Reflectance confocal microscopy for plaque psoriasis therapeutic follow‐up during an anti‐<scp>TNF</scp>‐α monoclonal antibody: an observational multicenter study

Ardigò, Marco; Agozzino, Marina; Longo, Caterina; Lallas, Aimilios; Lernia, Vito Di; Fabiano, Antonella; Conti, Andrea; Sperduti, Isabella; Argenziano, Giuseppe; Berardesca, Enzo; Pellacani, Giovanni

doi:10.1111/jdv.13235

Cited by 20 publications

(24 citation statements)

References 23 publications

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“…After reviewing all publications, an overview of general psoriatic RCM features was provided for diagnostic and monitoring purposes (Table ). Four therapeutic follow‐up studies monitored different therapeutics; phototherapy [ultraviolet B (UVB) and psoralen ultraviolet A], topical non‐steroidal anti‐inflammatory drugs, topical corticosteroids, Methotrexate, Acitretin and/or Calcipotriol and Adalimumab by RCM . RCM features showed a good correlation with clinical improvement and improvement of Psoriasis Area Severity Index (PASI) scores .…”

Section: Methodsmentioning

confidence: 99%

“…RCM features showed a good correlation with clinical improvement and improvement of Psoriasis Area Severity Index (PASI) scores . In addition, RCM was able to show subclinical psoriatic features (orthokeratosis with abnormal compact aspect, high number of dermal papillae (DP), vascularization in DP and drastic reduction in inflammation) and in non‐responders to UVB large clustered tortuous capillaries were shown . Based on this literature (Appendix S1), a therapeutic follow‐up scheme was proposed (Table ).…”

Section: Methodsmentioning

confidence: 99%

“…The correlation between histopathology and RCM imaging has been studied extensively in this inflammatory disease . In addition, some therapeutic follow‐up studies of psoriasis have been published …”

Section: Introductionmentioning

confidence: 99%

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A four‐phase strategy for the implementation of reflectance confocal microscopy in dermatology

Hoogedoorn

Gerritsen

Wolberink

et al. 2016

Acad Dermatol Venereol

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

A four‐phase strategy for the implementation of reflectance confocal microscopy in dermatology

Hoogedoorn

Gerritsen

Wolberink

et al. 2016

Acad Dermatol Venereol

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“…No difference could be found between the papillary diameters in the skin of healthy patients compared to those in non-lesional skin of psoriatic patients. Ardigo et al [41] investigated the applicability of confocal light microscopy for therapeutic psoriasis monitoring. In this case, dermal papillae of > 100 µm in diameter were defined as being widened.…”

Section: Discussionmentioning

confidence: 99%

Application of Photoacoustic Methods and Confocal Microscopy for Monitoring of Therapeutic Response in Plaque Psoriasis

Ossadnik

Philipp

Bost

et al. 2018

Skin Pharmacol Physiol

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Psoriasis is prone to relapses and requires long-term therapy that may induce a range of adverse effects; therefore, an efficient and early detection of relapses is desirable. In this study, photoacoustic imaging and confocal laser scanning microscopic (CLSM) methods were investigated for their suitability in psoriasis follow-up examinations. Using a high-resolution photoacoustic system, the vascular structures of 11 psoriatic patients and 6 healthy volunteers were investigated. No differences were detected with respect to the average vessel diameter and vasculature per unit volume in the tissue of healthy volunteers and non-lesional and lesional skin areas of psoriatic patients. By means of CLSM, the diameters of the dermal papillae of 6 volunteers and 6 psoriatic patients were determined. The diameters of the dermal papillae of the healthy volunteers (0.074 ± 0.006 mm) revealed no significant difference when compared to non-lesional skin areas of psoriatic patients (0.079 ± 0.005 mm). The results obtained for the lesions in psoriatic patients showed a significant difference (Wilcoxon test, p = 0.028) between the diameters of the dermal papillae of the lesional skin areas (0.114 ± 0.012 mm) and the non-lesional skin areas (0.079 ± 0.005 mm). Thus, CLSM can be applied for monitoring psoriasis follow-up examinations.

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“…Psoriasis, also defined as plaque psoriasis or psoriasis vulgaris , is a chronic inflammatory disease characterized by the infiltration of inflammatory cells in the skin and hyper-proliferation of keratinocytes, resulting in red-coloured plaques, mainly located on elbows, knees, scalp and in the sacral area [1–3]. Although the molecular mechanisms driving the pathogenesis of psoriasis is still unknown, both immune system dysregulation and environmental factors, including diet, psychosocial stress, certain drugs and infections, are critically involved [4–7].…”

Section: Introductionmentioning

confidence: 99%

Anti-TNF-α Drugs Differently Affect the TNFα-sTNFR System and Monocyte Subsets in Patients with Psoriasis

et al. 2016

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TNF-α has a central role in the development and maintenance of psoriatic plaques, and its serum levels correlate with disease activity. Anti-TNF-α drugs are, however, ineffective in a relevant percentage of patients for reasons that are currently unknown. To understand whether the response to anti-TNF-α drugs is influenced by the production of anti-drug antibodies or by the modulation of the TNFα-TNFα receptor system, and to identify changes in monocyte phenotype and activity, we analysed 119 psoriatic patients who either responded or did not respond to different anti-TNF-α therapies (adalimumab, etanercept or infliximab), and measured plasma levels of TNF-α, TNF-α soluble receptors, drug and anti-drug antibodies. Moreover, we analyzed the production of TNF-α and TNF-α soluble receptors by peripheral blood mononuclear cells (PBMCs), and characterized different monocyte populations. We found that: i) the drug levels varied between responders and non-responders; ii) anti-infliximab antibodies were present in 15% of infliximab-treated patients, while anti-etanercept or anti-adalimumab antibodies were never detected; iii) plasma TNF-α levels were higher in patients treated with etanercept compared to patients treated with adalimumab or infliximab; iv) PBMCs from patients responding to adalimumab and etanercept produced more TNF-α and sTNFRII in vitro than patients responding to infliximab; v) PBMCs from patients not responding to infliximab produce higher levels of TNF-α and sTNFRII than patients responding to infliximab; vi) anti- TNF-α drugs significantly altered monocyte subsets. A complex remodelling of the TNFα-TNFα receptor system thus takes place in patients treated with anti-TNF-α drugs, that involves either the production of anti-drug antibodies or the modulation of monocyte phenotype or inflammatory activity.

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Reflectance confocal microscopy for plaque psoriasis therapeutic follow‐up during an anti‐TNF‐α monoclonal antibody: an observational multicenter study

Abstract: Early detected RCM parameters related to Adalimumab activity could be used to identify an early response to the treatment. RCM seems to be able to give useful and practical information about follow-up in patients with PP under treatment with Adalimumab.

Cited by 20 publications

References 23 publications

A four‐phase strategy for the implementation of reflectance confocal microscopy in dermatology

A four‐phase strategy for the implementation of reflectance confocal microscopy in dermatology

Application of Photoacoustic Methods and Confocal Microscopy for Monitoring of Therapeutic Response in Plaque Psoriasis

Anti-TNF-α Drugs Differently Affect the TNFα-sTNFR System and Monocyte Subsets in Patients with Psoriasis

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