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Relationship between Histological and Clinical Course of Psoriasis: A Pilot Investigation by Reflectance Confocal Microscopy during Goeckerman Treatment
- Source :
- Skin pharmacology and physiology. 29(1)
- Publication Year :
- 2015
-
Abstract
- Alterations of the skin microvasculature are known to play an important role in the development and maintenance of psoriatic skin lesions. In this study, we investigated lesional skin in 11 psoriatic patients during a modified Goeckerman treatment using reflectance confocal microscopy (RCM) to study the relationship between clinical clearance and histological normalization of psoriatic skin and the significance of histological abnormalities on the course of disease. The treatment regimen resulted in a significant reduction of the Psoriasis Area and Severity Index (PASI) as well as capillary and papillary diameters (p < 0.0001). The capillary and papillary diameters were still enlarged when compared to those in normal skin (p < 0.001). Capillary and papillary diameters correlated with each other prior to and after treatment (correlation coefficient = 0.63 and 0.64, p = 0.01 and 0.002, respectively) but not with the PASI. Capillary and papillary diameters after treatment and percentage reduction of the PASI during treatment seemed to be better predictors for the clinical course of relapse than the PASI after treatment. These findings make the subclinical changes of psoriatic skin vessels and dermal papillae a legitimate target for treatment. Further investigations of a large group of patients are needed to evaluate the potential of RCM findings as successor of the PASI in the monitoring of psoriasis.
- Subjects :
- 0301 basic medicine
Reflectance confocal microscopy
Male
medicine.medical_specialty
Pathology
Castor Oil
Physiology
Pilot Projects
Dermatology
Severity of Illness Index
Disease course
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
Psoriasis Area and Severity Index
Psoriasis
medicine
Humans
Coal Tar
Subclinical infection
Skin
Pharmacology
Microscopy, Confocal
integumentary system
business.industry
Clinical course
General Medicine
Anthralin
Middle Aged
medicine.disease
Capillaries
030104 developmental biology
Dermal papillae
medicine.anatomical_structure
Female
Salts
Ultraviolet Therapy
Large group
business
Salicylic Acid
Subjects
Details
- ISSN :
- 16605535
- Volume :
- 29
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Skin pharmacology and physiology
- Accession number :
- edsair.doi.dedup.....e8cbc06b08dc06bce9d615d79c7e1aff