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Histology of psoriatic erythroderma in infants: analytical study of eight cases
Parimalam Kumar1, Jayakar Thomas2, Devaraj Dineshkumar3
1Department of Dermatology, Thanjavur Medical College, Thanjavur, India.
Insights
Histological examination of infants with erythroderma revealed consistent psoriasiform pattern with acanthosis and dilated papillary capillaries, aiding early diagnosis of infantile psoriasis.
Area of Science:
- Pediatric Dermatology
- Histopathology
- Infant Health
Background:
- Erythroderma in infants is rare with diverse causes.
- Psoriasis is increasingly recognized as a common cause of infantile erythroderma.
- Histological confirmation is crucial for timely and effective treatment.
Purpose of the Study:
- To investigate the characteristic histological findings in infants diagnosed with psoriatic erythroderma.
Main Methods:
- Histological analysis of skin biopsies from 8 infants (under 1 year) with clinically suspected psoriatic erythroderma.
- Biopsies were obtained after detailed clinical assessment.
- One case involved biopsies from two sites due to family history of psoriasis and asthma.
Main Results:
- All biopsies exhibited a psoriasiform pattern, characterized by acanthosis and dilated papillary capillaries.
- A spongiform pattern was observed in one infant with co-existing features of psoriasis and atopy.
- Neither Kogoj spongiform pustules nor Munro's abscesses were identified in any of the cases.
Conclusions:
- Consistent findings of acanthosis and papillary capillary dilatation are key histological indicators in infantile erythrodermic psoriasis.
- These histological features appear early, even in younger infants.
- The co-occurrence of psoriasis and atopic dermatitis suggests potential shared pathogenic pathways or immunogenetic factors.
Background:
Erythroderma in infants is a rare condition of varied etiology. Psoriasis is now emerging as the most common cause of erythroderma in infants. Early diagnosis of the etiological cause much depends upon the histological confirmation, which is essential for an early and appropriate treatment.
Aim:
It was aimed to study the histological findings in psoriatic erythroderma in infants.
Materials And Methods:
A total of 8 infants up to 1 year of age presenting with erythroderma, clinically suspected to be of psoriatic etiology attending private clinic were included. After detailed history taking and astute clinical exam, all of them were biopsied. In case 6, with a positive family history of psoriasis and asthma in parents, biopsy was taken from two sites. The histological findings of all nine biopsies were studied and analyzed.
Results:
Histology of all eight children showed psoriasi form pattern with acanthosis (AC) and dilated papillary capillaries (PC). Spongiform (SF) pattern was seen in the second biopsy (6b) of child with features of both psoriasis and atopy. SF pustule of Kogoj or Munro's abscess was not seen in any of them.
Conclusion:
Regular AC and PC dilatation were the consistent histological findings observed in infants with erythrodermic psoriasis. These were the early findings observed in younger infants. Co-existence of psoriasis with atopic dermatitis may indicate a common pathogenic mechanism or an immunogenetic spin-off.
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