Clinical, ultrasound, and videodermatoscopy monitoring of psoriatic patients following biological treatment

Abstract

VD and US may be useful to monitor psoriasis treatment. Further investigations are warranted to assess if the persistence of an altered vascular pattern despite clinical and US normalization, as observed in 22% of patients, may influence disease progression and/or correlate with rate and severity degree of relapse.

Dermoscopic features of psoriasis of the skin, scalp and nails – a systematic review

“…5). 14,23,24 Similar vasculature was observed in dermoscopy of psoriatic lesions located on glans penis. In 6 patients with psoriatic balanitis, Lacarrubba et al 17 reported homogenous, bushy vessels.…”

“…Also, the efficacy of therapy with biologics, with a good prognostic factor of purpuric dots, cyclosporine and long-term therapy with potent steroids, with patterns that indicate the overuse, was monitored by dermoscopy. 11,14,16,[19][20][21][22]56 While revising the literature, the authors noted the need of terminology unification which is subjective in terms, especially as regards studies concerning onychoscopic features of psoriasis. Further limitations of the present study were lack of histological confirmation of the disease in many cases and too small samples in some studies; moreover, the use of different dermoscopes may have influenced the results.…”

“…The mean diameter of bushy vessels was 79.6 lm (range 45-146 lm). 3,[14][15][16][19][20][21][22] The highest mean diameter of bushy capillaries equalling 87.9 lm (authors did not provide data of standard deviation of this diameter) was observed on elbows. 16 The lowest mean diameter of bushy capillaries, equalling 68.8 AE 17.2 lm was observed in psoriatic plaques located on upper limbs.…”

“…12,13 Videodermoscopy with the use of over a 50-fold magnification enables a detailed evaluation of the size and structure of vessels. Red dots/globules visualized by over 50-fold magnification are described as 'bushy capillaries', 3,12,[14][15][16][17][18] 'convoluted basket-like capillaries' [20][21][22] or 'basket-weave capillaries' (Fig. 3).…”

High capillary diameter in psoriatic plaques of the lower legs

“…Vascular pattern evaluation by VD in psoriasis provides important information on the therapeutic response, showing normalization or persistence in clinically healed psoriatic plaques . Our results showed a higher mean capillary bush diameter in psoriatic plaques located on the lower legs, reflecting increased vascular flow.…”