title: The histopathological differentiation between palmar psoriasis and hand eczema: A retrospective review of 96 cases.
abstract: BACKGROUND
  The histopathologic differences among palmar psoriasis (PP), hand eczema (HE), and hyperkeratotic hand dermatitis (HHD) have been poorly described.
  
  
  OBJECTIVE
  We sought to distinguish among PP, HE, and HHD on a histopathologic basis.
  
  
  METHODS
  We retrospectively analyzed the histology of hematoxylin-eosin-stained sections obtained from 96 patients diagnosed with PP, HE, or HHD.
  
  
  RESULTS
  The patients were divided into 4 subgroups: PP (n = 16, group A), HE without atopic or nummular dermatitis (n = 41, group B), HE with atopic or nummular dermatitis (n = 14, group C), and HHD (n = 25, group D). Loss of the granular layer (group A 62.5%, group B 24.4%, group C 0%) was more consistent with a diagnosis of PP (P = .047) than HE (P = .002). Psoriasiform epidermal hyperplasia (group B 36.6%, group C 35.7%, group D 72.0%) favored a diagnosis of HHD (P = .01) over HE (P = .043).
  
  
  CONCLUSIONS
  Limitations of this study include its retrospective nature and small sample size.
  
  
  CONCLUSIONS
  Our study demonstrated that a significant difference exists in the thickness of the granular layer between PP and HE, which might be helpful in differentiating between these 2 conditions. There was no difference between PP and HHD.
authors.affiliation: Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Jun Yeong
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Eun Byul
authors.initials: EB
authors.lastname: Cho
authors.affiliation: Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Park
authors.affiliation: Department of Pathology, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Hye Rim
authors.initials: HR
authors.lastname: Park
authors.affiliation: Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea. Electronic address: dermakkh@naver.com.
authors.forename: Kwang Ho
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Kwang Joong
authors.initials: KJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004485:Eczema / Q000473:pathology*; D005260:Female; D006229:Hand Dermatoses / Q000473:pathology*; D006801:Humans; D007645:Keratoderma, Palmoplantar / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000473:pathology*; D012189:Retrospective Studies; D055815:Young Adult