SKIN 
 

January 2019     Volume 3 Issue 1 
 

Copyright 2018 The National Society for Cutaneous Medicine 47 

COMPELLING COMMENTS 
 

 
Was it Auspitz’s Sign? 
 
Andrew M Armenta, BS1, Alex Steele, BS2, Mara M Dacso, MD3 
 
1University of Texas Medical Branch School of Medicine, Galveston, TX 
2University of Texas Health and Science Center at San Antonio, San Antonio, Texas 
3Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas 
 

 
 
The Auspitz sign describes the phenomenon 
of pinpoint bleeding following the scraping of 
psoriatic plaques’ silvery scale – a classic 
finding in psoriasis. This finding is due to both 
a thinning of the epidermis and exposure of 
the underlying dilated post-capillary venules 
located within the dermal papillae. Although 
first described in psoriasis, this clinical 
feature can be demonstrated in other skin 
conditions like Darier’s disease and actinic 
keratosis.1 
 
Today, most associate this psoriatic pinpoint 
bleeding with Carl Heinrich Auspitz, an 
Austrian dermatologist. However, contrary to 
what the eponym suggests, Auspitz was not 
the first to describe the phenomenom.2,3 The 
earliest known description of this finding was 
written by Daniel Turner, a disfranchised 
surgeon who, in 1736, wrote, “in [a 
patient],…whose Knee a large [Lichen] 
Eruption, was seated, accompanied with 
great itching: Whence, upon rubbing, a Scale 
should throw off…I raised one of these…with 
the Edge of my Spathula, several small 
Specks of Blood appeared underneath…”.2 
Again in 1808 while commenting on 
psoriasis, English dermatologist Robert 
Willan, wrote, “...should any portion of the 
diseased surface be forcibly excoriated, there 
issues out a thin lymph, mixed with some 
drops of blood”.2 30 years later, Auspitz’s 

mentor, Ferdinand Ritter von Hebra, was 
credited for first observing this clinical sign in 
one of Moritz Kaposi’s textbooks, without 
mention of Auspitz.2 How then did the name 
of Carl Heinrich Auspitz become tacked to 
this quickly recognizable finding?  
 
The Auspitz sign is known as it is today not 
because of his discovery, but rather his 
impactful treatise on pathology and 
therapeutics of the skin.3 It is in this treatise 
he describes the phenomenon that has been 
attributed to his name.3 It was translated into 
English in 1885 and became one of the early 
foundational pieces of modern European 
dermatopathology. 
 
 
Conflict of Interest Disclosures: None. 
 
Funding: None. 
 
Corresponding Author: 
Mara M. Dacso, M.D.  
University of Texas Southwestern Medical Center, 
Dallas, Texas 
mara.dacso@gmail.com  
  

References: 
1.  Bernhard, J.D., Auspitz sign is not 
sensitive or specific for psoriasis. J Am Acad 
Dermatol, 1990. 22(6 Pt 1): p. 1079-81. 

 

mailto:mara.dacso@gmail.com


SKIN 
 

January 2019     Volume 3 Issue 1 
 

Copyright 2018 The National Society for Cutaneous Medicine 48 

2. Holubar, K. and S. Fatović-Ferencić, 
Papillary tip bleeding or the Auspitz 
phenomenon: a hero wrongly credited and a 
misnomer resolved. J Am Acad Dermatol, 
2003. 48(2): p. 263-4. 
3. Shareef, S., et al., Acantholysis or the 
Auspitz sign? A revelation of the life of Carl 
Heinrich Auspitz. Indian J Dermatol 
Venereol Leprol, 2017. 83(4): p. 512.