Microcirculatory Impairment as a Factor in Inflammatory Tissue Damage*

Whole field laser Doppler imaging of the microcirculation in psoriasis and clinically unaffected skin

“…These vascular modifications of cutaneous microcirculation represent one of the earliest detectable histological changes and are typical in all stages of lesional development (13). In addition, the increased dilatation, tortuosity, and permeability of these dermal papillary capillaries precede visual epidermal hyperplasia (14,15) and disappear with disease clearance (12). The vascular changes during early stages of psoriasis pathogenesis closely correlate with enhanced cutaneous blood flow, even in the neighboring perilesional, clinically unaffected skin (16,17).…”

Dermal vasculature in psoriasis and psoriasiform dermatitis: A morphometric study

“…[2] Some authors have reported that these vascular morphologic changes precede the visible epidermal hyperplasia. [3] These changes also correlate with enhanced cutaneous blood flow, including in the perilesional clinically unaffected skin. [7] It has been proposed that vascular changes in the papillary dermis, including enhanced expression of adhesion molecules, permit leukocyte adhesion and assist in the establishment of inflammatory response.…”

“…[2] The vascular changes may also precede the epidermal alterations, as shown in some studies. [3] Morphometric evaluation of dermal vasculature in psoriasis has shown increased endothelial and luminal volume of vessels compared to control subjects. [4] Studies utilizing native capillaroscopy have demonstrated reduction in microvessel density and length density after pulsed dye laser treatment.…”

Angiogenesis and oxidative stress: Common mechanisms linking psoriasis with atherosclerosis

“…These factors stimulate the formation of thin-walled, fragile new capillaries with increased permeability, and primed to allow leukocyte transmigration into areas of inflammation via enhanced expression of cell adhesion molecules including Eselectin, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) [15,16,29,36,[50][51][52]. Inflammatory cells such as macrophages and T lymphocytes infiltrate the skin or vessel wall through these newly formed capillaries and produce pro-inflammatory cytokines that have also been shown to have pro-angiogenic effects, including IL-8, TNF-a, and IL-17 [44,45] (Table 1).…”