The histopathological differentiation between palmar psoriasis and hand eczema: A retrospective review of 96 cases
The histopathologic differences among palmar psoriasis (PP), hand eczema (HE), and hyperkeratotic hand dermatitis (HHD) have been poorly described.Objectives
We sought to distinguish among PP, HE, and HHD on a histopathologic basis.Methods
We retrospectively analyzed the histology of hematoxylin-eosin–stained sections obtained from 96 patients diagnosed with PP, HE, or HHD.Results
The patients were divided into 4 subgroups: PP (n = 16, group A), HE without atopic or nummular dermatitis (n = 41, group B), HE with atopic or nummular dermatitis (n = 14, group C), and HHD (n = 25, group D). Loss of the granular layer (group A 62.5%, group B 24.4%, group C 0%) was more consistent with a diagnosis of PP (P = .047) than HE (P = .002). Psoriasiform epidermal hyperplasia (group B 36.6%, group C 35.7%, group D 72.0%) favored a diagnosis of HHD (P = .01) over HE (P = .043).Limitations
Limitations of this study include its retrospective nature and small sample size.Conclusion
Our study demonstrated that a significant difference exists in the thickness of the granular layer between PP and HE, which might be helpful in differentiating between these 2 conditions. There was no difference between PP and HHD.