ABSTRACT

Differentiation of eczema and psoriasis can be difficult clinically and histopathologically. In this study, it is designed to evaluate the histological features and bcl-2 expression of cases clinically prediagnosed with psoriasis and eczema in our pathology deparment of Şişli Etfal Training and Research Hospital.

The biopsy results with psoriasis and eczema of 80 cases that clinically prediagnosed with psoriasis and eczema were collected from pathology archives. All biopsies were interpreted by two different dermatopathologists blinded clinical diagnosis and data collection forms were completed. Then data obtained were analyzed by SPSS.

There were histopathologic difference between palmoplantar psoriasis and eczema. Hypogranulosis (p=0.001; p<0.01), Munro’s microabscess (p=0.001; p<0.01), tortuous blood vessels in papillary dermis (p=0.001; p<0.01), suprapapillary plate thinning (p=0.001; p<0.01), plasma mounds (p=0.033; p<0.05), parakeratosis (p=0.001; p<0.01) ve kogoj (p=0.001; p<0.01) were found that statistically significant contributors for clinicopathological concordance in cases of psoriasis. Spongiosis (p=0.001; p<0.01), spongiotic vesicle (p=0.001; p<0.01), eosinophil infiltration in upper dermis (p=0.001; p<0.01) were significantly associated with diagnosis of eczema. In immunohistochemical studies, while it is found that bcl-2 expression is negative in psoriasis, it is showed that bcl-2 expression in eczema is positive and same intensity as much as bcl-2 expression of normal skin (p=0.001; p<0.01).

Histopathologic finding like hypogranulosis, Munro’s microabscess, tortuous blood vessels in papillary dermis, suprapapillary plate thinning, plasma omunds, parakeratosis and kogoj had significant associated with psoriasis and might be utilized in establishing its diagnosis. The differentiation between psoriasis and eczema can be made by bcl-2 immunohistochemical study.