Quantification of histopathological changes in patients with psoriasis before and after phototherapy

Abstract

Background One of the most used resources for the treatment of psoriasis is ultraviolet radiation (UV) with psoralens (PUVA) and narrow‐band UV (UVB‐NB 311‐312 nm). Although many researchers have assessed the histopathological effects of this therapy modality, none used a morphological classification system specific to psoriasis. Purpose To assess the clinical and histopathological response in the phototherapy treatment of plaque psoriasis with PUVA and UVB‐NB with use of PASI and TROZAK. Methods Histopathological changes of plaque psoriasis were quantified with help of the grading system for psoriasis—Trozak in 20 patients of both sexes, before and after 32 PUVA phototherapy sessions (10 patients—GPUVA) and UVB‐NB (10 patients—GUVB‐NB). The severity and extension of psoriasis was evaluated through PASI. The slides stained with hematoxylin and eosin were scanned in an Aperio CS2 scanner (Leica Biosystems) and evaluated through the software ImageScopeTM (Aperio Technologies). Statistical analysis was performed with the use of the program SPSS 22.0, with application of the Wilcoxon and Mann‐Whitney tests. Results All patients presented improvement in psoriatic plaques with decrease in PASI after treatment (P < 0.01) and significant reduction in histopathological changes in psoriasis from 15.4 ± 1.7 to 3.7 ± 3.2 (P < 0.01) in group GPUVA and from 13.2 ± 1.7 to 4.9 ± 5.2 (P < 0,01) in group GUVB‐NB. Conclusions Phototherapy, regardless of type, is an effective treatment for moderate and severe psoriasis, with possibility of being quantified clinically by PASI and histopathologically by Trozak.

Relationship between histomorphological findings and platelet activation in psoriasis

“…Still, the grading system applied to determine the severity of histopathological findings in psoriasis patients was partially subjective. However, the morphometric analysis objectively evaluates epidermal parameters 9,21,22 …”

“…However, the morphometric analysis objectively evaluates epidermal parameters. 9,21,22 To the best of our knowledge, our study is the first to investigate the relationship between histomorphological findings obtained by We assume that an increased risk of platelet activation-related diseases is expected in psoriasis patients displaying histopathological findings of suprapapillary thinning due to increased platelet activation; therefore, it may be beneficial to monitor these patients in terms of such risks.…”

Atypical koebner phenomenon on a tattoo

“…It is well known that psoriatic patients benefit from sun exposure; indeed, UV radiation is one of the approved treatments for psoriasis …”