{"id":1179,"date":"2026-05-06T02:55:09","date_gmt":"2026-05-06T02:55:09","guid":{"rendered":"https:\/\/edmpackz.com\/?p=1179"},"modified":"2026-05-06T02:55:09","modified_gmt":"2026-05-06T02:55:09","slug":"gianotti-crosti-syndrome","status":"publish","type":"post","link":"https:\/\/edmpackz.com\/?p=1179","title":{"rendered":"Gianotti-Crosti syndrome"},"content":{"rendered":"<header class=\"entry-header\">\n<div class=\"authorship_wrapper clearfix\">\n<div class=\"authorship floatleft\">\n<h1>Skin nontumor<\/h1>\n<h2>Spongiotic, psoriasiform and pustular reaction patterns<\/h2>\n<h3>Psoriasis<\/h3>\n<div>\n<div class=\"topic_page_author_section\">\n<div class=\"topic_page_author_box\">\n<div id=\"page-author-section\">\n<div>\n<div><strong>Authors:\u00a0<\/strong><a href=\"https:\/\/www.pathologyoutlines.com\/authors?id=887&amp;pap=5\" target=\"_blank\" rel=\"noopener\">Viktoryia Kozlouskaya, M.D., Ph.D.<\/a>,\u00a0<a href=\"https:\/\/www.pathologyoutlines.com\/authors?id=888&amp;pap=5\" target=\"_blank\" rel=\"noopener\">Mary-Katharine Collins, M.D.<\/a><\/div>\n<div><strong>Resident \/ Fellow Advisory Board:\u00a0<\/strong>Caroline I. Mullins, M.D.<\/div>\n<div><strong>Editorial Board Member:\u00a0<\/strong>Robert E. LeBlanc, M.D.<\/div>\n<\/div>\n<\/div>\n<div id=\"page-topic-complete-date\"><strong>Last author update:<\/strong>\u00a011 February 2021<\/div>\n<div id=\"page-lastedit\"><strong>Last staff update:<\/strong>\u00a09 November 2021<\/div>\n<\/div>\n<div>\n<div class=\"topic_page_image_box desktop\">\n<div class=\"topic_page_author_image\"><a title=\"Viktoryia Kozlouskaya, M.D., Ph.D.\" href=\"https:\/\/www.pathologyoutlines.com\/authors?id=887&amp;pap=5\" target=\"_blank\" rel=\"noopener\"><img decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/pathout_uploads\/2020\/12\/thumbs\/20201209-102049_VK.png\" alt=\"Viktoryia Kozlouskaya, M.D., Ph.D.\" \/><\/a><\/div>\n<div class=\"topic_page_author_image\"><a title=\"Mary-Katharine Collins, M.D.\" href=\"https:\/\/www.pathologyoutlines.com\/authors?id=888&amp;pap=5\" target=\"_blank\" rel=\"noopener\"><img decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/pathout_uploads\/2020\/12\/thumbs\/20201209-102259_MCPortrait.png\" alt=\"Mary-Katharine Collins, M.D.\" \/><\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"table_of_contents\">\n<div class=\"topicheading_title toc\">Table of Contents<\/div>\n<p><a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#definitiongeneral248954\">Definition \/ general<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#essentialfeatures248955\">Essential features<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#icdcoding248957\">ICD coding<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#epidemiology248958\">Epidemiology<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#sites248959\">Sites<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#pathophysiology248960\">Pathophysiology<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#etiology248961\">Etiology<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#clinicalfeatures248963\">Clinical features<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#diagnosis248964\">Diagnosis<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#laboratory248965\">Laboratory<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#radiologydescription248966\">Radiology description<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#radiologyimages248967\">Radiology images<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#prognosticfactors248968\">Prognostic factors<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#casereports248969\">Case reports<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#treatment248970\">Treatment<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#clinicalimages248971\">Clinical images<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#grossdescription248972\">Gross description<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#grossimages248973\">Gross images<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#microscopichistologicdescription248976\">Microscopic (histologic) description<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#microscopichistologicimages248977\">Microscopic (histologic) images<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#immunofluorescencedescription248981\">Immunofluorescence description<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#negativestains248984\">Negative stains<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#videos248989\">Videos<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#samplepathologyreport248990\">Sample pathology report<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#differentialdiagnosis248991\">Differential diagnosis<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#practicequestion1248993\">Practice question #1<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#practiceanswer1248994\">Practice answer #1<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#practicequestion2248995\">Practice question #2<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#practiceanswer2248996\">Practice answer #2<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#practicequestion3248997\">Practice question #3<\/a>\u00a0|\u00a0<a class=\"scrollto\" href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html#practiceanswer3248998\">Practice answer #3<\/a><\/div>\n<div class=\"table_of_contents\"><strong>Cite this page:<\/strong>\u00a0Kazlouskaya V, Collins MK. Psoriasis. PathologyOutlines.com website. https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html. Accessed May 5th, 2026.<\/div>\n<div class=\"block_content\">\n<div id=\"definitiongeneral248954\" class=\"block_section\">\n<div class=\"topicheading_title\">Definition \/ general<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Psoriasis is a chronic relapsing condition affecting skin, nails and joints that most commonly presents with well demarcated erythematous papules and plaques with silvery white scales<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"essentialfeatures248955\" class=\"block_section\">\n<div class=\"topicheading_title\">Essential features<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Most common clinical presentation: well demarcated erythematous plaques with silvery white scales<\/li>\n<li>Complex pathogenesis including genetic, autoimmune and environmental factors<\/li>\n<li>Common histopathological features: regular acanthosis, lymphocytic perivascular inflammation, parakeratosis with neutrophilic collections, spongiosiform pustules with neutrophils, dilated vessels in the papillary dermis, alternating areas of hyper and hypogranulosis and thinning of the suprapapillary plates<\/li>\n<li>Several different clinical and histopathologic variants<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"icdcoding248957\" class=\"block_section\">\n<div class=\"topicheading_title\">ICD coding<\/div>\n<div class=\"block_body\">\n<ul>\n<li>ICD-10:\n<ul>\n<li><a