A study of psoriasiform and lichenoid tissue reactions in various papulosquamous skin diseases and their clinicopathological association

Abstract

Background: Due to their overlapping clinical and histopathological features, the definitive diagnosis of papulosquamous skin diseases can only be made through clinicohistopathological association. Methods: Over a period of 18 months, we studied 100 patients with clinically suspected non-infectious papulosquamous skin lesions. Diagnosis was confirmed through histopathological examination using haematoxylin and eosin stain. The clinical pattern was associated with histopathological findings. Results: The results showed that the majority of the patients were in the age group of 21–30 years, with a male preponderance. The upper limbs were the most frequently involved site. Psoriasis was the most common papulosquamous skin disease, followed by lichen planus, pityriasis rosea, pityriasis rubra pilaris, lichen nitidus, pityriasis lichenoides, lichen striatus and parapsoriasis. Psoriasiform reaction was found to be more common than lichenoid tissue reaction. The study demonstrated a positive clinicohistopathological association in 86% of cases. Conclusions: Histopathology confirmed the diagnosis in 86% of cases, provided the diagnosis in 6% of cases and was non-contributory in 8% of cases.

Keywords

• histopathology
• lichen planus
• lichenoid
• psoriasiform
• psoriasis