Rosina Paolo, Giovannini Andrea, Gisondi Paolo, Girolomoni Giampiero
Department of Biomedical and Surgical Sciences, Section of Dermatology and Venereology, University of Verona, Verona, Italy.
Skin Res Technol. 2009 May;15(2):135-8. doi: 10.1111/j.1600-0846.2008.00336.x. Epub 2009 Jan 13.
BACKGROUND/PURPOSE: Videocapillaroscopy (VCP) can be used to explore microcirculatory modifications in skin diseases. Psoriasis presents a specifically altered capillaroscopic pattern with 'bushy' capillaries and a disarranged microangioarchitecture. The aim of the present study is to compare the clinical and capillaroscopic modifications of a psoriatic target lesion during topical therapy.
Thirty patients with chronic plaque psoriasis were included in the study. Clinical and capillaroscopic modifications in comparable lesions of the elbows were analyzed during different topical therapies (calcipotriol, betamethasone dipropionate and calcipotriol plus betamethasone dipropionate) at baseline, and after 15 and 30 days of therapy. A clinical global score (modified Psoriasis Area Severity Index), the mecapillary density per square mm and the mean diameter of capillary loops were measured.
Topical therapy with combined betamethasone dipropionate and calcipotriol induced a higher decrease in erythema, infiltration and desquamation (P<0.001), and a significant reduction of the mean 'bush' diameter (P<0.001) and capillary number/mm(2) (P<0.05) compared with betamethasone and calcipotriol alone. Microvascular restoration to a normal pattern, as detected by VCP, was faster than clinical improvement (P<0.05).
Videocapillaroscopy is an easily executable and non-invasive technique that detects early microcirculatory changes in psoriasis during topical therapy.
背景/目的：视频毛细血管镜检查（VCP）可用于探索皮肤病中的微循环改变。银屑病呈现出一种特殊的毛细血管镜检查模式，有“浓密”的毛细血管和紊乱的微血管结构。本研究的目的是比较局部治疗期间银屑病靶皮损的临床和毛细血管镜检查改变。
30例慢性斑块状银屑病患者纳入本研究。在基线以及治疗15天和30天后，分析不同局部治疗（卡泊三醇、二丙酸倍他米松以及卡泊三醇加二丙酸倍他米松）期间肘部类似皮损的临床和毛细血管镜检查改变。测量临床总体评分（改良银屑病面积和严重程度指数）、每平方毫米的毛细血管密度以及毛细血管袢的平均直径。
与单独使用二丙酸倍他米松和卡泊三醇相比，联合使用二丙酸倍他米松和卡泊三醇进行局部治疗可使红斑、浸润和脱屑有更明显的减轻（P<0.001），并且“浓密”的平均直径（P<0.001）和每平方毫米的毛细血管数量（P<0.05）有显著降低。通过VCP检测到的微血管恢复到正常模式比临床改善更快（P<0.05）。
视频毛细血管镜检查是一种易于实施且无创的技术，可检测局部治疗期间银屑病早期的微循环变化。
