Impetiginization Rates of Plaque Psoriasis Skin Lesions

Abstract
Psoriasis has generally been thought to have low rates of impetiginization, however literature to support this is scarce. Therefore, we studied the rate of impetiginization in biopsies of psoriasis. Furthermore, we compared the rate of impetiginization in psoriasis biopsies to biopsies of spongiotic dermatitis, a heterogenous group of disorders containing many eczematous processes that are often thought to have higher rates of impetiginization. Retrospective chart review was used to identify individuals who underwent biopsies with a final diagnosis of psoriasis or spongiotic dermatitis. 50 biopsies of psoriasis and 51 biopsies of spongiotic dermatitis were analyzed histologically for presence of bacteria, erosion and neutrophils which showed similar rates of bacterial impetiginization between psoriasis (18.0%) and dermatitis (17.65%) samples. Erosion was seen less frequently in psoriasis (6.0%) compared to dermatitis (29.41%) samples, however, presence of neutrophils was significantly higher in psoriasis (98%) in comparison to dermatitis (41.18%) biopsies. When characterizing prevalence of bacteria by anatomic site or age group, no significant difference was seen between the two cohorts. Potential limitations include small cohort size and inability to control for treatments which may have influenced the prevalence of bacteria, erosion, and neutrophils in skin biopsies. In conclusion, rates of bacterial impetiginization are similar between atopic dermatitis and psoriasis biopsies adding to the limited existing literature that psoriatic lesions indeed do experience impetiginization.

Financial Disclosure:
No current or relevant financial relationships exist.

Published in: ASDP 59th Annual Meeting, USA

Publisher: The American Society of Dermatopathology
Date of Conference: October 17-23, 2022