Systemic pathology: psoriasis histology: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Systemic pathology: psoriasis histology

Sample item

A 30-year-old man has well-demarcated silvery scaly plaques on the elbows and knees, with pinpoint bleeding on scraping the scale. Which histological feature is characteristic?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Neutrophil collections in a parakeratotic stratum corneum

Psoriasis shows regular epidermal hyperplasia, parakeratosis, loss of the granular layer, thinned suprapapillary plates and neutrophil collections in the stratum corneum (Munro microabscesses). Removal of the scale causes the Auspitz sign of pinpoint bleeding from dilated papillary capillaries.

Option by option

  • A. Suprabasal acantholysis with a tombstone appearance

    Suprabasal acantholysis is the feature of pemphigus vulgaris.

  • B. Saw-tooth rete ridges with a band-like lymphocytic infiltrate

    Saw-tooth rete ridges with a band-like infiltrate describe lichen planus.

  • C. Neutrophil collections in a parakeratotic stratum corneum (correct)

    Correct. Munro microabscesses in parakeratotic scale are typical of psoriasis.

  • D. Subepidermal blisters with eosinophils

    Subepidermal blisters with eosinophils are seen in bullous pemphigoid.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Neutrophil collections in a parakeratotic stratum corneum. Psoriasis shows regular epidermal hyperplasia, parakeratosis, loss of the granular layer, thinned suprapapillary plates and neutrophil collections in the stratum corneum (Munro microabscesses).

Why is "Suprabasal acantholysis with a tombstone appearance" not the answer?

Suprabasal acantholysis is the feature of pemphigus vulgaris.

Why is "Saw-tooth rete ridges with a band-like lymphocytic infiltrate" not the answer?

Saw-tooth rete ridges with a band-like infiltrate describe lichen planus.

Why is "Subepidermal blisters with eosinophils" not the answer?

Subepidermal blisters with eosinophils are seen in bullous pemphigoid.

What concept does this question test?

It tests Systemic pathology: psoriasis histology in Pathology. Removal of the scale causes the Auspitz sign of pinpoint bleeding from dilated papillary capillaries.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic pathology: psoriasis histology?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.