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Features of Psoriasiform

Reaction Pattern

Dr Sampurna Roy MD            






Images of lesions showing Psoriasiform Reaction Pattern:

Histopathology image of Psoriasis

Histopathology image of Pustular Psoriasis

Histopathology image of Clear Cell Acanthoma



Psoriasiform Reaction Pattern is characterised by:

-Epidermal hyperplasia

-Elongation of rete ridges

-Thickening, clubbing and fusing of rete ridges

-Thinning of suprapapillary plate

-"Squirting dermal papillae" (Migration of neutrophils from the dermal papillae into the overlying epidermis).

- Inflammatory cells in the epidermis

-Parakeratotic hyperkeratosis




-Pustular psoriasis:

-Reiter's disease:

-Clear cell acanthoma:

-Lichen Simplex chronicus:

- Inflammatory Linear Verrucous Epidermal Nevus

-Chronic eczematous dermatitis: In Chronic eczematous dematitis there is spongiosis (unlike psoriasis).

-Pityriasis rubra pilaris:  Alternate vertical and horizontal hyperkeratosis and parakeratosis is characteristic of pityriasis rubra pilaris.

- Mycosis fungoides:

- Fungal Infections :

- Bowen's disease (psoriasiform variant):

- Drug reaction. Drug related cutaneous lesions


Further reading:

Histopathologic spectrum of psoriasiform skin reactions associated with tumor necrosis factor-α inhibitor therapy. A study of 16 biopsies.

Psoriasiform eruption and oral ulcerations as adverse effects of topical 5% imiquimod treatment in children: a report of four cases.

Psoriasiform dermatitis is driven by IL-36-mediated DC-keratinocyte crosstalk.

Cytokine imbalance with increased production of interferon-alpha in psoriasiform eruptions associated with antitumour necrosis factor-alpha treatments.

Psoriasiform dermatoses.

The histopathologic spectrum of psoriasis.

Clear-cell acanthoma versus acanthosis: a psoriasiform reaction pattern lacking tricholemmal differentiation.





Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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