Histopathological Correlation of Diagnostic Parameters in Psoriasis: A Prospective Observational Study

Authors: Rajashekar Reddy Bijjam, Tejaswi Reddy, Krishna Kumar Vadlamani, Shalini Cheeti

DOI: 10.18231/j.jdpo.12651.1760502490

Keywords: Psoriasis, Histopathology, Parakeratosis, Capillary proliferation, Immune-mediated inflammation

Abstract: Abstract Background: Psoriasis is a chronic immune-mediated skin disorder characterized by abnormal keratinocyte proliferation, inflammation, and dermal vascular changes. Histological features are well documented, but the correlations among them provide important clues to disease mechanisms. Aim: To analyze and correlate key histopathological parameters in psoriasis to better understand their role in disease pathogenesis. Materials and Methods: This prospective observational study included 50 histologically confirmed cases of psoriasis. Eight histological parameters were evaluated: hyperkeratosis, parakeratosis, suprapapillary thinning, inflammatory infiltrate, capillary proliferation, Munro’s microabscesses, pustules of Kogoj, and widened rete ridges. Features were graded on a visual analogue scale, and Spearman’s correlation coefficient was used for analysis. Results: Hyperkeratosis correlated strongly with parakeratosis (r = 0.62) and pustules of Kogoj (r = 0.65). Parakeratosis also correlated with Munro’s abscesses, suprapapillary thinning, and widened rete ridges. Munro’s microabscesses and Kogoj’s pustules were closely associated (r = 0.77). Inflammatory infiltrate correlated strongly with capillary proliferation (r = 0.72), which also associated with suprapapillary thinning. Conclusion: Significant correlations among histopathological parameters confirm that immune activation and angiogenesis are central to psoriasis pathogenesis. Findings support the involvement of T-cell mediated inflammation and suggest that histological patterns can inform targeted therapies and disease monitoring strategies.