞屑,这对于将银屑病与其他皮肤病区分开来至关重要。进一步的皮肤镜检查结果包括25例患者(41.7%)有微糜烂,15例患者(25%)有出血点,20例患者(33.3%)有淡黄色鳞屑,反映了疾病的活动度和炎症情况。

结论 本研究强调了多方面方法在CPP诊断和管理中的重要性。银屑病在中年男性中的患病率以及在头皮和肘部的常见临床表现与先前研究一致。组织病理学和皮肤镜特征提供了关键的诊断支持,并可指导有效的治疗策略。持续的研究对于加强对这种常见皮肤病的理解和管理至关重要。

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