The histopathological hallmark that uniquely distinguishes lichen planus from psoriasis is:
- A Munro's microabscesses in the stratum corneum
- B Saw-tooth acanthosis with band-like lymphohistiocytic infiltrate and civatte bodies ✓
- C Spongiosis with intraepidermal vesicle formation
- D Granular layer absent with parakeratosis
Correct answer: B. Saw-tooth acanthosis with band-like lymphohistiocytic infiltrate and civatte bodies
Explanation
Lichen planus histopathology shows: (1) saw-tooth (zigzag) acanthosis, (2) hypergranulosis (thickened granular layer), (3) band-like lymphohistiocytic infiltrate at DEJ, (4) civatte (colloid/hyaline) bodies — apoptotic keratinocytes at the DEJ, and (5) vacuolar degeneration of basal layer. Munro's microabscesses and lack of granular layer with parakeratosis are psoriasis features. Spongiosis with intraepidermal vesicle is eczema/spongiotic dermatitis.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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