Psoriazisin klinik şiddeti ile histopatolojik bulgular arasında ilişki var mıdır? klinikopatolojik bir çalışma
Öz
Amaç: Psoriazis, şiddeti hastadan hastaya değişen yaygın bir kronik inflamatuar deri hastalığıdır. Bu çalışmada, histopatolojik bulgular ile hastalığın klinik şiddeti arasında ilişki olup olmadığını araştırmayı amaçladık.
Gereç ve Yöntem: Bu retrospektif çalışmada, hem klinik hem de deri biyopsisi ile histopatolojik olarak psoriazis vulgaris tanısı konulan 51 olgu incelendi. Olguların parafin bloklarından hazırlanan kesitleri mikroskobik olarak incelendi ve bulgular çeşitli histopatolojik özellikler açısından kaydedildi. Hastalığın şiddetini değerlendirmek için psoriazis alan şiddet indeksi (PASI) kullanıldı. PASI ile ilgili veriler hastaların tıbbi dosyalarından elde edildi. Hastalar daha sonra yüksek PASI skoru (≥10) ve düşük PASI skoru (<10) olanlar olarak gruplandırıldı. Histopatolojik özellikler ile PASI skoru arasındaki ilişki Pearson korelasyon testi ile değerlendirildi.
Bulgular: Elli bir hastanın yaş ortalaması 45.19 idi. Çalışmada, Psoriazis vulgaris olgularında (31 erkek, 20 kadın) 1.5: 1 olan erkek: kadın oranıyla erkek baskınlığı görüldü. Psoriazisin aile öyküsü % 29 hastada pozitifti. En sık görülen histopatolojik özellikler: hiperkeratoz (% 100), parakeratoz (% 100) (fokal parakeratoz (% 23), konfluent parakeratoz (% 77)), rete ridgelerin uzaması (% 98) ve vasküler dilatasyon (% 88) idi. Hastaların 30'unda (% 58.8) düşük PASI skoru (<10), 21'inde (% 41.2) yüksek PASI skoru (≥10) vardı. Hastalığın şiddeti (PASI skoru) ile histopatolojik özelliklerin herhangi biri ile ilişki bulunmadı.
Sonuç: Psoriazisin karakteristik temel histopatolojik bulguları olmasına rağmen bu histopatolojik bulguların hiçbiri doğrudan hastalığın klinik şiddeti ile ilişkili değildir.
Anahtar Kelimeler
Kaynakça
- 1.Bai S, Sowmya S. Histopathologic diagnostic parameters of psoriasis; a clinicopathological study. International Journal of Research in Medical Sciences 2016; 4 (6): 1915-20.
- 2. Kaddu S, Hödl S, Soyer HP. Histopathologic spectrum of psoriasis. Acta Dermatovenerologica A.P.A 1999; 8: 94-100.
- 3. Puri N, Mahajan BB, Kaur S. Clinicohistopathological correlation of psoriasis in acute exacerbation. Open Access Sci Rep 2012; 1: 455.
- 4. Kim BY, Choi JV, Kim BR, Youn SW. Histopathological findings are associated with the clinical types of psoriasis but not with the corresponding lesional psoriasis severity index. Annals of dermatology 2015; 27 (1): 26-31.
- 5. Langley RG, Ellis CN. Evaluating psoriasis with psoriasis area and severity index, psoriasis global assessment, and lattice system physician's global assessment. Journal of the American Academy of Dermatology 2004; 51 (4): 563-9.
- 6. Chau T, Parsi KK, OgaWa T, Kiuru M, Konia T, Li CS, et al. Psoriasis or not? Review of 51 clinically confirmed cases reveals an expanded histopathologic spectrum of psoriasis. Journal of cutaneous pathology 2017; 44 (12): 1018-26.
- 7. Mehta S, Singal A, Singh N, Bhattacharya SN. A study of clinicohistopathological correlation in patients of psoriasis and psoriasiform dermatitis. Indian Journal of Dermatology, Venereology, and Leprology 2009; 75 (1): 100.