href=\"https:\/\/www.icd10data.com\/ICD10CM\/Codes\/L00-L99\/L40-L45\/L40-\/L40\">L40<\/a>\u00a0&#8211; Psoriasis<\/li>\n<li><a href=\"https:\/\/www.icd10data.com\/ICD10CM\/Codes\/L00-L99\/L40-L45\/L40-\/L40.0\">L40.0<\/a>\u00a0&#8211; Psoriasis vulgaris<\/li>\n<li><a href=\"https:\/\/www.icd10data.com\/ICD10CM\/Codes\/L00-L99\/L40-L45\/L40-\/L40.1\">L40.1<\/a>\u00a0&#8211; Generalized pustular psoriasis<\/li>\n<li><a href=\"https:\/\/www.icd10data.com\/ICD10CM\/Codes\/L00-L99\/L40-L45\/L40-\/L40.2\">L40.2<\/a>\u00a0&#8211; Acrodermatitis continua<\/li>\n<li><a href=\"https:\/\/www.icd10data.com\/ICD10CM\/Codes\/L00-L99\/L40-L45\/L40-\/L40.3\">L40.3<\/a>\u00a0&#8211; Pustulosis palmaris et plantaris<\/li>\n<li><a href=\"https:\/\/www.icd10data.com\/ICD10CM\/Codes\/L00-L99\/L40-L45\/L40-\/L40.4\">L40.4<\/a>\u00a0&#8211; Guttate psoriasis<\/li>\n<li><a href=\"https:\/\/www.icd10data.com\/ICD10CM\/Codes\/L00-L99\/L40-L45\/L40-\/L40.5\">L40.5<\/a>\u00a0&#8211; Arthropathic psoriasis<\/li>\n<li><a href=\"https:\/\/www.icd10data.com\/ICD10CM\/Codes\/L00-L99\/L40-L45\/L40-\/L40.8\">L40.8<\/a>\u00a0&#8211; Other psoriasis<\/li>\n<li><a href=\"https:\/\/www.icd10data.com\/ICD10CM\/Codes\/L00-L99\/L40-L45\/L40-\/L40.9\">L40.9<\/a>\u00a0&#8211; Psoriasis, unspecified<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"epidemiology248958\" class=\"block_section\">\n<div class=\"topicheading_title\">Epidemiology<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Adults:\n<ul>\n<li>Prevalence of 0.14 &#8211; 1.99%, higher in Western Europe, central Europe, North America and high income areas of South America (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32467098\">BMJ 2020;369:m1590<\/a>)<\/li>\n<li>Incidence ranges from 30.3 to 321.0 per 100,000 person years (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32467098\">BMJ 2020;369:m1590<\/a>)<\/li>\n<\/ul>\n<\/li>\n<li>Children:\n<ul>\n<li>Prevalence of 0.02 &#8211; 0.22% (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32467098\">BMJ 2020;369:m1590<\/a>)<\/li>\n<li>Incidence is less studied, from 2.6 to 70.5 per 100,000 person years (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32467098\">BMJ 2020;369:m1590<\/a>)<\/li>\n<\/ul>\n<\/li>\n<li>Peak incidence is at 20 &#8211; 30 years and at 50 &#8211; 60 years<\/li>\n<li>Psoriatic arthritis occurs in 5 &#8211; 30% of patients with psoriasis<\/li>\n<li>Associated with cardiovascular complications (increased rate of myocardial infarction, hypertension, hyperlipidemia, obesity, hyperlipidemia), depression, inflammatory bowel disease, diabetes, fatty liver disease and chronic kidney disease (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32914667\">J Am Heart Assoc 2020;9:e016956<\/a>,\u00a0<a class=\"bl\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28623046\">J Am Acad Dermatol 2017;77:287<\/a>,\u00a0<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28212760\">J Am Acad Dermatol 2017;76:393<\/a>)<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"sites248959\" class=\"block_section\">\n<div class=\"topicheading_title\">Sites<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Skin, nails, musculoskeletal system and rarely oral mucosa<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"pathophysiology248960\" class=\"block_section\">\n<div class=\"topicheading_title\">Pathophysiology<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Complex pathogenesis, including genetic, autoimmune and environmental factors (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28887948\">J Allergy Clin Immunol 2017;140:645<\/a>,\u00a0<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30909615\">Int J Mol Sci 2019;20:1475<\/a>,\u00a0<a class=\"bl\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29226422\">J Dermatol 2018;45:264<\/a>,\u00a0<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30181299\">J Immunol 2018;201:1605<\/a>)<\/li>\n<li>T cell (Th1) activation and release of cytokines (TNF\u03b1, IF\u03b3, IL12, etc.)<\/li>\n<li>Dendritic cells produce IL23, which activates Th17 cells, which then play a key role in the development of psoriasis; IL23 also induces macrophages to secrete TNF\u03b1<\/li>\n<li>Th17 cells produce IL17, which promotes the production of other proinflammatory molecules (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29232931\">Int J Mol Sci 2017;18:2684<\/a>)<\/li>\n<li>IL22, produced by Th17 and Th22 cells, plays a role in stimulating the proliferation of keratinocytes and causing the development of psoriatic plaques<\/li>\n<li>Overexpression of antimicrobial peptides (\u03b2-defensins, cathelicidin and S100) stimulate inflammation<\/li>\n<li>NF\u03baB induces expression of keratins 6 and 16, leading to acanthosis and increased turnover of keratinocytes<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"etiology248961\" class=\"block_section\">\n<div class=\"topicheading_title\">Etiology<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Genetic:\n<ul>\n<li>PSOR1 locus map on chromosome 6 is the most important genetic region responsible for the disease<\/li>\n<li>HLA-Cw6 is associated with early onset of psoriasis<\/li>\n<li>Additional associations include HLA-B27 (pustular psoriasis, psoriatic arthritis), HLA-B13, HLA-B17 and HLA-DR7<\/li>\n<\/ul>\n<\/li>\n<li>Triggering factors: numerous, most common are infections, HIV, hypocalcemia, stress, alcohol consumption, obesity and smoking (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/31417571\">Front Immunol 2019;10:1807<\/a>,\u00a0<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29387595\">Psoriasis (Auckl) 2016;6:65<\/a>)<\/li>\n<li>Drugs: antimalarials, lithium, beta blockers, terbinafine and imiquimod (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29387611\">Psoriasis (Auckl) 2017;7:87<\/a>)<\/li>\n<li>Paradoxically, TNF inhibitors, which are used to treat psoriasis, may also trigger psoriasis when used for other conditions<\/li>\n<li><i>Streptococcus<\/i>\u00a0infections may trigger acute guttate psoriasis<\/li>\n<li>Systemic steroid withdrawal may trigger pustular psoriasis, von Zumbusch type<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"clinicalfeatures248963\" class=\"block_section\">\n<div class=\"topicheading_title\">Clinical features<\/div>\n<div class=\"block_body\"><a id=\"skinnontumorpsoriasisclinicalfeatures\"><\/a><\/p>\n<ul>\n<li>Variants:\n<ul>\n<li>Plaque psoriasis (most common): sharply demarcated erythematous plaques with silvery scales, commonly present on extensor surfaces (elbows, knees, etc.)