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Psoriasiform keratosis.

Sarah N Walsh1, Mark A Hurt, Daniel J Santa Cruz

  • 1Cutaneous Pathology, WCP Laboratories, Inc, St. Louis, MO 63043-3530, USA.

The American Journal of Dermatopathology
|April 7, 2007
PubMed
Summary
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Researchers identified a new skin condition, psoriasiform keratosis, presenting as scaly papules with features of both seborrheic keratosis and psoriasis. This distinct entity requires further investigation to determine its exact nature and relationship to psoriasis.

Area of Science:

  • Dermatology
  • Pathology
  • Oncology

Background:

  • 18 cases of erythematous, scaly papules/plaques with overlapping histopathological features of seborrheic keratosis and psoriasis were observed.
  • Patients lacked a prior or subsequent clinical diagnosis of psoriasis, suggesting a distinct clinical entity.

Purpose of the Study:

  • To characterize a novel group of skin lesions exhibiting histological similarities to both seborrheic keratosis and psoriasis.
  • To propose a provisional term, 'psoriasiform keratosis,' for these unique lesions.

Main Methods:

  • Clinical and histopathological analysis of 18 patient cases.
  • Detailed examination of lesion morphology, location, patient demographics, and clinical diagnoses.
  • Histologic evaluation included assessment of epidermal acanthosis, hyperkeratosis, parakeratosis, hypergranulosis, neutrophil collections, and dermal inflammation.

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Main Results:

  • Lesions were typically solitary, dome-shaped, scaly papules/plaques (<1 cm) on extremities, scalp, neck, shoulders, or back.
  • Clinically, differential diagnoses included seborrheic keratosis, basal cell carcinoma, Bowen's disease, actinic keratosis, and squamous cell carcinoma.
  • Histopathology revealed features such as irregular verrucous epidermal acanthosis, hyperkeratosis, parakeratosis, hypergranulosis, intracorneal neutrophils, and superficial dermal inflammation. PAS stains for fungi were negative.

Conclusions:

  • A provisional diagnosis of psoriasiform keratosis is proposed for these lesions due to their unique combination of clinical and histological findings.
  • The exact nature of psoriasiform keratosis remains undetermined; it may represent an early form of psoriasis or a separate condition.
  • Further research is necessary to definitively classify psoriasiform keratosis and understand its pathogenesis.