diagnosis of psoriasis

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Diagnosis : Physicians usually diagnose psoriasis by examining the affected skin. Less often, a small piece of skin affected by the psoriasis is cut out and examined under a microscope. A microscopic examination of tissue taken from the affected skin patch is required to make a definitive diagnosis of psoriasis and to distinguish it from other skin disorders. Usually in psoriasis, the examination will show proliferation of dry skin cells but without many signs of inflammation or infection. Changes in the nails typical of psoriasis are often strong indicators of psoriasis

Psoriasis is characterized by dysfunction of keratopoesis .the major pathological features are parakeratosis . munnro abscesses and an increased number of mitoses. Acantosis and spongiosis are often seen . the dermal-epidermal border is well marked. The upper derma shows papillomatosis and dilation of capillaries with excess of perivascular neutrophilic infilteration . the nerve fibers are Dystrophic, with enalarged neurolema and central cylinder. It’ s also reported that the stratum granulosum is thinned or absent .

It can be difficult for the doctor to diagnose psoriasis in the early stages, when the disease may be limited to rough patches on the elbows. Certain symptoms, such as a dandruff-like scalp condition or what looks like a fungal infection, may be hard to recognize as psoriasis. Nail pits may be a sign of early psoriasis, but they may also be a sign of other conditions. The diagnosis is straightforward if the doctor examines the skin and sees thick, red, flaky patches-the plaques characteristic of psoriasis.

In people with psoriatic arthritis, the arthritis usually follows the appearance of psoriasis. Typically, psoriatic arthritis first appears in the finger and toe joints closest to the nail. Other forms of psoriatic arthritis may be more difficult to diagnose. The joints may be affected in no recognizable pattern. Unlike , psoriatic arthritis cannot be diagnosed by a blood test and also x-ray may taken for diagnosis
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1-" THE HISTOPATHOLOGY OF PSORIASIS ", G. DE ROSA, C. MIGNOGNA, Department of Biomorphological and Functional Sciences, Pathology Section, “Federico II” University of Naples, Italy

2-" Rook’sTextbook of Dermatology ", Tony Burns, Stephen Breathnach, Neil Cox, Christopher Griffi ths, This edition fi rst published 2010, © 1968, 1972, 1979, 1986, 1992, 1998, 2004, 2010 by Blackwell Publishing Ltd, ISBN: 978-1-4051-6169-5

3-" ROBBINS AND COTRAN PATHOLOGIC BASIS OF DISEASE, 8/E",ISBN: 978-1-4160-3121-5, Copyright © 2010 by Saunders, an imprint of Elsevier Inc.