<\/li>\n<li>Guttate psoriasis: small scattered erythematous papules with silvery scales; often triggered by infections<\/li>\n<li>Erythrodermic psoriasis: confluent plaques affecting nearly all of the skin but often sparing the central face; lymphadenopathy, electrolyte and thermoregulation abnormalities may also be present<\/li>\n<li>Pustular psoriasis: presence of superficial pustules; generalized (von Zumbusch type), annular, palmar-plantar, localized and exanthemic variants are described<\/li>\n<li>Acrodermatitis continua of Hallopeau: pustules on the distal parts of the fingers and toes, as well as on the nail bed, which may cause shedding of the nail plate<\/li>\n<li>Scalp psoriasis: well demarcated plaques on the retroauricular areas and posterior upper neck<\/li>\n<li>Sebopsoriasis lesions on the scalp, face, upper back and chest mimicking seborrheic dermatitis<\/li>\n<li>Linear psoriasis: development of psoriasis lesions along Blaschko lines<\/li>\n<li>Annular \/ figurate psoriasis: annular lesions of psoriasis with central clearing<\/li>\n<li>Flexural (inverse) psoriasis: plaques affecting intertriginous folds, scaling may be less prominent<\/li>\n<li>Napkin psoriasis: may be seen in napkin (diaper) area in newborns<\/li>\n<li>Nail psoriasis: pits, splinter hemorrhages, oil drop sign (translucent yellow discoloration of the nail caused by parakeratosis of the nail bed), salmon patches and leukonychia are common on the nail plate<\/li>\n<li>Follicular psoriasis: small keratotic follicular papules with scaling (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32898397\">Dermatol Online J 2020;26:3<\/a>)<\/li>\n<li>Psoriatic arthritis: inflammation of distal interphalangeal joints and proximal interphalangeal joints of the feet and hands<\/li>\n<li>Oral psoriasis: red patches, geographic tongue, ulcerations, gingivitis or pustules<\/li>\n<\/ul>\n<\/li>\n<li>Signs:\n<ul>\n<li>Koebner phenomenon: new psoriatic papules at sites of skin trauma<\/li>\n<li>Auspitz sign: pinpoint bleeding when scales are removed<\/li>\n<li>Woronoff ring: an area of blanching surrounding resolving psoriatic plaques<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"diagnosis248964\" class=\"block_section\">\n<div class=\"topicheading_title\">Diagnosis<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Clinical examination<\/li>\n<li>Skin biopsy<\/li>\n<li>Xray if joints are affected<\/li>\n<li>Complete blood count, comprehensive metabolic panel (kidney and hepatic function), pregnancy, tuberculosis, HIV and hepatitis tests may be considered if systemic treatment is planned<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"laboratory248965\" class=\"block_section\">\n<div class=\"topicheading_title\">Laboratory<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Usually not needed to establish the diagnosis; should be performed if systemic treatment is desired<\/li>\n<li>Rheumatoid factor is negative<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"radiologydescription248966\" class=\"block_section\">\n<div class=\"topicheading_title\">Radiology description<\/div>\n<div class=\"block_body\">\n<ul>\n<li>5 main types of psoriatic arthritis:\n<ul>\n<li>Symmetrical peripheral polyarthritis resembling RA<\/li>\n<li>Asymmetrical mono or oligoarthritis, usually involving the knee and small peripheral joints<\/li>\n<li>Axial spondyloarthropathy<\/li>\n<li>Predominant DIP joint involvement<\/li>\n<li>Arthritis mutilans<\/li>\n<\/ul>\n<\/li>\n<li>Dactylitis, inflammatory changes in the distal interphalangeal joints and proximal interphalangeal joints, finger deformities (pencil in cup)<\/li>\n<li>Increase of radiographic density of the distal phalanx due to extra bone formation (ivory phalanx)<\/li>\n<li>Enthesitis<\/li>\n<li>Abnormalities of the sacroiliac joints (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27104004\">J Ultrason 2016;16:65<\/a>,\u00a0<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27446601\">J Ultrason 2016;16:163<\/a>)<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"radiologyimages248967\" class=\"block_section\">\n<div class=\"topicheading_title\">Radiology images<\/div>\n<div class=\"block_body\">\n<span class=\"f11bi\">Images hosted on other servers:<\/span><\/p>\n<div class=\"img1\"><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27104004\/#&amp;gid=article-figures&amp;pid=fig-1-uid-0\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/thumb\/skinnontumorpsoriasis_nih01.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Polyarticular psoriatic arthritis<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27104004\/#&amp;gid=article-figures&amp;pid=fig-5-uid-4\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/thumb\/skinnontumorpsoriasis_nih02.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Sacroiliac involvement in psoriatic arthritis<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27446601\/#&amp;gid=article-figures&amp;pid=fig-5-uid-4\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/thumb\/skinnontumorpsoriasis_nih03.png\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Onychopathy and periostitis at base of phalanx<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"prognosticfactors248968\" class=\"block_section\">\n<div class=\"topicheading_title\">Prognostic factors<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Chronic disease with frequent relapses; early systemic treatment to achieve control and prevent systemic comorbidities<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"casereports248969\" class=\"block_section\">\n<div class=\"topicheading_title\">Case reports<\/div>\n<div class=\"block_body\">\n<ul>\n<li>5 year old girl developed guttate psoriasis after throat infection (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/31038900\">Am Fam Physician 2019;99:575<\/a>)<\/li>\n<li>45 year old woman with nail psoriasis treated with intralesional methotrexate (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/31644634\">An Bras Dermatol 2019;94:491<\/a>)<\/li>\n<li>65 year old man with history of psoriasis exacerbating to erythroderma after HIV infection (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29924218\">An Bras Dermatol 2018;93:438<\/a>)<\/li>\n<li>66 year old woman with acrodermatitis continua of Hallopeau responded to adalimumab therapy (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30800311\">SAGE Open Med Case Rep 2019;7:2050313X19829620<\/a>)<\/li>\n<li>81 year old man with verrucous psoriasis plaque mimicking squamous cell carcinoma (<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/31440568\">JAAD Case Rep 2019;5:723<\/a>)<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"treatment248970\" class=\"block_section\">\n<div class=\"topicheading_title\">Treatment<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Topical treatment: corticosteroids (most common); vitamin D analogs (calcipotriene and calcitriol); topical retinoids; immunomodulators (pimecrolimus and tacrolimus); coal tar; keratolytics (salicylic acid and urea)<\/li>\n<li>Intralesional steroids to resistant plaques<\/li>\n<li>Light therapy (UVB, PUVA)<\/li>\n<li>Systemic therapies (methotrexate, cyclosporine and mycophenolate mofetil, JAK inhibitors)<\/li>\n<li>Biological therapies:\n<ul>\n<li>TNF inhibitors: infliximab, etanercept, adalimumab<\/li>\n<li>IL12 \/ 23 inhibitor: ustekinumab<\/li>\n<li>IL17 inhibitors: ixekinumab, brodalumab, secukinumab<\/li>\n<li>IL23 inhibitors: guselkimab, tildrakizumb, risankizumab<\/li>\n<li>Phosphodiesterase-4 inhibitors: apremilast<\/li>\n<li>Reference:\u00a0<a class=\"gr\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30909615\">Int J Mol Sci 2019;20:1475<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"clinicalimages248971\" class=\"block_section\">\n<div class=\"topicheading_title\">Clinical images<\/div>\n<div class=\"block_body\"><a id=\"skinnontumorpsoriasisclinicalimages\"><\/a><br \/>\n<span class=\"f11bi\">Contributed by Viktoryia Kazlouskaya, M.D., Ph.D., Mary-Katherine Collins, M.D. and Natalia Zhovta, M.D.