Lifting the Silver Flakes: The Pathogenesis and Management of Chronic Plaque Psoriasis
Clinical and histological appearance of stable chronic psoriatic plaques. Note the well-demarcated erythematous plaques covered by white-silvery scales distributed on the lower back (a), extremities (b), and scalp (c). Histological appearance of the chronic psoriatic plaque (d) reveals acanthosis (white arrow head), elongated epidermal rete ridges (two-headed arrow), and hyperkeratosis (black arrow head). Inflammatory cells are present in the dermis (long arrow) and sometimes in the epidermis known as Munro’s microabscess which are composed of neutrophils (short arrow).