Psoriasis plaque test with confocal microscopy: evaluation of different microscopic response pathways in NSAID and steroid treated lesions
Psoriasis plaque test with confocal microscopy: evaluation of different microscopic response pathways in NSAID and steroid treated lesions
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DOI：
10.1111/srt.12062
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发表时间：
2013-11-01
影响因子：
2.2
通讯作者：
Pellacani, Giovanni
中科院分区：
文献类型：
--
作者：
Ardigo, Marco;Agozzino, Marina;Pellacani, Giovanni
背景银屑病的病理生理学是复杂的，其特征是微观的、特定的变化。体内反射共焦显微镜（RCM）以非侵入性方式提供组织和细胞形态信息，产生准组织学分辨率。关于斑块型银屑病，共聚焦标准已被描述，揭示了 RCM 和传统组织学之间的高度一致性。目的我们试图评估两种不同活性物质（醋氯芬酸和倍他米松）治疗期间斑块型银屑病发生的体内微观变化。方法总共招募了 32 名银屑病患者。在基线时和 3-6 周后通过 RCM 评估来自同一身体区域或对称的两个病变。结果醋氯芬酸在 3 周后使 32% 的患者出现临床改善，在 6 周后使 76% 的患者出现临床改善。使用倍他米松，在第 3 周结束时，45% 的患者表现出改善，在研究结束时增加到 81%。考虑到两种治疗期间微观变化的修改，评估单一共焦标准并对结果进行统计分析。结论RCM 跟踪治疗期间的微观变化，并能够区分不同活性物质的效果。尽管数据是初步的并且基于有限的样本，但醋氯芬酸似乎对治疗牛皮癣有效。
BackgroundPathophysiology of psoriasis is complex and characterized by microscopic, specific changes. In vivo reflectance confocal microscopy (RCM) provides tissue and cell morphology information in non-invasive way, generating quasi-histologic resolution. Concerning plaque psoriasis, confocal criteria have been described disclosing high agreement between RCM and conventional histology.ObjectiveWe sought to evaluate the in vivo microscopic changes in plaque psoriasis occurring during treatment with two distinct actives (aceclofenac and betamethason).MethodsA total of 32 patients with psoriasis were recruited. Two lesions from the same body area or symmetrical were evaluated at baseline and after 3-6weeks by RCM.ResultsAceclofenac induced clinical improvement in 32% of patients after 3weeks and in 76% after 6weeks. With betamethason, at the end of the 3rd week, the 45% of patients showed improvement that increased to 81% at the end of the study. Single confocal criteria was evaluated and results underwent to statistical analysis considering the modification of the microscopical changes during the two treatments.ConclusionRCM followed the microscopic changes during treatment and enabled to differentiate effects of different actives. Although data are preliminary and based on a limited sample, aceclofenac seems to be effective in the treatment for psoriasis.