<\/span><\/p>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskaya01.jpg\" data-lightbox=\"skinnontumorpsoriasis_clinical\" data-title=\"Verrucous psoriasis on the knee.&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskaya01.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Verrucous psoriasis on the knee<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskaya02.jpg\" data-lightbox=\"skinnontumorpsoriasis_clinical\" data-title=\"Palmar psoriasis with well demarcated plaque.&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskaya02.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Palmar psoriasis with well demarcated plaque<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskaya03.JPG\" data-lightbox=\"skinnontumorpsoriasis_clinical\" data-title=\"Localized pustular psoriasis.&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskaya03.JPG\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Localized pustular psoriasis<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskaya04.jpg\" data-lightbox=\"skinnontumorpsoriasis_clinical\" data-title=\"Plaque psoriasis, wrists; well demarcated plaque with superficial pustules.&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskaya04.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Plaque psoriasis, wrists<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskaya05.jpg\" data-lightbox=\"skinnontumorpsoriasis_clinical\" data-title=\"Plaque psoriasis, elbows.&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskaya05.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Plaque psoriasis, elbows<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskaya06.jpg\" data-lightbox=\"skinnontumorpsoriasis_clinical\" data-title=\"Intertriginous psoriasis.&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskaya06.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Intertriginous psoriasis<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Collins07.jpg\" data-lightbox=\"skinnontumorpsoriasis_clinical\" data-title=\"Pustular psoriasis; grouped superficial pustules with scaling.&lt;br&gt;Contributed by Mary-Katherine Collins, M.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Collins07.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Pustular psoriasis<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Collins08.jpg\" data-lightbox=\"skinnontumorpsoriasis_clinical\" data-title=\"Erythrodermic psoriasis; diffuse erythema with scaling.&lt;br&gt;Contributed by Mary-Katherine Collins, M.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Collins08.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Erythrodermic psoriasis<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Zhovta09.jpg\" data-lightbox=\"skinnontumorpsoriasis_clinical\" data-title=\"Guttate psoriasis; disseminated small papules on the lower extremities.&lt;br&gt;Contributed by Natalia Zhovta, M.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Zhovta09.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Guttate psoriasis<\/p>\n<\/div>\n<p><span class=\"f11b\"><i>Contributed by Mark R. Wick, M.D.<\/i><\/span><\/p>\n<div class=\"img2\"><a href=\"https:\/\/www.pathologyoutlines.com\/wick\/breast\/psoriasisvulgarisskinclinical.jpg\" data-lightbox=\"skinnontumorpsoriasis_clinical\" data-title=\"Disseminated well demarcated psoriatic papules and plaques on the trunk.&lt;br&gt;Contributed by Mark R. Wick, M.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/wick\/breast\/psoriasisvulgarisskinclinical.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>\u00a0\u2003\u00a0<a href=\"https:\/\/www.pathologyoutlines.com\/wick\/breast\/psoriasisvulgarisskininverseclinical.jpg\" data-lightbox=\"skinnontumorpsoriasis_clinical\" data-title=\"Close image of intertriginous psoriasis with well demarcated plaque without apparent scaling.&lt;br&gt;Contributed by Mark R. Wick, M.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/wick\/breast\/psoriasisvulgarisskininverseclinical.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Breast skin<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"grossdescription248972\" class=\"block_section\">\n<div class=\"topicheading_title\">Gross description<\/div>\n<div class=\"block_body\">\n<ul>\n<li>See\u00a0<a class=\"scrollto\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/#skinnontumorpsoriasisclinicalfeatures\">clinical features<\/a><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"grossimages248973\" class=\"block_section\">\n<div class=\"topicheading_title\">Gross images<\/div>\n<div class=\"block_body\">\n<ul>\n<li>See\u00a0<a class=\"scrollto\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/#skinnontumorpsoriasisclinicalimages\">clinical images<\/a><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"microscopichistologicdescription248976\" class=\"block_section\">\n<div class=\"topicheading_title\">Microscopic (histologic) description<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Regular acanthosis, often with elongated rete (psoriasiform)<\/li>\n<li>Alternating zones of hypo and hypergranulosis in the epidermis<\/li>\n<li>Thinning of the suprapapillary plates<\/li>\n<li>Areas of parakeratosis in the stratum corneum with mounds of neutrophils (Munro microabscesses)<\/li>\n<li>Perivascular, predominantly lymphocytic infiltrate in the upper and middle portions of the dermis; few neutrophils or eosinophils may be seen<\/li>\n<li>Collections of neutrophils in the spinosum (spongiosiform pustules of Kogoj)<\/li>\n<li>Dilated and tortuous vessels in the dermal papillae<\/li>\n<li>Focal spongiosis may be present in the evolving lesions, intertriginous, acral and scalp variants<\/li>\n<li>Subcorneal pustules in the pustular forms of psoriasis<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"microscopichistologicimages248977\" class=\"block_section\">\n<div class=\"topicheading_title\">Microscopic (histologic) images<\/div>\n<div class=\"block_body\">\n<span class=\"f11bi\">Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.<\/span><\/p>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya01.JPG\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Punch biopsy of pustular psoriasis from the trunk with regular acanthosis with subcorneal pustule, dilated capillaries in the papillary dermis, lymphocytic infiltrate (20x).