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. 2017 Jul;77(1):130-135.
doi: 10.1016/j.jaad.2017.01.005. Epub 2017 Feb 9.

The histopathological differentiation between palmar psoriasis and hand eczema: A retrospective review of 96 cases

Jun Yeong Park  1 , Eun Byul Cho  1 , Eun Joo Park  1 , Hye Rim Park  2 , Kwang Ho Kim  3 , Kwang Joong Kim  1
Affiliations

The histopathological differentiation between palmar psoriasis and hand eczema: A retrospective review of 96 cases

Jun Yeong Park et al. J Am Acad Dermatol. 2017 Jul.

Abstract

Background: The histopathologic differences among palmar psoriasis (PP), hand eczema (HE), and hyperkeratotic hand dermatitis (HHD) have been poorly described.

Objectives: We sought to distinguish among PP, HE, and HHD on a histopathologic basis.

Methods: We retrospectively analyzed the histology of hematoxylin-eosin-stained sections obtained from 96 patients diagnosed with PP, HE, or HHD.

Results: The patients were divided into 4 subgroups: PP (n = 16, group A), HE without atopic or nummular dermatitis (n = 41, group B), HE with atopic or nummular dermatitis (n = 14, group C), and HHD (n = 25, group D). Loss of the granular layer (group A 62.5%, group B 24.4%, group C 0%) was more consistent with a diagnosis of PP (P = .047) than HE (P = .002). Psoriasiform epidermal hyperplasia (group B 36.6%, group C 35.7%, group D 72.0%) favored a diagnosis of HHD (P = .01) over HE (P = .043).

Limitations: Limitations of this study include its retrospective nature and small sample size.

Conclusion: Our study demonstrated that a significant difference exists in the thickness of the granular layer between PP and HE, which might be helpful in differentiating between these 2 conditions. There was no difference between PP and HHD.

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