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PSORIATIC ERYTHRODERMA UNDER THE MICROSCOPE

Miadzelets, Valeryia

Pathology - Journal of the RCPA: 2009 - Volume 41 - Issue - p 80
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Vitebsk State Medical University, Vitebsk, Belarus

Erythroderma is a severe form of psoriasis and life threatening condition characterised by a universal inflammatory affection of the skin and generalised lymphadenopathy.

Aim: To reveal histological criteria of psoriatic erythroderma.

Results: Our patients was 43 years old with psoriatic erythroderma. The patient's skin was characterised by universal inflammation and scaling, which appeared 3–4 days after onset of erythroderma. Pathomorphological features in epidermis lesions were as follows: regular acanthosis, spongiosis, hyperkeratosis, Munro microabscesses. Granular and corneum layers were sometimes absent which may confirm an abnormal differential process of the keratinocytes. Rete ridges were not only long but also wide; the length was 302.8 mkm (25.2 keratinocytes), width 269.8 mkm (24.1 keratynocytes). The quantity of mitotic cells was up to 15.7% in the basal layer, and up to 13.6% in suprabasal layers. Intercellular and intracellular oedema was seen. Perivascular infiltrates in the derma consisted of lymphocytes, macrophages and fibroblasts. The density of cells was 2856.0 cells/mm2. Widening of miscrovessels was prominent. Destructive changes were seen in capillaries of papillary dermis – capillaritis, adhesion of erythrocytes. In the upper vessels there was phlebitis, trombophlebitis and arteriolitis. Such changes are not seen in psoriasis vulgaris.

Conclusion: Histological signs of psoriatic erythroderma may serve as differential tools for making a diagnosis between different types of erythroderma.

© 2009 Royal College of Pathologists of Australasia