&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya01.JPG\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Acanthosis with subcorneal pustule<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya02.JPG\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Higher magnification of subcorneal pustule in pustular psoriasis with elongated and dilated capillaries in the papillary dermis. Punch biopsy from the trunk (40x).&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya02.JPG\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Subcorneal pustule<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya03.JPG\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Eruptive psoriasis with mild acanthosis of the epidermis, dilated vessels in the superficial dermis and mounds of parakeratosis with focal neutrophilic collections. Shave biopsy from the lower extremity (20x).&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya03.JPG\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Parakeratosis with neutrophilic collections<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya04.JPG\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Verrucous psoriasis with regular acanthosis and papillomatosis, extensive hyperkeratosis with collections of parakeratosis and neutrophils. Punch biopsy from the lower extremity (10x).&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya04.JPG\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Acanthosis and verrucous changes<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya05.JPG\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Higher magnification of verrucous psoriasis highlighting edema of the superficial dermis, extensive hyperkeratosis with collections of parakeratosis and neutrophils. Punch biopsy from the lower extremity (20x).&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya05.JPG\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Dilated dermal capillaries<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya06.jpg\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Eruptive pustular psoriasis with minimal acanthosis, subcorneal pustules, mounds of parakeratosis with neutrophils, dilated vessels in the superficial dermis and lymphocytic perivascular infiltrate. Shave biopsy from the trunk (20x).&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya06.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Subcorneal pustules<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya07.JPG\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Plaque psoriasis with regular acanthosis, hypogranulosis, perivascular lymphocytic infiltrate, elongated dilated vessels in the superficial dermis and parakeratosis with neutrophils. Punch biopsy from the chest (10x).&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya07.JPG\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Regular acanthosis<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya08.jpg\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Higher magnification of plaque psoriasis with regular acanthosis, hypogranulosis, perivascular lymphocytic infiltrate, elongated dilated vessels in the superficial dermis and parakeratosis with neutrophils. Punch biopsy from the chest (40x).&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya08.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Acanthosis, parakeratosis with neutrophils<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya09.jpg\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Acral pustular psoriasis with subcorneal pustule filled with neutrophils. Punch biopsy from the palm (20x).&lt;br&gt;Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasismicro_Kazlouskaya09.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Acral subcorneal pustule<\/p>\n<\/div>\n<p><span class=\"f11b\"><i>Contributed by Hillary Rose Elwood, M.D.<\/i><\/span><\/p>\n<div class=\"img3\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skin-nontumor\/skinnontumorpsoriasisElwood01.jpg\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Contributed by Hillary Rose Elwood, M.D.&lt;br \/&gt;\nClassic features of psoriasiform hyperplasia, confluent parakeratosis, loss of granular layer and dilated capillaries with thinned suprapapillary plate\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skin-nontumor\/skinnontumorpsoriasisElwood01.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>\u00a0\u2003\u00a0<a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skin-nontumor\/skinnontumorpsoriasisElwood02.jpg\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Contributed by Hillary Rose Elwood, M.D.&lt;br \/&gt;\nClassic features of psoriasiform hyperplasia, confluent parakeratosis, loss of granular layer and dilated capillaries with thinned suprapapillary plate\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skin-nontumor\/skinnontumorpsoriasisElwood02.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>\u00a0\u2003\u00a0<a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skin-nontumor\/skinnontumorpsoriasisElwood03.jpg\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Contributed by Hillary Rose Elwood, M.D.&lt;br \/&gt;\nClassic features of psoriasiform hyperplasia, confluent parakeratosis, loss of granular layer and dilated capillaries with thinned suprapapillary plate\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skin-nontumor\/skinnontumorpsoriasisElwood03.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Classic features of psoriasiform hyperplasia, confluent parakeratosis, loss of granular layer and dilated capillaries with thinned suprapapillary plate<\/p>\n<\/div>\n<p><span class=\"f11b\"><i>Contributed by Angel Fernandez-Flores, M.D., Ph.D.<\/i><\/span><\/p>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/images\/skinnonpsor1.jpg\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Regular psoriasiform acanthosis with perivascular lymphocytic infiltrates and neutrophils in the stratum corneum and superficial epidermis.&lt;br&gt;Contributed by Angel Fernandez-Flores, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/images\/skinnonpsor1.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Regular psoriasiform acanthosis<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/images\/skinnonpsor2.jpg\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Dilated capillaries in the dermal papillae.&lt;br&gt;Contributed by Angel Fernandez-Flores, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/images\/skinnonpsor2.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Dilated capillaries in the dermal papillae<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/images\/skinnonpsor3.jpg\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Collections of neutrophils in the stratum corneum and superficial epidermis.&lt;br&gt;Contributed by Angel Fernandez-Flores, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/images\/skinnonpsor3.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Neutrophils in stratum corneum<\/p>\n<\/div>\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/images\/skinnonpsor4.jpg\" data-lightbox=\"skinnontumorpsoriasis_micro\" data-title=\"Hypogranulosis and collections of neutrophils in the stratum corneum.