A 35-year-old guy visits the office to have a rash on his elbows evaluated. This rash has been bothering the patient periodically for several months, but it has recently grown more persistent and unpleasant. He's had slight itching but no discomfort, and he's tried a topical moisturizing lotion without success. The patient works at a home construction firm, installing tile flooring. He has no chronic medical concerns and does not use any drugs on a daily basis. The patient does not smoke, drink alcohol, or use illegal drugs. The vital indicators are within normal ranges. The rash on his elbow is seen here, and a similar rash can be seen on his other elbow. Which of the following histologic changes would be most likely if this patient's skin lesion were biopsied?

Question

A 35-year-old guy visits the office to have a rash on his elbows evaluated. This rash has been bothering the patient periodically for several months, but it has recently grown more persistent and unpleasant. He's had slight itching but no discomfort, and he's tried a topical moisturizing lotion without success. The patient works at a home construction firm, installing tile flooring. He has no chronic medical concerns and does not use any drugs on a daily basis. The patient does not smoke, drink alcohol, or use illegal drugs. The vital indicators are within normal ranges. The rash on his elbow is seen here, and a similar rash can be seen on his other elbow.  Which of the following histologic changes would be most likely if this patient's skin lesion were biopsied?

Quizplus · Accepted Answer

Eductional Objective: On histology, psoriasis is distinguished by hyperkeratosis and confluent parakeratosis of the stratum corneum (which results in the characteristic silvery scales seen on gross examination), diffuse epidermal hyperplasia with elongated and clubbed rete ridges (which correspond to the typical erythematous plaques), and dilated capillaries in the dermal papillae.

A 35-Year-Old Guy Visits the Office to Have a Rash