Auspitz's sign

Auspitz's sign is the appearance of punctate bleeding spots when psoriasis scales are scraped off, named after Heinrich Auspitz.{{WhoNamedIt|synd|101|Auspitz' symptom}} It may also be seen in Darier's disease and actinic keratosis.{{cite journal |last1=Freiman |first1=Anatoli |last2=Kalia |first2=Sunil |last3=O'Brien |first3=Elizabeth A. |title=Dermatologic Signs |journal=Journal of Cutaneous Medicine and Surgery |date=July 2006 |volume=10 |issue=4 |pages=175–182 |doi=10.2310/7750.2006.00042|pmid=17234116 |s2cid=44484524 }}

Importantly, as with many eponymous clinical signs,{{cite journal |last1=Woywodt |first1=Alexander |last2=Matteson |first2=Eric |title=Head to Head: Should eponyms be abandoned? Yes |journal=BMJ: British Medical Journal |date=1 September 2007 |volume=335 |issue=7617 |pages=424 |doi=10.1136/bmj.39308.342639.AD |pmid=17762033 |pmc=1962844 |language=en}}{{cite journal |last1=Ferguson |first1=Robert P. |last2=Thomas |first2=Deborah |title=Medical eponyms |journal=Journal of Community Hospital Internal Medicine Perspectives |date=2014 |volume=4 |issue=3 |pages=10.3402/jchimp.v4.25046 |doi=10.3402/jchimp.v4.25046 |pmid=25147644 |pmc=4120137 |language=en}} Heinrich Auspitz was not the first to discover the sign named after him. It was Auspitz's mentor at the Medical University of Vienna (Ferdinand von Hebra) and Parisian dermatologist Marie Devergie who first noted the punctate hemorrhages underlying psoriasis scales.{{cite journal |title=Acantholysis or the Auspitz sign? A revelation of the life of Carl Heinrich Auspitz |journal=Indian Journal of Dermatology, Venereology and Leprology |date=30 June 2017 |url=https://ijdvl.com/acantholysis-or-the-auspitz-sign-a-revelation-of-the-life-of-carl-heinrich-auspitz/ |access-date=26 December 2021}}

This pinpoint bleeding results from a thinning of the epidermal layer overlying the tips of the dermal papillae. Blood vessels within the papillae are dilated and tortuous, and often bleed readily when the scale is removed.{{cite book|last=Kumar|title=Robbin's Text book of Pathology|year=2010|publisher=Elsevier|location=New Delhi|isbn=978-81-312-1036-9|pages=841|display-authors=etal}}

Although classically associated with psoriasis, subsequent research has found Auspitz's sign to be of very little diagnostic value for the disease. This is because several other diseases display the sign (including Darier's disease and actinic keratosis). Additionally, only a minority of psoriasis scales show it when removed (<18%).{{cite journal |last1=Bernhard |first1=J. D. |title=Auspitz sign is not sensitive or specific for psoriasis |journal=Journal of the American Academy of Dermatology |date=June 1990 |volume=22 |issue=6 Pt 1 |pages=1079–1081 |doi=10.1016/0190-9622(90)70155-b |pmid=2370333 |url=https://pubmed.ncbi.nlm.nih.gov/2370333/ |access-date=26 December 2021 |issn=0190-9622}} This overall indicates that Auspitz's sign is neither highly sensitive nor specific for psoriasis, and thus should only be used in combination with other findings to make a diagnosis.{{clarify|date=July 2023}}