&lt;br&gt;Contributed by Angel Fernandez-Flores, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/images\/skinnonpsor4.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>Hypogranulosis and neutrophils in stratum corneum<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"immunofluorescencedescription248981\" class=\"block_section\">\n<div class=\"topicheading_title\">Immunofluorescence description<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Direct and indirect immunofluorescence are negative<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"negativestains248984\" class=\"block_section\">\n<div class=\"topicheading_title\">Negative stains<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Fungal stains (<a href=\"https:\/\/www.pathologyoutlines.com\/topic\/stainspas.html\">PAS<\/a>,\u00a0<a href=\"https:\/\/www.pathologyoutlines.com\/topic\/stainsgms.html\">GMS<\/a>, etc.)<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"videos248989\" class=\"block_section\">\n<div class=\"topicheading_title\">Videos<\/div>\n<div class=\"block_body\">\n<div class=\"img2\"><iframe loading=\"lazy\" id=\"495477600\" title=\"Psoriasis: clinical presentation, histopathology and differential diagnosis.\" src=\"https:\/\/www.youtube.com\/embed\/lNyfrLgRen4?enablejsapi=1&amp;origin=https%3A%2F%2Fwww.pathologyoutlines.com\" width=\"210\" height=\"157.5\" frameborder=\"0\" scrolling=\"no\" allowfullscreen=\"allowfullscreen\" data-gtm-yt-inspected-14=\"true\" data-gtm-yt-inspected-36267760_11=\"true\" data-gtm-yt-inspected-36267760_46=\"true\" data-gtm-yt-inspected-36267760_126=\"true\" data-mce-fragment=\"1\"><\/iframe>Psoriasis: clinical presentation, histopathology and differential diagnosis<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"samplepathologyreport248990\" class=\"block_section\">\n<div class=\"topicheading_title\">Sample pathology report<\/div>\n<div class=\"block_body\">\n<ul>\n<li>Skin, biopsy:\n<ul>\n<li>Psoriasiform dermatosis, suggestive for \/ consistent with psoriasis (see comment)<\/li>\n<li>Comment: Biopsy examination demonstrates a regular psoriasiform acanthosis of the epidermis. There is a mild inflammatory perivascular and interstitial infiltrate composed predominantly of lymphocytes. Thinning of suprapapillary plates, widened vessels in the superficial dermis and collections of neutrophils in the stratum corneum were noted. No fungal elements were identified with PAS stain.<\/li>\n<li>Overall, the histopathological features are consistent with psoriasis but only in appropriate clinical setting; psoriasiform drug eruptions may be indistinguishable.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"differentialdiagnosis248991\" class=\"block_section\">\n<div class=\"topicheading_title\">Differential diagnosis<\/div>\n<div class=\"block_body\">\n<ul>\n<li><b>Subacute spongiotic processes (atopic dermatitis, nummular dermatitis, contact dermatitis, dyshidrotic eczema)<\/b>:\n<ul>\n<li>More prominent spongiosis<\/li>\n<li>Sometimes abundant eosinophils in the infiltrate<\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorseborrheicdermatitis.html\">Seborrheic dermatitis<\/a>:\n<ul>\n<li>Spongiosis, mounds of parakeratosis at the follicular ostia<\/li>\n<li>In some instances, differentiation is not possible<\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpityriasisrosea.html\">Pityriasis rosea<\/a>:\n<ul>\n<li>Foci of spongiosis with small mounds of parakeratosis in the overlying stratum corneum<\/li>\n<li>Herald patch may have acanthosis<\/li>\n<\/ul>\n<\/li>\n<li><b>Psoriasiform drug eruption<\/b>:\n<ul>\n<li>May be indistinguishable, greater number of eosinophils may be present<\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpityriasisrubra.html\">Pityriasis rubra pilaris<\/a>\u00a0(<a class=\"bl\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30045068\">Am J Dermatopathol 2019;41:37<\/a>):\n<ul>\n<li>Alternating areas of ortho and parakeratosis vertically and horizontally in the stratum corneum (checkerboard pattern)<\/li>\n<li>Acantholysis may be present<\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorlichensimplexchronicus.html\">Lichen simplex chronicus<\/a>:\n<ul>\n<li>Presence of vertical collagen bundles in the papillary dermis<\/li>\n<li>No significant parakeratosis and collections of neutrophils in the stratun corneum<\/li>\n<\/ul>\n<\/li>\n<li><b>Inflammatory linear verrucous<\/b>\u00a0<a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skintumornonmelanocyticepidermalnevus.html\">epidermal nevus<\/a>\u00a0(ILVEN):\n<ul>\n<li>Vertically alternating areas of ortho and parakeratosis in the stratum corneum with orthokeratotic areas overlying epidermal hypergranulosis and parakeratosis overlying hypogranulosis<\/li>\n<li>No neutrophilic collections in the stratum corneum nor the epidermis<\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorporokeratosis.html\">Porokeratosis<\/a>\u00a0<b>ptychotropica<\/b>:\n<ul>\n<li>Presence of cornoid lamellae and dyskeratotic cells<\/li>\n<\/ul>\n<\/li>\n<li><b>Fungal infections<\/b>:\n<ul>\n<li>May have similar findings, stains (<a href=\"https:\/\/www.pathologyoutlines.com\/topic\/stainspas.html\">PAS<\/a>\u00a0or\u00a0<a href=\"https:\/\/www.pathologyoutlines.com\/topic\/stainsgms.html\">GMS<\/a>\u00a0should be performed when in question)<\/li>\n<\/ul>\n<\/li>\n<li><b>Nutritional dermatosis<\/b>:\n<ul>\n<li>May have variable findings<\/li>\n<li>In classical cases, a pallor of the superficial epidermis is seen<\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skintumornonmelanocyticclearcellacanthoma.html\">Clear cell acanthoma<\/a>:\n<ul>\n<li>Usually a solitary lesion<\/li>\n<li>Sharp demarcation between normal epidermis and clear cell areas<\/li>\n<\/ul>\n<\/li>\n<li><b>Pustular psoriasis<\/b>:\n<ul>\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumoragep.html\">Acute generalized exanthematous pustulosis (AGEP)<\/a>:\n<ul>\n<li>May have similar findings but with larger amount of eosinophils<\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorbullousimpetigo.html\">Bullous impetigo<\/a>:\n<ul>\n<li>May be very similar<\/li>\n<li>Clinical correlation is required<\/li>\n<li>Bacteria may be found in the intact bullas<\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpemphigus.html\">Pemphigus foliaceus<\/a>\u00a0or\u00a0<b>IgA pemphigus<\/b>:\n<ul>\n<li>May be indistinguishable<\/li>\n<li>Acantholytic cells may be present<\/li>\n<li>Direct immunofluorescence is required if suspected<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skintumornonmelanocyticmycosisfungoides.html\">Mycosis fungoides<\/a>:\n<ul>\n<li>Epidermotropism, folliculotropism or syringotropism (tropism to eccrine glands)<\/li>\n<li>Lymphocytes display atypical features (irregular contours, hyperchromasia, sometimes enlarged, etc.)