A Study of Conjunctival Impression Cytology in Patients with Various Types of Psoriasis
Maurya Rajendra P, Kumar Prakash, Bhushan Prashant, Singh Virendra P, Singh Mahendra K, Singh Sanjay, Garbyal Rajendra S, Garbyal Rajendra S and Kumar Mohan
World Journal of Pathology 2012, 1:11
To evaluate the changes in specimens of conjunctival impression cytology specimens in patients suffering from various types of psoriasis.
Departments of Ophthalmology, Pathology and Dermatology & Venerology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) INDIA.
Materials and Methods:
In this case control study, conjunctival impression cytology specimens were obtained from 29 psoriatic patients and 12 healthy controls without having any ocular abnormalities between November 2006 and May 2008. Specimens were graded on a scale of zero to three according to Nelson’s grading systems.
Out of 29 psoriatic patients, 82.3% had chronic plaque type, 10.3% had Erythrodermoid and 3.9% had pustular type of psoriasis. Conjunctival epithelial changes were observed in 23 (79.31%) patients (grade I changes in 41.4%, grade II in 27.6% and grade III changes in 20.7%). In the control group only 2(16.7%) cases had grade I changes while rest showed no epithelial changes. All cases of psoriatic erythroderma revealed worse cytological changes (grade III in 66% and grade II in 33.3% cases) while 29.2% of chronic plaque psoriasis and 50% of pustular psoriasis showed worse cytological changes. There was no significant correlation between duration of the disease and severity with cytological grading.
Conjunctival impression cytology being a simple and non-invasive technique can be an important guideline in early diagnosis and treatment of ocular changes in psoriasis patients. As in our study, psoriatic erythroderma cases showed worse cytological changes (grade II
& III) than other types of psoriasis. Hence early intervention and referral of these types of psoriasis patients to ophthalmologists is essential.