After the plaque of psoriasis resolves, there is often an area of altered pigmentation that remains. This may appear as a splotchy area that is of altered pigmentation to the surrounding skin.
The study by Wang et al. provides insight into the pathogenesis of this skin change.
They note that tumor necrosis factor-alpha (TNF-alpha) and interleukin-17 (IL-17) synergistically increased the number of melanocytes whilst decreasing the pigmentary production of those melanocytes.
The article states:
"We observed increased density of melanocytes at the basal layer of the epidermis during psoriasis resolution, which highly resembled the pathology of lentigo (Figure 4b). Increased number of melanocytes, combined with a rapid recovery of pigmentation function during psoriasis resolution, may lead to an abundant production of melanin, which will persist in keratinocytes during treatment until the pigmented keratinocytes are shed."
In addition to explaining the pigmentary changes that result when a psoriatic plaque heals, the article may shift the paradigm of potential tumorigenesis in psoriasis.
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