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Skin Pathology, Case 4
• A 25-year-old male presents to his dermatologist with well-demarcated, scaly, pink to salmon-colored plaques over the elbows. Areas of “pin-point” bleeding are noted when the scales are lifted off the surface of the plaque.
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Epidermal thickening (acanthosis)
Parakeratosis
Downward projections of epidermis = “rete ridges”
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Parakeratosis
Dermal papillae
Dermal papilla with dilated bloodvessels(when scale is lifted from plaques minute bleeding is seen – Auspitz sign. This is because of the close proximity of the dilated blood vessels to the overlying parakeratotic scale)
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Small clusterof neutrophils in parakeratotic stratumcorneum
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Psoriasis of the legs
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Psoriasis. A rather small amount of the characteristic silvery scale is presenton these psoriatic plaques.
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Patient with severe psoriatic arthritis. There is marked deformity and destruction of the digits. The nail plates are thickened and hyperkeratotic. Some psoriatic skin lesions are present.