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Psoriasis — SCE Dermatology MCQ

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ModerateDermatopathologyPsoriasisSCE Dermatology

A 46-year-old man has well-demarcated erythematous scaly plaques on the elbows, knees and scalp. A biopsy is taken because a palmar plaque is atypical. Histology shows regular acanthosis, thinning of suprapapillary plates, parakeratosis and neutrophils in the stratum corneum. What is the most likely diagnosis?

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Correct answer: E — Chronic plaque psoriasis

The best answer is “Chronic plaque psoriasis”. Dermatological surgery should preserve diagnostic architecture, orient closure with local tension and cosmetic units, and select reconstruction by defect depth, size, subunit and functional distortion risk. The alternatives “Hypertrophic lichen planus”, “Tinea corporis”, “Subacute cutaneous lupus”, “Pityriasis rubra pilaris” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: NICE HTG388 melanoma diagnostic practice: https://www.nice.org.uk/guidance/htg388/chapter/3-Clinical-need-and-practice