Psoriasis is an inflammatory skin condition that affects about 3% of U.S. adults. It causes patches of scaly plaques to form on one or more parts of the body, as well as changes in the appearance of fingernails or toenails.
When psoriasis scales have been rubbed or picked off and tiny points of blood are visible, the condition is called Auspitz sign. It does not happen only with psoriasis but may happen with other skin conditions as well.
The goals of treatment are to prevent infection and speed up healing. This is usually done with a combination of topical and oral medications. Because Auspitz sign can lead to infection and worsening inflammation, it’s important to see a doctor if you suspect the condition has developed.
The main symptom of Auspitz sign is pinpoint bleeding that emerges when a patch of scaly skin is removed.
Skin plaques can fall off on their own, be picked off intentionally, or be rubbed off by clothing or contact with another part of the body. For example, psoriasis rashes can form behind the knee. When you bend your knee, the plaques could rub against unaffected skin, and some plaques could flake off.
Areas affected by Auspitz sign may be large or small. You may see the bleeding easily or a healthcare professional may need to use a dermascope, an instrument similar to a magnifying glass.
Auspitz sign develops because the tissue just beneath the inflamed outer skin layer contains tiny blood vessels, called capillaries, that are vulnerable to injury when the scaly skin comes off. The forcible removal of surface skin can cause the capillaries to rupture.
A healthcare professional can often diagnose psoriasis with a visual inspection of the skin. If they see Auspitz sign, it may suggest that you have psoriasis — but it’s not enough to confirm a diagnosis.
A visual exam for other signs of psoriasis is often enough to make a diagnosis. A healthcare professional may also perform a biopsy, where they’ll remove a small sample of skin and have it tested at a lab.
Auspitz sign is most often associated with psoriasis, but it may be present with other skin conditions as well. Two conditions in particular — actinic keratosis and Darier disease — are commonly accompanied by Auspitz sign.
Actinic keratosis
Actinic keratosis is a much more common condition than psoriasis. It affects an estimated 40 million Americans. Like psoriasis, actinic keratosis can cause patches of scaly bumps and plaques on the skin.
Actinic keratosis is a precancerous skin condition, usually triggered by sun damage.
Darier disease
While psoriasis is usually characterized by patches of scaly plaques, Darier disease symptoms include wart-like patches. The patches are often yellowish in color, greasy, and hard to the touch. They may give off a strong odor, too.
Auspitz sign treatment is primarily focused on healing the affected skin and preventing an infection. A dermatologist will likely prescribe a topical antibiotic and recommend gently cleaning and covering the areas of bleeding to allow them to recover and remain protected.
Further treatments depend on the underlying cause of Auspitz sign. Certain treatments and precautions may be similar across all conditions where you might have Auspitz sign.
For example, the use of topical retinoids may be appropriate whether you have psoriasis, actinic keratosis, or Darier disease. Retinoids are medications that promote new skin cell formation.
It’s also important, regardless of the current health of your skin, to use sunscreen and wear protective clothing when outdoors.
Other common treatments for the conditions most commonly associated with Auspitz sign include:
Psoriasis
Because psoriasis is an inflammatory condition related to atypical immune system function, a dermatologist may prescribe topical corticosteroids to manage the inflammation and an oral immunosuppressant medication to reduce the body’s immune system response.
Skin moisturizers may also help keep the affected areas from drying out and flaking off, which raises the risk of more Auspitz sign complications.
Actinic keratosis
Treatment of actinic keratosis often involves the removal of the skin growths. Common procedures that healthcare professionals may use include:
A healthcare professional may sometimes prescribe a type of antimetabolite medication, such as topical 5 fluorouracil. This may come in either oral form or as a topical ointment, and it works to destroy fast-growing cells.
Darier disease
Healthcare professionals often prescribe topical corticosteroids and benzoyl peroxide to treat the patches that happen with Darier disease. They may also prescribe an oral antibiotic and an immunosuppressant drug like cyclosporine.
When psoriasis flares up, the tissue underneath the plaques hasn’t matured enough to protect the capillaries underneath. If plaques are picked or rubbed off, those little blood vessels can break.
They may then look like a patch of pinpoint bleeding called Auspitz sign.
You can work with a dermatologist or other medical professional to manage your skin conditions effectively. If you or a doctor think you have Auspitz sign, it may help them diagnose an underlying condition.
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