What Is Auspitz Sign?

Find Out What Auspitz Sign Is and When It Appears

The "Auspitz sign" (also sometimes called "Auspitz's sign") refers to the bleeding that can occur when the surface of a scaling rash (such as psoriasis or another condition) has been removed. Removing the top of a scale results in bleeding because it slices the capillaries, thin blood vessels that run just under the top layer skin.

This bleeding occurs due to the thinning of the epidermis—the outermost layer of the skin—in conditions such as psoriasis.

When the epidermis is thin, the dermis (the layer of the skin just below the epidermis that is rich in blood vessels) is in close contact with the scale. This causes multiple tiny dots of blood to form on the surface of the skin.

The Auspitz sign was named in honor of Heinrich Auspitz (1835-1886), the Austrian dermatologist who discovered it. 

Conditions in Which Auspitz Sign May Occur

Auspitz's sign can be associated with any of these three skin conditions:

  • Psoriasis
  • Darier's disease
  • Actinic keratoris

Now, take a look at these conditions individually for a more in-depth look at each.

Psoriasis

Psoriasis is a common condition that affects roughly two percent of the population. If you've ever wondered (perhaps after skinning your knees) what would happen if your skin grew more quickly—for example, if new cells took just a few days to grow, rather than weeks—psoriasis is an example. Psoriasis is essentially an immune disorder in which your skin grows too fast, but, unfortunately, this disorder doesn't lead to faster healing of scrapes.

That's because the old cells don't go away—they stay put. The result is a pile of cells that form the characteristic plaques and scales of psoriasis.

There are several different types of psoriasis, and even without these groups, the severity of the disease can vary greatly. Common types include:

Darier's Disease

Darier's disease (also known as Darier disease) is another condition that can cause scales and plaques on the skin—often on the scalp, knees, and elbows, as with psoriasis. It is an uncommon condition that's caused by a mutation in the ATP2A2 gene.

The lesions on the skin look similar to warts and often have a yellow tinge. They may appear greasy (in contrast to psoriasis and actinic keratoses, which have a dry appearance). They may also emit a strong and unpleasant odor.

A different sign, the carpet tack sign, is a characteristic of Darier's disease that is not seen in psoriasis or actinic keratoses. This sign describes the appearance of the underside of a scale, which has horn-like projections on it. 

People with Darier's disease may have lesions inside the mouth, and they may have other conditions related to the gene mutation, such as epilepsy or mild intellectual disability.

Actinic Keratoses

Actinic keratoses are precancerous skin growths that are most often caused by sun exposure. As such, they most commonly occur on skin surfaces that are exposed to the sun.

They can turn into squamous cell carcinomas of the skin if they're not treated. It's thought that 20 to 40 percent of squamous cell cancers first present as an actinic keratosis.

Actinic keratoses may be flesh-colored, pink, brown, or black and have a rough texture. They may appear like something is stuck to the skin, rather than a part of the skin.

Like psoriasis, actinic keratoses are also very common. They are more common in people over the age of 50.

Sources:

Kumar, Vinay, Abul K. Abbas, Jon C. Aster, and James A. Perkins. Robbins and Cotran Pathologic Basis of Disease. Philadelphia, PA: Elsevier/Saunders, 2015. Print.

Nellen, R., Steijlen, P., van Steensel, M. et al. Mendelian Disorders of Cornification Caused by Defects in Intracellular Calcium Pumps: Mutation Update and Database for Variants in ATP2A2 and ATP2C1 Associated with Darier Disease and Hailey-Hailey Disease. Human Mutation. 2016 Dec 30. (Epub ahead of print).

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