Which of the following features are associated with psoriasis: September 2009

Ans. B: Munro's micro-abscesses, parakeratosis, and epidermal hyperplasia Psoriasis is a common, relapsing chronic inflammatory condition affecting about 1.5-3% of the world's population, causing significant morbidity. The presence of a well-defined margin and a silvery white scale, over a glossy homogenous membrane, is clinically diagnostic of psoriasis. The successive removal of the psoriatic scales usually reveals an underlying, smooth, glossy red membrane with multiple bleeding points where thin suprapapillary epithelium is torn off (Auspitz's sign). When the scaling is not evident, it can be induced by light tangential scratching with the edge of glass slide (Grattage). Psoriasis often involves nails, scalp, mucosae, and joints, as well. Parakeratosis (nuclei retained in the horny layer), dilated blood vessels, regular epidermal hyperplasia (regular acanthosis), and presence of Munro microabscess and/or Kogoj's abscess have been described to be the most constant or characteristic histopathological features in skin biospy of psoriasis. Similarly, spongiosis, irregular epidermal hyperplasia, and absence of Munro micro and Kogoj's abscess have been found consistently in psoriasiform dermatitis Moreover, the "diagnostic" histopathological findings of psoriasis, namely, Kogoj's spongiform pustules and Munro microabscess, can also be seen in dermatophytoses, candida infection, and others.