robin082006
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A 37-year-old white man presents with a chief complaint of rash for 2-3 years. He says the rash initially started on the intergluteal fold, but progressed to involve areas on his extremities and trunk. He admits to occasionaI, moderate-to-severe pruritus with the rash. On cutaneous examination, there are large erythematous plaques with thick micaceous, silvery scales located on extensor surface of his elbows and knees bilaterally. Similar lesions are seen on his lower back and intergluteal fold. In addition, there are thick, welI-defined scaly plaques on his scalp, extending beyond the hairline.
A biopsy from one of the lesions would most likely show which of the following?
/ A. Acanthosis with intracorneal pustule formation
/ B. Basal cell liquefaction with band-Iike chronic inflammatory infiltrate in the papillary dermis
/ C. Hyperkeratosis with intra-epidermal clefts containing "corps ronds"
/ D. Large intraepidermal cleft in the suprabasal region
/ E. Large subepidermal blister with sparse inflammatory infiltrate
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| Natasa
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I am not quite sure,but it should be Psoriasis and is characterized with acanthosis and parakeratosis with Munro microabsceses(pustules) in stratum corneum.Therefore,I go with A.It usually doesn't go with intense pruritus-but occasionaly it can be a symptom.So-
ANSWER-A.
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| reet
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yes,,its psoriasis---silvery scales on extensors gives the CLUE.
answer is A -- Acanthosis + strtum corneum-pustule
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| robin082006
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| docarchana
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i think E is bullous pemphigoid. can some one help with the other choices.
thanku.
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