- 8. Rosa G, Fernandez AP, Schneider S, Billings SD. Eosinophils are rare in biopsy specimens of psoriasis vulgaris. Journal of cutaneous pathology 2017; 44 (12): 1027-32
- 9. Hermawan WC, Hermin A, Dendi S. Clinical and Histopathological Characteristics of Psoriasis in Dr. Hasan Sadikin General Hospital Bandung from 2009 to 2013. Althea Medical Journal 2017; 3 (4): 556-61.
- 10. Stuart P, Malick F, Nair RP, Henseler T, Lim HW, JenisCh S, et al. Analysis of phenotypic variation in psoriasis as a function of age at onset and family history. Archives of dermatological research 2002; 294 (5): 207-13.
- 11. Raghuveer C, Doddarangaiah RS, Nadiga R. A Clinico-histopathological Study of Psoriasis. International Journal of Scıentıfıc Study 2015; 3 (7): 176-9.
- 12. Silva MF, Fortes MR, Miot LD, Marques SA. Psoriasis: correlation between severity index (PASI) and quality of life index (DLQI) in patients assessed before and after systemic treatment. An Bras Dermatol 2013;88 (5):760-3.
- 13. Murphy M, Kerr P, Grant-Kels JM. The histopathologic spectrum of psoriasis. Clinics in dermatology 2007; 25 (6): 524-8.
- 14. Karumbaiah KP, Anjum A, Danger K, Mallikarjun M, Kariappa TM, Paramesh. A Clinicopathological study of Psoriasis. Sch J App Med Sci. 2014; 2 (1C):298–302. 15. Oji V, Luger TA. The skin in psoriasis: assessment and challenges. Clin Exp Rheumatol 2015; 33 (5):14-9.
- 16. Norlin JM, Calara PS, Persson U, Schmitt-Egenolf M. Real-world outcomes in 2646 psoriasis patients: one in five has PASI≥ 10 and/or DLQI≥ 10 under ongoing systemic therapy. Journal of Dermatological Treatment 2017; 28 (6): 500-4.
- 17. Mrowietz U, Kragballe K, Reich K, Spuls P, Griffiths CEM, Nast A. et al. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Archives of dermatological research 2011; 303 (1): 1-10.
Is there a relationship between clinical severity of psoriasis and histopathological findings? a clinicopathological study
Öz
Purpose: In this study, we aimed to investigate whether there is a relationship between histopathologic findings and clinical severity of the disease.
Materials and Methods: In this retrospective study, 51 cases with psoriasis vulgaris diagnosed both clinically and histopathologically through a skin biopsy were analyzed. The sections prepared from the paraffin blocks of the cases were examined microscopically and the findings were recorded for various histopathological features. The psoriasis area severity index (PASI) used to assess the severity of the disease. Data regarding PASI were obtained from the patients’medical files. The patients were then grouped as those with high PASI score (≥10) and
low PASI score (<10). The relation between the histopathological features and the PASI score was assessed with the Pearson’s correlation test.
Results: The meanage of 51 patients was 45.19 years old. The study showed male predominance with male:female ratio-1.5:1 of psoriasis vulgaris cases (31 males, 20 females). Family history of psoriasis was positive in 29% patients. The most prevalent histopathological features were hyperkeratosis (100%), parakeratosis (100%) (focal parakeratosis (23%), confluent parakeratosis (77%)), elongation of rete ridges (98%), and vascular dilatation (88%). Out of the patients, 30 (58.8%) had low PASI score (<10),whereas 21 (41.2%) had high PASI score (≥10). There was no relationship between the severity of the disease (PASI score) and any of the histopathological features.
Conclusion: Although there are characteristic histopathological findings of psoriasis, none of these histopathological findings are directly related to the clinical severity of the disease.