<\/li>\n<li>Presence of neutrophils in the stratum corneum is rare<\/li>\n<li>Presence of thickened collagen bundles in the superficial dermis<\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/lymphomanonBsezary.html\">Sezary syndrome<\/a>:\n<ul>\n<li>May be indistinguishable unless clear history and histopathological features of psoriasis are present<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"practicequestion1248993\" class=\"block_section\">\n<div class=\"topicheading_title\">Practice question #1<\/div>\n<div class=\"block_body\">\n<div class=\"img1\"><a href=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskayabrq1.jpg\" data-lightbox=\"skinnontumorpsoriasis_brq\" data-title=\"Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pathologyoutlines.com\/imgau\/skinnontumorpsoriasis_Kazlouskayabrq1.jpg\" alt=\"\" width=\"96\" height=\"96\" \/><\/a>&nbsp;<\/p>\n<\/div>\n<p>What are the expected histopathological features of this condition?<\/p>\n<ol class=\"liststyle2\">\n<li>Regular psoriasiform acanthosis with subcorneal neutrophilic collections, PAS stain negative<\/li>\n<li>Regular psoriasiform acanthosis with subcorneal neutrophilic collections, PAS stain positive<\/li>\n<li>Irregular psoriasiform acanthosis with spongiosis<\/li>\n<li>Perifollicular pustules<\/li>\n<li>Intraepidermal bullae filled with neutrophils<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"practiceanswer1248994\" class=\"block_section\">\n<div class=\"topicheading_title\">Practice answer #1<\/div>\n<div class=\"block_body\"><b>A<\/b>. The image demonstrates pustular psoriasis. Histopathological features of pustular psoriasis include regular psoriasiform acanthosis with subcorneal neutrophilic collections. PAS stain is negative. Positive PAS staining is seen in fungal infections (answer B). Spongiosis, although may be focally seen in psoriasis, is more typical for eczematous conditions (answer C). Pustules in pustular psoriasis are not perifollicular (answer D). Intraepidermal bullae are not seen in psoriasis (answer E).<\/p>\n<p><a class=\"contact_form_trigger\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/#\">Comment Here<\/a><\/p>\n<p>Reference:\u00a0<a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html\">Psoriasis<\/a><\/div>\n<\/div>\n<div id=\"practicequestion2248995\" class=\"block_section\">\n<div class=\"topicheading_title\">Practice question #2<\/div>\n<div class=\"block_body\">A patient was treated for onychomycosis with a systemic medication and developed a rash. Biopsy of the rash demonstrated regular psoriasiform acanthosis, parakeratosis with neutrophils in the stratum corneum, thinning of parapapillary plated with dilated vessels in the superficial dermis. What was the most likely medication causing this condition?<\/p>\n<ol class=\"liststyle2\">\n<li>Griseofulvin<\/li>\n<li>Voriconazole<\/li>\n<li>Terbinafine<\/li>\n<li>Itraconazole<\/li>\n<li>Fluconazole<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"practiceanswer2248996\" class=\"block_section\">\n<div class=\"topicheading_title\">Practice answer #2<\/div>\n<div class=\"block_body\"><b>C<\/b>. The vignette describes psoriasis that started after administration of an oral antifungal agent. Terbinafine is known to exacerbate psoriasis. This side effect is not typical for griseofulvin (answer A) and azoles (voriconazole, itraconazole or fluconazole &#8211; answers B, D and E).<\/p>\n<p><a class=\"contact_form_trigger\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/#\">Comment Here<\/a><\/p>\n<p>Reference:\u00a0<a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skinnontumorpsoriasis.html\">Psoriasis<\/a><\/div>\n<\/div>\n<div id=\"practicequestion3248997\" class=\"block_section\">\n<div class=\"topicheading_title\">Practice question #3<\/div>\n<div class=\"block_body\">What histopathological feature is helpful in differentiating psoriasis versus inflammatory linear verrucous epidermal nevus?<\/p>\n<ol class=\"liststyle2\">\n<li>Presence of spongiosis<\/li>\n<li>Presence of lichenoid infiltrate<\/li>\n<li>Presence of eosinophils in the inflammatory infiltrate<\/li>\n<li>Erythrocyte extravasates<\/li>\n<li>Alternating orthokeratosis with parakeratosis<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"practiceanswer3248998\" class=\"block_section\">\n<div class=\"topicheading_title\">Practice answer #3<\/div>\n<div class=\"block_body\"><b>E<\/b>. Alternating orthokeratosis with parakeratosis is the most specific sign that helps to differentiate ILVEN with psoriasis. Focal areas of spongiosis and erythrocyte extravasates may be seen in both conditions but these features are not specific. Eosinophils and lichenoid infiltrate are not typical for ILVEN and psoriasis.<\/div>\n<\/div>\n<\/div>\n<\/header>\n<div class=\"entry-content\">\n<div class=\"wp-block-group\">\n<div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<div id=\"jig1\" class=\"justified-image-grid jig-b7668bb08aa8b215b81112091f80bd80 jig-preset-17 jig-source-wp-gallery jig-no-touch\" data-touched-by-j-i-g=\"true\">\n<div class=\"jig-imageContainer jig-contentID-ML-968\">\n<div class=\"jig-overflow\"><a class=\"jig-link jig-loaded\" title=\"&lt;a href=&quot;\/all-diagnoses\/gianotti-crosti-syndrome\/&quot; target=&quot;_blank&quot; rel=&quot;noopener noreferrer&quot;&gt;Learn more about Gianotti-Crosti syndrome&lt;\/a&gt; &lt;br\/&gt; &lt;a class=&quot;jig-downloadLink&quot; href=&quot;https:\/\/dftbskindeep.com\/?download-gallery-image=https%3A%2F%2Fdftbskindeep.com%2Fwp-content%2Fuploads%2F2020%2F08%2FE1-Gianotti-Crosti-syndrome.jpg&quot;&gt;&lt;b&gt;Download&lt;\/b&gt;&lt;\/a&gt;\" href=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2020\/08\/E1-Gianotti-Crosti-syndrome-1024x1024.jpg\" rel=\"jig[1]\" data-wh=\"1024x1024\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2020\/08\/E1-Gianotti-Crosti-syndrome-1024x1024.jpg\" width=\"292\" height=\"292\" \/><\/a><\/div>\n<\/div>\n<div class=\"jig-imageContainer jig-contentID-ML-2491\">\n<div class=\"jig-overflow\"><a class=\"jig-link jig-loaded\" title=\"&lt;a href=&quot;\/all-diagnoses\/gianotti-crosti-syndrome\/&quot; target=&quot;_blank&quot; rel=&quot;noopener noreferrer&quot;&gt;Learn more about Gianotti-Crosti syndrome&lt;\/a&gt; &lt;br\/&gt; &lt;a class=&quot;jig-downloadLink&quot; href=&quot;https:\/\/dftbskindeep.com\/?download-gallery-image=https%3A%2F%2Fdftbskindeep.com%2Fwp-content%2Fuploads%2F2020%2F08%2F52-Gianotti-Crosti-sydnrome.jpg&quot;&gt;&lt;b&gt;Download&lt;\/b&gt;&lt;\/a&gt;\" href=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2020\/08\/52-Gianotti-Crosti-sydnrome-1024x1024.jpg\" rel=\"jig[1]\" data-wh=\"1024x1024\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2020\/08\/52-Gianotti-Crosti-sydnrome-1024x1024.jpg\" width=\"292\" height=\"292\" \/><\/a><\/div>\n<\/div>\n<div class=\"jig-imageContainer jig-contentID-ML-3547\">\n<div class=\"jig-overflow\"><a class=\"jig-link jig-loaded\" title=\"&lt;a href=&quot;\/all-diagnoses\/gianotti-crosti-syndrome\/&quot; target=&quot;_blank&quot; rel=&quot;noopener noreferrer&quot;&gt;Learn more about Gianotti-Crosti syndrome&lt;\/a&gt; &lt;br\/&gt; &lt;a