There was a significant difference in thickness of the granular layer in patients with palmar psoriasis vs. those with hand eczema, according to study results recently published in the Journal of the American Academy of Dermatology.

Researchers conducted a retrospective analysis of hematoxylin-eosinstained biopsies of 96 patients who presented at an outpatient clinic at Hallym University Sacred Heart Hospital, Anyang, Republic of Korea. The patients were diagnosed with palmar psoriasis, hand eczema or hyperkeratotic hand dermatitis.

The patients were categorized into four cohorts: Palmar psoriasis (n=16; group A); hand eczema without atopic dermatitis or nummular dermatitis (n = 41; group B); hand eczema with atopic dermatitis or nummular dermatitis (n = 14; group C); or hyperkeratotic hand dermatitis (n = 25; group D).

Aa greater proportion of patients in the palmar psoriasis cohort (group A) experienced loss of granular layer (62.5%) compared with group B (24.4%; P = .047) and group C (0%; P = .002).

The proportion of patients experiencing psoriasiform epidermal hyperplasia were 36.6% in group B, 35.7% in group C and 72% in group D. The diagnosis favored the hyperkaratotis hand dermatitis cohort (group D) over group B (P = .01) and group C (P = .043).

There were no significant histologic differences between [palmar psoriasis] and [hyperkeratotic hand dermatitis], the researchers concluded. Most of the characteristic histologic features of psoriasis did not help in the differential diagnosis. Further studies involving the use of other useful diagnostic tools such as immunohistochemical staining should be performed. by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.

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Granular layer thickness differed in palmar psoriasis and hand eczema - Healio