Dermoscopic evaluation of psoriasis and its association with clinical and histopathological features – A cross-sectional analytical study

• Author Details:   
• Sheron Christin Armel
• Trishna Vaishali ^*
• Manjiri Phansalkar

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Background: Limited data on the effectiveness of dermoscopy in diagnosing psoriasis.
Aim and objectives: To document the dermoscopic findings and to determine the association between clinical, dermoscopic and histopathological features in psoriasis.
Materials and Methods: It is a hospital based cross sectional analytical study conducted among psoriatic patients during a period of 18 months. Sample size was calculated as 55. Clinical variables like morphology, character and color of scales, dermoscopic features like background color, pattern and distribution of vessels, scale color and distribution, and histopathologic parameters were documented. The data was analysed using SPSS software version 29.0. Chi square or Fisher’s Exact test was used to find association between clinical, dermoscopic and histopathological features.
Results:  The commonest morphology was plaque type psoriasis (63.64%). The scales were larger (83.6%) and white in color (100%) clinically. Dermoscopy demonstrated white scales in diffuse arrangement (89.1%) and dotted vessels (90.9%) arranged regularly in a light red background (60%). Biopsy showed parakeratosis, regular acanthosis and club shaped rete ridges in all participants. Other features demonstrated were agranulosis (80%), dilated blood vessels (86.6%), perivascular lymphocytic infiltrate (96.6%), Munro microabscess (66.6%) and spongiform pustules of Kogoj (36.6%). Statistically significant association was found between clinical morphology and vascular morphology (p=0.011), agranulosis and background color (p=0.013), dilated blood vessel and vascular morphology (p=0.003). Also, the red dotted vessels in dermoscopy was consistent with all the histopathological parameters.
Limitation: Larger sample size is required to strengthen the study.
Conclusion: Dermoscopy can be understandably within reason used to diagnose and differentiate psoriasis from other similar psoriasiform conditions.

Keywords: Chronic plaque psoriasis, Dermoscopy, Red dotted vessels, Munro microabscess, Spongiform pustules of Kogoj