Negrutiu Mircea, Danescu Sorina, Popa Theodor, Focsan Monica, Vesa Stefan Cristian, Szasz Florin, Baican Adrian
Department of Dermatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Department of Rehabilitation, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Diagnostics (Basel). 2024 May 7;14(10):969. doi: 10.3390/diagnostics14100969.
(1) Background: the aim of the study was to demonstrate its usefulness in the field of imaging evaluation of plaque morphology in psoriasis vulgaris, with an emphasis on the use of confocal microscopy and other advanced skin-imaging techniques. (2) Methods: we conducted a prospective study over two years (July 2022-April 2024), on patients diagnosed with moderate or severe psoriasis vulgaris, treated in the dermatology department of our institution. We selected 30 patients, of whom 15 became eligible according to the inclusion and the exclusion criteria. A total of 60 psoriasis plaques were analyzed by dermatoscopy using a Delta 30 dermatoscope and Vidix 4.0 videodermoscope (VD), by cutaneous ultrasound (US) using a high-resolution 20 MHz linear probe, and by confocal microscopy, along with histopathological analysis. (3) Results: the study included fifteen patients with vulgar psoriasis, diagnosed histopathologically, of whom six were women and nine were men, with an average age of 55. Between two and six plaques per patient were selected and a total of sixty psoriasis plaques were analyzed by non-invasive imaging techniques. Twelve lesions were analyzed with ex vivo fluorescence confocal microscopy (FCM), compared to histology. US showed that the hyperechoic band and the lack of damage to the subcutaneous tissue were the most common criteria. The epidermis and dermis were found to be thicker in the area of psoriasis plaques compared to healthy skin. Dermatoscopy showed that the specific aspect of psoriasis plaques localized on the limbs and trunk was a lesion with an erythematous background, with dotted vessels with regular distribution on the surface and covered by white scales with diffuse distribution. The presence of bushy vessels with medium condensation was the most frequently identified pattern on VD. Good correlations were identified between the histological criteria and those obtained through confocal microscopy. (4) Conclusions: the assessment and monitoring of patients with psoriasis vulgaris can be conducted in a more complete and all-encompassing manner by incorporating dermatoscopy, ultrasonography, and confocal microscopy in clinical practice.
(1) 背景：本研究的目的是证明其在寻常型银屑病斑块形态学成像评估领域的实用性，重点是共聚焦显微镜和其他先进的皮肤成像技术的应用。(2) 方法：我们对2022年7月至2024年4月期间在我院皮肤科接受治疗的中度或重度寻常型银屑病患者进行了为期两年的前瞻性研究。我们选取了30例患者，其中15例根据纳入和排除标准符合条件。使用Delta 30皮肤镜和Vidix 4.0视频皮肤镜（VD）通过皮肤镜检查、使用20 MHz高分辨率线性探头通过皮肤超声（US）以及通过共聚焦显微镜对总共60个银屑病斑块进行分析，并进行组织病理学分析。(3) 结果：该研究纳入了15例经组织病理学诊断的寻常型银屑病患者，其中6例为女性，9例为男性，平均年龄为55岁。每位患者选取2至6个斑块，共60个银屑病斑块通过非侵入性成像技术进行分析。与组织学相比，12个病变通过离体荧光共聚焦显微镜（FCM）进行分析。超声显示高回声带和皮下组织无损伤是最常见的标准。发现银屑病斑块区域的表皮和真皮比健康皮肤更厚。皮肤镜检查显示，位于四肢和躯干的银屑病斑块的特定表现是有红斑背景的病变，表面有规则分布的点状血管，覆盖着弥漫分布的白色鳞屑。VD上最常识别的模式是存在中等程度聚集的浓密血管。在组织学标准与通过共聚焦显微镜获得的标准之间发现了良好的相关性。(4) 结论：在临床实践中纳入皮肤镜检查、超声检查和共聚焦显微镜，可以更全面、全方位地对寻常型银屑病患者进行评估和监测。
