Palmoplantar Psoriasis versus Hyperkeratotic Palmoplantar Dermatitis: Study of Histopathological Paramounts in a Tertiary Care Centre
DOI:
https://doi.org/10.21276/apalm.3825Keywords:
palmoplantar psoriasis, hyperkeratotic palmoplantar dermatitis, histopathologyAbstract
Background: Palmoplantar Psoriasis and Hyperkeratotic Palmoplantar Dermatitis have overlapping clinical features and are difficult to diagnose. Literature shows few findings thickness of the granular layer, suprapapillary thinning of epidermis, Munro microabscess, Kogoj abscess and tortous capillaries in dermis give a clue to the diagnosis.
Methods: This study was conducted in Gayatri Vidya Parishad Institute of Health Care and Medical Technology, tertiary care health centre in Visakhapatnam, Andhra Pradesh from 1-5-24 to 1-5-25. This prospective observational study included 66 patients aged 20 and 70 years with a differential diagnosis of PPP and HPPD. Formalin fixed skin punch biopsies were processed and hematoxylin and eosin sections were studied.
Result: Among 66 patients, 32 were psoriasis and 34 were dermatitis. On histopathological examination, characteristic features of psoriasis lesion were parakeratosis in 62.5% (20/32), neutrophils in stratum corneum seen in 12.5% (4/32), plasma moulds in stratum corneum 25% (8/32), hypogranulosis in 59.3% (19/32), regular acanthosis in 75% (24/32), irregular acanthosis in 6% (2/32), neutrophils in stratum malpighi 6.25% (2/32), spongiosis in 12.5% (4/32) and suprapapillary thinning of epidermis in 43.7% (14/32). In hyperkeratotic dermatitis features of parakeratosis in 55.8% (19/34), neutrophils in stratum corneum 0% (0/34), plasma moulds in stratum corneum 41.1% (14/34), hypogranulosis in 0% (0/34), regular acanthosis in 8.82% (3/34), irregular acanthosis in 67.64% (23/34), neutrophils in stratum malpighi 0% (0/32), spongiosis in 79.4% (27/34) and suprapapillary thinning of epidermis in 2.9% (1/34).
Conclusion: Suprapapillary thinning, hypogranulosis and spongiosis of epidermis are helpful in differentiating palmoplantar psoriasis and hyperkeratotic palmoplantar dermatitis.
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Copyright (c) 2026 Sudhakar Raksha, Akshay Babu Yejjala, Krishnadivya Poruri, Ronica Marshall Vaddeswarapu, Kiran Kumar Epari, Sireesha Behara
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