Clinical and dermoscopic response predictors in psoriatic patients undergoing narrowband ultraviolet B phototherapy: results from a prospective study

Abstract

Therapeutic response of psoriasis vulgaris to NB-UVB treatment may be negatively affected by local clinical factors, that is, significant scaling/infiltration and legs localization, and dermoscopy may be useful in highlighting possible response predictors, with globular and dotted vessels associated with bad and good outcomes, respectively.

Dermoscopic features of psoriasis of the skin, scalp and nails – a systematic review

“…According to authors, the presence of red lines may suggest the overuse of topical glucocorticosteroids . According to the study by Errichetti et al ,. globular vessels were significantly more frequently found on lower extremities as compared to other locations ( P < 0.01), whereas dotted vessels (considered by the authors as a smaller variant of globular vessels) were less commonly observed in this location as compared to other sites ( P < 0.01).…”

“…Furthermore, there is only one study concerning the dependence of vascular features on the location. Errichetti et al 9 reported that lesions located on the legs had a higher prevalence of globular vessels (regularly distributed or clustered) and a lower prevalence of dotted vessels, and they were associated with no/limited response to narrowband ultraviolet B phototherapy. Also, the efficacy of therapy with biologics, with a good prognostic factor of purpuric dots, cyclosporine and long-term therapy with potent steroids, with patterns that indicate the overuse, was monitored by dermoscopy.…”

“…Furthermore, there is only one study concerning the dependence of vascular features on the location. Errichetti et al . reported that lesions located on the legs had a higher prevalence of globular vessels (regularly distributed or clustered) and a lower prevalence of dotted vessels, and they were associated with no/limited response to narrowband ultraviolet B phototherapy.…”

Dermoscopy in Monitoring and Predicting Therapeutic Response in General Dermatology (Non-Tumoral Dermatoses): An Up-To-Date Overview

“…The possibility to evaluate vascular changes in psoriasis has a double practical implication: (I) early assessment of treatment response, as reduction in vessels' diameter and tortuosity may already be seen in the first weeks of therapy [15][16][17][18][19][20][21][22][23], and (II) evaluation of persistence of vascular abnormalities in clinically healed lesions, as their presence has been supposed to be related to a higher tendency to relapse [22]. Interestingly, recent studies showed that even hand-held dermoscopy (910 magnification) may be of aid in treatment outcomes assessment in plaque-type psoriasis [24][25][26]. Specifically, the appearance of haemorrhagic dots in the first 2/4 weeks of treatment is a predictor of subsequent response to biological agents [24], while the baseline evidence of globular and dotted vessels has respectively been related to a negative and positive response to both narrowband ultraviolet B phototherapy [25] and calcipotriene/betamethasone aerosol foam ( Fig.…”

“…Interestingly, recent studies showed that even hand-held dermoscopy (×10 magnification) may be of aid in treatment outcomes assessment in plaque-type psoriasis [ 24 – 26 ]. Specifically, the appearance of haemorrhagic dots in the first 2/4 weeks of treatment is a predictor of subsequent response to biological agents [ 24 ], while the baseline evidence of globular and dotted vessels has respectively been related to a negative and positive response to both narrowband ultraviolet B phototherapy [ 25 ] and calcipotriene/betamethasone aerosol foam (Fig. 1 ) [ 26 ].…”