Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
The Auspitz sign (a.k.a. Auspitz’s sign) refers to pinpoint bleeding that can occur when the surface of a scaling rash has been removed andcapillariesjust beneath the skin’s surface rupture. Although the Auspitz sign is commonly associated withpsoriasis, it can appear with other skin diseases, includingactinic keratosisand Darier’s disease. Its presence can often help doctors make a diagnosis.
This article will take you through the symptoms, causes, diagnosis, and treatment of Auspitz’s sign.
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The Auspitz sign was named after Heinrich Auspitz (1835–1886), the Austrian dermatologist who first identified the clinical symptom.
Symptoms of Auspitz Sign
The clustered blood spots may be large or small depending on the area of skin involved. If scratched intensely, there may even be crusted clots on the surface of the skin. In other cases, the skin may be peppered with tiny red spots, almost pore-like in their distribution, with little to no bleeding.
The location of the Auspitz sign, along with accompanying symptoms, may provide clues as to the type of disease involved. Potentials include:
Unlike psoriasis or actinic keratosis, Darier’s disease can also affect mucosal tissues of the mouth, esophagus, and vagina.
Symptoms of Psoriasis
Causes of Auspitz Sign
Because the underlying cells have not yet matured into the enclosed outer layer of skin, called thestratum corneum, the capillaries just below remain largely unprotected. If scales are removed prematurely, they can rupture the still-developing tissues along with the walls of the capillaries.
Diagnosis of Auspitz Sign
Psoriasis
Psoriasis is diagnosed with a physical examination and a review of your medical history, such as a family history of psoriasis or a recent incident that may havetriggered the event.
If needed, tissue samples can be examined under the microscope to look for the characteristic flattening and compression of cells, called acanthosis. The skin scales will also appear lamellar (flat and like a fish scale).
How Psoriasis Is Diagnosed
Actinic Keratosis
The diagnosis of actinic keratosis is similar to that of psoriasis. For this condition, the doctor will look for evidence of sun damage. A microscopic examination of askin biopsywould reveal a “flag sign” in which alternating layers of skin cells—some with nuclei and others without—are visible. The skin scales will also be more horn-like rather than lamellar.
Darier’s Disease
Most people with Darier’s disease will have a family member with a history of the condition. If no family history is found, a skin biopsy may be performed.
Under the microscope, apathologistwould see three things: the thickening of tissue, a plugging of hair follicles, and the granulation of keratinocytes near the surface of the skin. The scales would also have a characteristic “carpet tack” appearance similar to other follicular diseases.
To confirm the diagnosis of Darier’s disease, a genetic test can be performed to identify the ATP2A2 gene mutation. Another tell-tale sign is the appearance of mucosal lesions.
Treatment of Auspitz Sign
The Auspitz sign is not treated, per se. Rather, the aim is to prevent infection with warm soap and water and atopical antibiotic. To resolve the symptoms, you would need to resolve the underlying disorder.
With psoriasis, this may involve:
With actinic keratosis, this may involve:
With Darier disease, they may involve:
Summary
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gisondi P, Bellinato F, Girolomoni G.Topographic differential diagnosis of chronic plaque psoriasis: challenges and tricks.J Clin Med. 2020;9(11):3594. doi:10.3390/jcm9113594Luengas-Martinez A, Hardman-Smart J, Paus R, Young HS.Vascular endothelial growth factor-A as a promising therapeutic target for the management of psoriasis.Exp Dermatol. 2020;29(8):687-698. doi:10.1111/exd.14151Tampa M, Mitran MI, Mitran CI, Matei C, Georgescu SR.Psoriasis: what is new in markers of disease severity?.Medicina (Kaunas). 2024;60(2):337. doi:10.3390/medicina60020337Reinehr CPH, Bakos RM.Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects.An Bras Dermatol. 2019;94(6):637-657. doi:10.1016/j.abd.2019.10.004Leong IUS, Stuckey A, Ahanian T, Cederlöf M, Wikstrom JD.Novel mutations in Darier disease and association to self-reported disease severity.PLoS One. 2017;12(10):e0186356. doi:10.1371/journal.pone.0186356Suryawanshi H, Dhobley A, Sharma A, Kumar P.Darier disease: a rare genodermatosis.J Oral Maxillofac Pathol. 2017;21(2):321. doi:10.4103/jomfp.JOMFP_170_16Nițescu DA, Mușetescu A, Nițescu M, Costescu M, Coman OA.Experimental research in topical psoriasis therapy (review).Exp Ther Med. 2021;22(3):971. doi:10.3892/etm.2021.10403Dianzani C, Conforti C, Giuffrida R, et al.Current therapies for actinic keratosis.Int J Dermatol. 2020;59(6):677-684. doi:10.1111/ijd.14767Deepika K.Darier’s disease.Pon J Nurs.2020;13(2):43–45. doi:10.5005/jp-journals-10084-12138
