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Is there a histopathologic difference between palmar psoriasis and hand eczema?

16 Jul 2017

There is a marked difference in the thickness of the granular layer between palmar psoriasis and hand eczema, and this may be helpful in differentiating between the two skin conditions, according to a recent study.

Additionally, no significant difference exists between palmar psoriasis and hyperkeratotic hand dermatitis (HHD).

Researchers sought to distinguish the histopathologic differences among palmar psoriasis, hand eczema and HHD, which have been poorly characterized. They conducted a retrospective analysis of the histology of hematoxylin-eosin‒stained sections obtained from patients (n=96) with palmar psoriasis, hand eczema or HHD.

The participants were divided into four subgroups: palmar psoriasis (n=16; group A), hand eczema without atopic or nummular dermatitis (n=41; group B), hand eczema with atopic or nummular dermatitis (n=14; group C), and HHD (n=25; group D).

Patients diagnosed with palmar psoriasis (p=0.047) had a more consistent loss of the granular layer (group A, 62.5 percent; group B, 24.4 percent; group C, 0 percent) than hand eczema patients (p=0.002). Psoriasiform epidermal hyperplasia (group B, 36.6 percent; group C, 35.7 percent; group D, 72.0 percent) favoured a diagnosis of HHD (p=0.01) over hand eczema (p=0.043).

This study is limited by its retrospective design and small sample size, according to researchers.

A previous study reported that the relationship between clinical type of hand eczema and aetiological diagnosis fitted with general experience, but there was no simple relationship observed, emphasizing that patch testing and exposure analysis are mandatory. Furthermore, researchers identified hyperkeratotic palmar hand eczema as a distinct clinical subtype. [Contact Dermatitis 2011;65:13-21]

Editor's Recommendations
Most Read Articles
07 May 2015
The treatment armamentarium of atopic dermatitis (AD) includes pharmaceuticals like emollients, topical corticosteroids, and topical calcineurin inhibitors. Recently available, medical devices are a newer class of topical, non-steroidal, semi-solid formulation for the treatment of AD and touted to possess emollient, anti-inflammatory, and anti-pruritic properties. To determine the role of medical devices in flare and remission management in AD, a panel of local experts from the field of dermatology, paediatric dermatology, and allergy convened to review the available evidence and highlights of the meeting are reported here.
4 days ago
Hydrochlorothiazide (HCTZ) appears to significantly increase the risks of nonmelanoma skin cancer (NMSC), particularly squamous cell carcinoma (SCC), a recent study has shown.
24 Nov 2017
It appears that patients with psoriasis have lesser health-related quality of life (HRQoL) burden than those with hidradenitis suppurativa (HS), a recent study has found.
12 Nov 2017
Active and passive smoking are associated with atopic dermatitis, a new study from Korea reveals.