Histopathological correlation of diagnostic parameters in psoriasis: A prospective observational study

• Author Details:   
• Tejaswi Reddy ^*
• Rajashekar Reddy Bijjam
• Shalini Cheeti
• Krishna Kumar Vadlamani

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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 and therapeutic opportunities.

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.