Local variation in cutaneous and subcutaneous blood flow measured by CdTe(C1) minidetectors in normal and psoriatic skin.

The accuracy of the 133Xe washout method and the validity of newly developed cadmium telluride CdTe(Cl) minisemiconductor detectors were estimated by performing comparative, simultaneous measurements of both cutaneous (CBF) and subcutaneous (SBF) blood flow using 2 conventional scintillation sodium iodide NaI(Tl) and CdTe(Cl) detectors over the same radioactive depot in each of 10 individuals. The accuracy of the 133Xe washout method was found to be 13-15% (C.V.) for the CBF measurements and 9-12% (C.V.) for the SBF measurements. The CdTe(Cl) detectors, which have a weight of 20 g and were attached directly over the radioactive depot, may replace stationary NaI(Tl) detectors placed 20 cm from the depot for measurements of both CBF and SBF. Two CdTe(Cl) detectors were used for estimations of the local variation in CBF and SBF within a distance of 5 cm in normal skin of 10 individuals. The C.V. was 7% for the CBF measurements and 18% for the SBF measurements. Measurements of CBF and SBF were performed in 6 psoriatic patients who, after about 1 week of antipsoriatic treatment with beech tar, developed typical Woronoff rings. The local CBF differed significantly from the center of psoriatic plaques to the margin, in the Woronoff ring, and in nonlesional skin. In contrast, SBF was remarkably equal within the plaque and in the Woronoff ring. The color of the Woronoff ring cannot be ascribed to a local cutaneous vasoconstriction. Cutaneous blood flow in chronic stable, lesional psoriatic skin was significantly lower than previously published values for active lesional psoriatic skin, but significantly higher than CBF in normal individuals. Measurements of CBF in tetrahydrofurfuryl nicotinic acid (Trafuril)-treated skin showed higher values than measurements of CBF in the postischemic hyperemia period both in normal and in lesional psoriatic skin. Trafuril induced a significant increase of CBF in both lesional and nonlesional skin. The high CBF rates in lesional psoriatic skin are not due to a maximally, passively dilated vascular bed.