class=&quot;jig-downloadLink&quot; href=&quot;https:\/\/dftbskindeep.com\/?download-gallery-image=https%3A%2F%2Fdftbskindeep.com%2Fwp-content%2Fuploads%2F2020%2F11%2F116a-Gianotti-Crosti-syndrome.jpg&quot;&gt;&lt;b&gt;Download&lt;\/b&gt;&lt;\/a&gt;\" href=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2020\/11\/116a-Gianotti-Crosti-syndrome-1024x1024.jpg\" rel=\"jig[1]\" data-wh=\"1024x1024\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2020\/11\/116a-Gianotti-Crosti-syndrome-1024x1024.jpg\" width=\"292\" height=\"292\" \/><\/a><\/div>\n<\/div>\n<div class=\"jig-imageContainer jig-contentID-ML-3703 jig-last\">\n<div class=\"jig-overflow\"><a class=\"jig-link jig-loaded\" title=\"&lt;a href=&quot;\/all-diagnoses\/gianotti-crosti-syndrome\/&quot; target=&quot;_blank&quot; rel=&quot;noopener noreferrer&quot;&gt;Learn more about Gianotti-Crosti syndrome&lt;\/a&gt; &lt;br\/&gt; &lt;a class=&quot;jig-downloadLink&quot; href=&quot;https:\/\/dftbskindeep.com\/?download-gallery-image=https%3A%2F%2Fdftbskindeep.com%2Fwp-content%2Fuploads%2F2021%2F01%2F210d-Gianotti-Crosti-syndrome.jpg&quot;&gt;&lt;b&gt;Download&lt;\/b&gt;&lt;\/a&gt;\" href=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2021\/01\/210d-Gianotti-Crosti-syndrome-1024x1024.jpg\" rel=\"jig[1]\" data-wh=\"1024x1024\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2021\/01\/210d-Gianotti-Crosti-syndrome-1024x1024.jpg\" width=\"292\" height=\"292\" \/><\/a><\/div>\n<\/div>\n<div class=\"jig-imageContainer jig-contentID-ML-3915\">\n<div class=\"jig-overflow\"><a class=\"jig-link jig-loaded\" title=\"&lt;a href=&quot;\/all-diagnoses\/gianotti-crosti-syndrome\/&quot; target=&quot;_blank&quot; rel=&quot;noopener noreferrer&quot;&gt;Learn more about Gianotti-Crosti syndrome&lt;\/a&gt; &lt;br\/&gt; &lt;a class=&quot;jig-downloadLink&quot; href=&quot;https:\/\/dftbskindeep.com\/?download-gallery-image=https%3A%2F%2Fdftbskindeep.com%2Fwp-content%2Fuploads%2F2021%2F05%2FRESEARCH-KC21a-Gianotti-Crosti-syndrome.jpg&quot;&gt;&lt;b&gt;Download&lt;\/b&gt;&lt;\/a&gt;\" href=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2021\/05\/RESEARCH-KC21a-Gianotti-Crosti-syndrome-1024x1024.jpg\" rel=\"jig[1]\" data-wh=\"1024x1024\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2021\/05\/RESEARCH-KC21a-Gianotti-Crosti-syndrome-1024x1024.jpg\" width=\"292\" height=\"292\" \/><\/a><\/div>\n<\/div>\n<div class=\"jig-imageContainer jig-contentID-ML-5846\">\n<div class=\"jig-overflow\"><a class=\"jig-link jig-loaded\" title=\"&lt;a class=&quot;jig-downloadLink&quot; href=&quot;https:\/\/dftbskindeep.com\/?download-gallery-image=https%3A%2F%2Fdftbskindeep.com%2Fwp-content%2Fuploads%2F2023%2F07%2F449a-gianotti-crosti.jpg&quot;&gt;&lt;b&gt;Download&lt;\/b&gt;&lt;\/a&gt;\" href=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2023\/07\/449a-gianotti-crosti-1024x1024.jpg\" rel=\"jig[1]\" data-wh=\"1024x1024\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2023\/07\/449a-gianotti-crosti-1024x1024.jpg\" alt=\"Gianotti Crosti\" width=\"292\" height=\"292\" \/><\/a><\/p>\n<div class=\"jig-caption-wrapper jig-cw-role-real\"><\/div>\n<\/div>\n<\/div>\n<div class=\"jig-imageContainer jig-contentID-ML-5847\">\n<div class=\"jig-overflow\"><a class=\"jig-link jig-loaded\" title=\"Gianotti-Crosti syndrome (GCS) is a skin condition that usually affects children, but can also occur in adolescents and adults &lt;br\/&gt; &lt;a class=&quot;jig-downloadLink&quot; href=&quot;https:\/\/dftbskindeep.com\/?download-gallery-image=https%3A%2F%2Fdftbskindeep.com%2Fwp-content%2Fuploads%2F2023%2F07%2F449b-gianotti-crosti.jpg&quot;&gt;&lt;b&gt;Download&lt;\/b&gt;&lt;\/a&gt;\" href=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2023\/07\/449b-gianotti-crosti-1024x1024.jpg\" rel=\"jig[1]\" data-wh=\"1024x1024\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2023\/07\/449b-gianotti-crosti-1024x1024.jpg\" width=\"292\" height=\"292\" \/><\/a><\/div>\n<\/div>\n<div class=\"jig-imageContainer jig-contentID-ML-5848 jig-last\">\n<div class=\"jig-overflow\"><a class=\"jig-link jig-loaded\" title=\"Gianotti-Crosti syndrome (GCS) is a skin condition that usually affects children, but can also occur in adolescents and adults &lt;br\/&gt; &lt;a class=&quot;jig-downloadLink&quot; href=&quot;https:\/\/dftbskindeep.com\/?download-gallery-image=https%3A%2F%2Fdftbskindeep.com%2Fwp-content%2Fuploads%2F2023%2F07%2F449c-gianotti-crosti.jpg&quot;&gt;&lt;b&gt;Download&lt;\/b&gt;&lt;\/a&gt;\" href=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2023\/07\/449c-gianotti-crosti-1024x1024.jpg\" rel=\"jig[1]\" data-wh=\"1024x1024\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2023\/07\/449c-gianotti-crosti-1024x1024.jpg\" width=\"292\" height=\"292\" \/><\/a><\/div>\n<\/div>\n<div class=\"jig-imageContainer jig-contentID-ML-5849 jig-last\">\n<div class=\"jig-overflow\"><a class=\"jig-link jig-loaded\" title=\"&lt;a class=&quot;jig-downloadLink&quot; href=&quot;https:\/\/dftbskindeep.com\/?download-gallery-image=https%3A%2F%2Fdftbskindeep.com%2Fwp-content%2Fuploads%2F2023%2F07%2F449d-gianotti-crosti.jpg&quot;&gt;&lt;b&gt;Download&lt;\/b&gt;&lt;\/a&gt;\" href=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2023\/07\/449d-gianotti-crosti-1024x1024.jpg\" rel=\"jig[1]\" data-wh=\"1024x1024\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dftbskindeep.com\/wp-content\/uploads\/2023\/07\/449d-gianotti-crosti-1024x1024.jpg\" width=\"292\" height=\"292\" \/><\/a><\/div>\n<\/div>\n<div class=\"jig-clearfix\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Skin nontumor Spongiotic, psoriasiform and pustular reaction patterns Psoriasis Authors:\u00a0Viktoryia Kozlouskaya, M.D., Ph.D.,\u00a0Mary-Katharine Collins, M.D. Resident \/ Fellow Advisory Board:\u00a0Caroline I. Mullins, M.D. Editorial Board Member:\u00a0Robert E. LeBlanc, M.D. Last &hellip; <\/p>\n","protected":false},"author":1,"featured_media":1180,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1179","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/edmpackz.com\/index.php?rest_route=\/wp\/v2\/posts\/1179","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/edmpackz.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/edmpackz.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/edmpackz.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/edmpackz.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1179"}],"version-history":[{"count":1,"href":"https:\/\/edmpackz.com\/index.php?rest_route=\/wp\/v2\/posts\/1179\/revisions"}],"predecessor-version":[{"id":1181,"href":"https:\/\/edmpackz.com\/index.php?rest_route=\/wp\/v2\/posts\/1179\/revisions\/1181"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/edmpackz.com\/index.php?rest_route=\/wp\/v2\/media\/1180"}],"wp:attachment":[{"href":"https:\/\/edmpackz.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1179"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/edmpackz.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1179"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/edmpackz.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1179"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}