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gisondi P, Bellinato F, Girolomoni G.Topographic differential diagnosis of chronic plaque psoriasis: challenges and tricks.J Clin Med. 2020;9(11):3594. doi:10.3390/jcm9113594Luengas-Martinez A, Hardman-Smart J, Paus R, Young HS.Vascular endothelial growth factor-A as a promising therapeutic target for the management of psoriasis.Exp Dermatol. 2020;29(8):687-698. doi:10.1111/exd.14151Tampa M, Mitran MI, Mitran CI, Matei C, Georgescu SR.Psoriasis: what is new in markers of disease severity?.Medicina (Kaunas). 2024;60(2):337. doi:10.3390/medicina60020337Reinehr CPH, Bakos RM.Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects.An Bras Dermatol. 2019;94(6):637-657. doi:10.1016/j.abd.2019.10.004Leong IUS, Stuckey A, Ahanian T, Cederlöf M, Wikstrom JD.Novel mutations in Darier disease and association to self-reported disease severity.PLoS One. 2017;12(10):e0186356. doi:10.1371/journal.pone.0186356Suryawanshi H, Dhobley A, Sharma A, Kumar P.Darier disease: a rare genodermatosis.J Oral Maxillofac Pathol. 2017;21(2):321. doi:10.4103/jomfp.JOMFP_170_16Nițescu DA, Mușetescu A, Nițescu M, Costescu M, Coman OA.Experimental research in topical psoriasis therapy (review).Exp Ther Med. 2021;22(3):971. doi:10.3892/etm.2021.10403Dianzani C, Conforti C, Giuffrida R, et al.Current therapies for actinic keratosis.Int J Dermatol. 2020;59(6):677-684. doi:10.1111/ijd.14767Deepika K.Darier’s disease.Pon J Nurs.2020;13(2):43–45. doi:10.5005/jp-journals-10084-12138
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Gisondi P, Bellinato F, Girolomoni G.Topographic differential diagnosis of chronic plaque psoriasis: challenges and tricks.J Clin Med. 2020;9(11):3594. doi:10.3390/jcm9113594Luengas-Martinez A, Hardman-Smart J, Paus R, Young HS.Vascular endothelial growth factor-A as a promising therapeutic target for the management of psoriasis.Exp Dermatol. 2020;29(8):687-698. doi:10.1111/exd.14151Tampa M, Mitran MI, Mitran CI, Matei C, Georgescu SR.Psoriasis: what is new in markers of disease severity?.Medicina (Kaunas). 2024;60(2):337. doi:10.3390/medicina60020337Reinehr CPH, Bakos RM.Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects.An Bras Dermatol. 2019;94(6):637-657. doi:10.1016/j.abd.2019.10.004Leong IUS, Stuckey A, Ahanian T, Cederlöf M, Wikstrom JD.Novel mutations in Darier disease and association to self-reported disease severity.PLoS One. 2017;12(10):e0186356. doi:10.1371/journal.pone.0186356Suryawanshi H, Dhobley A, Sharma A, Kumar P.Darier disease: a rare genodermatosis.J Oral Maxillofac Pathol. 2017;21(2):321. doi:10.4103/jomfp.JOMFP_170_16Nițescu DA, Mușetescu A, Nițescu M, Costescu M, Coman OA.Experimental research in topical psoriasis therapy (review).Exp Ther Med. 2021;22(3):971. doi:10.3892/etm.2021.10403Dianzani C, Conforti C, Giuffrida R, et al.Current therapies for actinic keratosis.Int J Dermatol. 2020;59(6):677-684. doi:10.1111/ijd.14767Deepika K.Darier’s disease.Pon J Nurs.2020;13(2):43–45. doi:10.5005/jp-journals-10084-12138
Gisondi P, Bellinato F, Girolomoni G.Topographic differential diagnosis of chronic plaque psoriasis: challenges and tricks.J Clin Med. 2020;9(11):3594. doi:10.3390/jcm9113594
Luengas-Martinez A, Hardman-Smart J, Paus R, Young HS.Vascular endothelial growth factor-A as a promising therapeutic target for the management of psoriasis.Exp Dermatol. 2020;29(8):687-698. doi:10.1111/exd.14151
Tampa M, Mitran MI, Mitran CI, Matei C, Georgescu SR.Psoriasis: what is new in markers of disease severity?.Medicina (Kaunas). 2024;60(2):337. doi:10.3390/medicina60020337
Reinehr CPH, Bakos RM.Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects.An Bras Dermatol. 2019;94(6):637-657. doi:10.1016/j.abd.2019.10.004
Leong IUS, Stuckey A, Ahanian T, Cederlöf M, Wikstrom JD.Novel mutations in Darier disease and association to self-reported disease severity.PLoS One. 2017;12(10):e0186356. doi:10.1371/journal.pone.0186356
Suryawanshi H, Dhobley A, Sharma A, Kumar P.Darier disease: a rare genodermatosis.J Oral Maxillofac Pathol. 2017;21(2):321. doi:10.4103/jomfp.JOMFP_170_16
Nițescu DA, Mușetescu A, Nițescu M, Costescu M, Coman OA.Experimental research in topical psoriasis therapy (review).Exp Ther Med. 2021;22(3):971. doi:10.3892/etm.2021.10403
Dianzani C, Conforti C, Giuffrida R, et al.Current therapies for actinic keratosis.Int J Dermatol. 2020;59(6):677-684. doi:10.1111/ijd.14767
Deepika K.Darier’s disease.Pon J Nurs.2020;13(2):43–45. doi:10.5005/jp-journals-10084-12138
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