Anahtar Kelimeler
Kaynakça
- 1.Bai S, Sowmya S. Histopathologic diagnostic parameters of psoriasis; a clinicopathological study. International Journal of Research in Medical Sciences 2016; 4 (6): 1915-20.
- 2. Kaddu S, Hödl S, Soyer HP. Histopathologic spectrum of psoriasis. Acta Dermatovenerologica A.P.A 1999; 8: 94-100.
- 3. Puri N, Mahajan BB, Kaur S. Clinicohistopathological correlation of psoriasis in acute exacerbation. Open Access Sci Rep 2012; 1: 455.
- 4. Kim BY, Choi JV, Kim BR, Youn SW. Histopathological findings are associated with the clinical types of psoriasis but not with the corresponding lesional psoriasis severity index. Annals of dermatology 2015; 27 (1): 26-31.
- 5. Langley RG, Ellis CN. Evaluating psoriasis with psoriasis area and severity index, psoriasis global assessment, and lattice system physician's global assessment. Journal of the American Academy of Dermatology 2004; 51 (4): 563-9.
- 6. Chau T, Parsi KK, OgaWa T, Kiuru M, Konia T, Li CS, et al. Psoriasis or not? Review of 51 clinically confirmed cases reveals an expanded histopathologic spectrum of psoriasis. Journal of cutaneous pathology 2017; 44 (12): 1018-26.
- 7. Mehta S, Singal A, Singh N, Bhattacharya SN. A study of clinicohistopathological correlation in patients of psoriasis and psoriasiform dermatitis. Indian Journal of Dermatology, Venereology, and Leprology 2009; 75 (1): 100.
- 8. Rosa G, Fernandez AP, Schneider S, Billings SD. Eosinophils are rare in biopsy specimens of psoriasis vulgaris. Journal of cutaneous pathology 2017; 44 (12): 1027-32
- 9. Hermawan WC, Hermin A, Dendi S. Clinical and Histopathological Characteristics of Psoriasis in Dr. Hasan Sadikin General Hospital Bandung from 2009 to 2013. Althea Medical Journal 2017; 3 (4): 556-61.
- 10. Stuart P, Malick F, Nair RP, Henseler T, Lim HW, JenisCh S, et al. Analysis of phenotypic variation in psoriasis as a function of age at onset and family history. Archives of dermatological research 2002; 294 (5): 207-13.
- 11. Raghuveer C, Doddarangaiah RS, Nadiga R. A Clinico-histopathological Study of Psoriasis. International Journal of Scıentıfıc Study 2015; 3 (7): 176-9.
- 12. Silva MF, Fortes MR, Miot LD, Marques SA. Psoriasis: correlation between severity index (PASI) and quality of life index (DLQI) in patients assessed before and after systemic treatment. An Bras Dermatol 2013;88 (5):760-3.
- 13. Murphy M, Kerr P, Grant-Kels JM. The histopathologic spectrum of psoriasis. Clinics in dermatology 2007; 25 (6): 524-8.
- 14. Karumbaiah KP, Anjum A, Danger K, Mallikarjun M, Kariappa TM, Paramesh. A Clinicopathological study of Psoriasis. Sch J App Med Sci. 2014; 2 (1C):298–302. 15. Oji V, Luger TA. The skin in psoriasis: assessment and challenges. Clin Exp Rheumatol 2015; 33 (5):14-9.
- 16. Norlin JM, Calara PS, Persson U, Schmitt-Egenolf M. Real-world outcomes in 2646 psoriasis patients: one in five has PASI≥ 10 and/or DLQI≥ 10 under ongoing systemic therapy. Journal of Dermatological Treatment 2017; 28 (6): 500-4.
- 17. Mrowietz U, Kragballe K, Reich K, Spuls P, Griffiths CEM, Nast A. et al. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Archives of dermatological research 2011; 303 (1): 1-10.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2019 |
| Kabul Tarihi | 29 Kasım 2018 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 44 Sayı: 2 |
