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Dermoscopy in General Dermatology
Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Konstantinos Lallas, Zoe Apalla, Aimilios Lallas
Often, thick superficial scales may impede the visualization of the vascular structures. Mechanical removal of the scales or application of isopropyl alcohol often will help reveal the dotted vessels (dermoscopic Auspitz sign).66
Diagnosing Skin Disease
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
The unique accessibility of the skin allows for the utilization of a variety of tests that can be readily carried out in the clinical setting. Manipulation of the skin by a clinician is one such test that can yield useful diagnostic information. In the case of Darier’s sign, vigorous rubbing of the patient’s skin can support the diagnosis of mastocytosis when it results in significant swelling, itch, and erythema. The presence of Auspitz’s sign, which is the appearance of punctate bleeding after the scraping of scaly lesions, can be indicative of psoriasis. Additionally, the shearing of skin with rubbing, known as the Nikolsky sign, can be a clinically useful diagnostic finding in the evaluation of blistering skin disorders, such as pemphigus and toxic epidermal necrolysis.
Angiogenesis and Roles of Adhesion Molecules in Psoriatic Disease
Published in Siba P. Raychaudhuri, Smriti K. Raychaudhuri, Debasis Bagchi, Psoriasis and Psoriatic Arthritis, 2017
Asmita Hazra, Saptarshi Mandal
The angiogenesis in the psoriatic plaque clinically manifests as the Auspitz sign, named after Austrian dermatologist Carl Heinrich Auspitz (1835–1886 AD), who may have noted the sign when he was a medical student; however, some consider it a misnomer, as it may have been discovered even earlier. It is the view of the array of pinpoint capillary bleeding from the tips of psoriatic papillae containing the dilated loops when the silvery scaly parakeratotic epidermal roof is peeled off.
Skin diseases of the vulva: inflammatory, erosive-ulcerating and apocrine gland diseases, zinc and vitamin deficiency, vulvodynia and vestibulodynia
Published in Journal of Obstetrics and Gynaecology, 2018
Freja Lærke Sand, Simon Francis Thomsen
Psoriasis is a common chronic inflammatory skin disease that may affect the vulva. Pruritic vulvar psoriatic lesions have been described in 23% of women with plaque type psoriasis (Zamirska et al. 2008). Vulvar psoriasis is likely to be underdiagnosed, especially as perianal-genital inverse psoriasis often is the initial presentation of the disease and may long be considered to be simple intertrigo (Kapila et al. 2012). Vulvar psoriasis is common in children with genital complaints (Fischer and Rogers 2000). Vulvar psoriasis is characterised by well-demarcated, symmetrical, erythematous, slightly scaly, macular, infiltrated plaques (Figure 8). Upon scraping off the scaly roof of one of these lesions, a brightly red, punctately bleeding (Auspitz’s sign) membrane (Bulkley’s membrane) appears which aids in the diagnostic work up. Histopathological examination is usually not required but shows an acanthotic epidermis with hyper-parakeratosis, widened dermal papillae with dilated, twisted capillaries and a sparse inflammatory infiltrate dominated by lymphocytes. Remission can usually be obtained by topical treatment with mediopotent corticosteroids, but since long-term therapy is often needed, topical tacrolimus ointment may be of benefit (Wang and Lin 2014). In severe refractory vulvar psoriasis therapy with methotrexate or biologics may be indicated.