Department of Dermatology, Taksim Training and Research Hospital, Istanbul, Turkey.
Department of Dermatology, Göztepe Prof Dr Süleyman Yalçın City Hospital, Medeniyet University, Istanbul, Turkey.
Microvasc Res. 2023 Jan;145:104441. doi: 10.1016/j.mvr.2022.104441. Epub 2022 Oct 1.
This study aimed to evaluate VEGF level, capillaroscopic findings, and these features for differential diagnosis of palmoplantar psoriasis and eczema patients.
This comparative cross-sectional study included 40 patients clinical and histopathologically diagnosed with eczema or psoriasis (20 psoriasis and 20 eczema) and 30 patients of similar age and gender without inflammatory disease in the control group. Serum samples of patients were collected and analyzed for VEGF by enzyme-linked immunosorbent assay (ELISA) and at the same time, we applied capillaroscopy with computerized dermatoscopy qualitatively and semiquantitatively.
In the qualitative evaluation, a decrease in capillary density and a significant increase of the avascular area was in palmoplantar plaque psoriasis (PPP) and palmoplantar eczema (PPE) patients compared to the control group. In the semiquantitative evaluation, the mean score decreased capillary density was significantly higher in PPE than in the PPP and control groups (p < 0.001). Minor morphological change (tortuous, crossed and enlarged capillary) scores were significantly higher in patients with PPE compared to PPP and control groups (p = 0.011). Major morphological change (mega, meandering, branching, bushy, bizarre, and disorganized polymorphic capillary) score was significantly higher in patients with PPP than PPE and the control group (p < 0.001). Major morphological change and m-PPPASI scores were correlated in PPP patients (p < 0.05). Disorganized capillaries in PPP patients were significantly higher than in the PPE and control groups (p < 0.001). There was no significant correlation between serum VEGF value and clinical severity and capillaroscopy findings of the patients.
Significant morphological changes were detected between PPP, PPE, and control groups in the qualitative and semi-quantitative evaluation of capillaroscopic findings. In the differential diagnosis of PPP and PPE, major morphological change, especially the presence of disorganized polymorphic capillaries, was considered an important finding in the capillaroscopic evaluation. These capillaroscopic findings may be helpful to discriminate eczema and psoriasis. However, there was no significant relationship between serum VEGF level and the patients' capillaroscopic findings and clinical severity.
本研究旨在评估血管内皮生长因子 (VEGF) 水平、毛细血管镜检查结果，并利用这些特征对掌跖银屑病和湿疹患者进行鉴别诊断。
本研究采用病例对照的横断面研究，纳入了 40 例临床和组织病理学诊断为湿疹或银屑病（20 例银屑病和 20 例湿疹）的患者，以及 30 例年龄和性别相匹配且无炎症性疾病的对照组患者。采集患者血清样本，采用酶联免疫吸附试验 (ELISA) 检测 VEGF 水平，同时采用计算机化共聚焦显微镜对毛细血管镜进行定性和半定量评估。
在定性评估中，与对照组相比，掌跖斑块状银屑病 (PPP) 和掌跖湿疹 (PPE) 患者的毛细血管密度降低，无血管区明显增加。在半定量评估中，PPE 患者的平均毛细血管密度评分明显低于 PPP 和对照组 (p < 0.001)。与 PPP 和对照组相比，PPE 患者的微小形态改变（迂曲、交叉和扩大的毛细血管）评分显著升高 (p = 0.011)。PPP 患者的主要形态改变（巨大、蜿蜒、分支、丛生、奇异和紊乱的多形性毛细血管）评分明显高于 PPE 和对照组 (p < 0.001)。PPP 患者的主要形态改变和 m-PPPASI 评分呈正相关 (p < 0.05)。PPP 患者紊乱的毛细血管明显高于 PPE 和对照组 (p < 0.001)。血清 VEGF 值与患者的临床严重程度和毛细血管镜检查结果之间无显著相关性。
在毛细血管镜定性和半定量评估中，PPP、PPE 和对照组之间观察到显著的形态学变化。在 PPP 和 PPE 的鉴别诊断中，主要形态改变，尤其是紊乱的多形性毛细血管的存在，被认为是毛细血管镜评估中的一个重要发现。这些毛细血管镜检查结果可能有助于区分湿疹和银屑病。然而，血清 VEGF 水平与患者的毛细血管镜检查结果和临床严重程度之间无显著相关性。
