Conflict of interest None declared.
Histological differentiation between palmoplantar pustulosis and pompholyx
Article first published online: 13 JUN 2012
© 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 27, Issue 7, pages 889–893, July 2013
How to Cite
Yoon, S.Y., Park, H.S., Lee, J.H. and Cho, S. (2013), Histological differentiation between palmoplantar pustulosis and pompholyx. Journal of the European Academy of Dermatology and Venereology, 27: 889–893. doi: 10.1111/j.1468-3083.2012.04602.x
Funding sources None.
- Issue published online: 13 JUN 2013
- Article first published online: 13 JUN 2012
- Received: 16 February 2012; Accepted: 10 May 2012
Background Palmoplantar pustulosis (PPP) is a chronic and intensely inflammatory skin disease with pustules, erythema and scaling localized to the palms and soles. Pompholyx is characterized by recurrent crops of vesicles on the lateral aspects of the fingers and the palms and soles. Because both PPP and pompholyx share similar clinical and histological features, it is difficult to differentiate between these two diseases even for dermatologists.
Objective To compare the histological features of PPP and pompholyx and to analyse their clinical characteristics.
Methods The clinical history from 45 patients with PPP and 42 with pompholyx was evaluated. Among these patients, the punch biopsies from acute lesions of 40 PPP patients and 35 pompholyx ones were analysed, blind to the clinical diagnosis.
Results There was no sexual predilection in either group, and 65.5% of PPP patients had smoking history. About half of the patients had concomitant palmoplantar lesions in PPP and pompholyx respectively. In histological evaluation, loss of granular layer, suprapapillary plates thinning, eosinophils in the pustules or vesicles, tortuous capillaries, capillaries touching the undersurface of epidermis and extravasated erythrocytes were statistically significant features of PPP. Confluent parakeratosis, psoriasiform epidermal hyperplasia, clubbing and anastomosing of the rete ridges favoured PPP. Meanwhile, multiple foci of parakeratosis, irregular epidermal hyperplasia and thinning of rete ridges were more often observed in pompholyx. However, dyskeratotic cells, papillary dermal oedema, dilated capillaries and acrosyringium were not significantly different between the two diseases.
Conclusions Several histological features could serve as useful ‘clues’ to differentiate between PPP and pompholyx.