Proportion of psoriasis among the patients with psoriasiform disorders

Abstract
Background: Psoriasis is a prevalent chronic inflammatory skin disease with several clinical symptoms. Psoriasis has clinical forms that resemble a variety of dermatological disorders and may necessitate histological confirmation of the diagnosis. The aim of the study was to assess the proportion of psoriasis among patients with psoriasiform disorders. Methods: This cross-sectional observational study was carried out at the department of dermatology and venereology, Shahid Syed Nazrul Islam Medical College, Kishoreganj during the period from January 2021 to December 2021 on 200 patients with psoriasiform disorders was enrolled in this study. Detailed history along with relevant family history and drug history was obtained. All the patients underwent skin biopsy followed by a histopathological examination to reveal the actual pathology of dermal lesions. Statistical analyses of the results were obtained by using window-based computer software devised with statistical packages for social sciences (SPSS-25). Results: The proportion of psoriasis among the patients with psoriasiform disorders was found at 53.5%. The majority of patients (72.0%) had extensor surfaces and a well-demarcated border was found in 166 (83.0%) patients. Subungual hyperkeratosis was found in 30 (28.0%) and 16 (17.3%) in psoriasis and non-psoriasis groups respectively. Regular epidermal hyperplasia was 2 (1.9%) in psoriasis but not found in non-psoriasis. Spongiosis was 45 (42.1%) in psoriasis and 30 (32.3%) in non-psoriasis. The vertical orientation of the collagen bundle was 2 (1.9%) and 2 (2.2%) in psoriasis and non-psoriasis respectively. Perivascular lymphocyte infiltration was 75 (70.1%) in psoriasis and 63 (67.7%) in non-psoriasis. The difference was not statistically significant (p>0.05) between the two groups. Conclusions: All clinical features were significantly associated with psoriasis in patients who presented with psoriasiform disorders except subungual hyperkeratosis. In histopathology, all features were significantly associated with psoriasis excluding regular epidermal hyperplasia, spongiosis, vertical orientation of collagen bundle, and perivascular lymphocyte infiltration.