Auspitz sign

What is Auspitz sign?

Auspitz sign is seen in psoriasis which is described as small or pinpoint bleeding points on removal of psoriatic plaques.

What is Grattage test?

Grattage test - Test by which Auspitz sign is elicited is called as Grattage test.

What are the conditions in which Auspitz sign is seen?

	Auspitz sign positive
1	Psoriasis
2	Darier’s disease
3	Actinic keratosis

What is the cause of Auspitz sign [pinpoint bleeding]?

Pinpoint bleeding - bleeding that is found with removal of psoriatic plaques is due to:

• Abnormal growth of keratinocytes push cells to the surface of the skin faster which becomes dry out and harden.
• Thinning of the epidermal layer overlying the tips of the dermal papillae.
• Because the underlying cells have not yet matured, the capillaries just below remain largely unprotected.
• Blood vessels within the papillae [papillary vessels] are dilated and tortuous.
• When scales are removed the premature tissues may rupture and can cause damage of the capillary walls.

What is the sensitivity and specificity of psoriasis?

Not specific for psoriasis - also seen in other diseases

Not sensitive for psoriasis - frequently absent in psoriasis [seen in only <18% cases]