Vascularity and Fractal Dimension of the Dermo-Epidermal Interface in Guttate and Plaque-Type Psoriasis

Abstract

Background: Histological structures of the skin are often irregular in size and shape. Euclidean geometry and fractal analysis are complementary for assessing distinct aspects of their dimensions. Objective: To determine and compare the variations in shape of the dermo-epidermal junction and the size of the superficial vessels in psoriatic lesions. Method: The relative microvasculature area and the fractal dimension D of the dermo-epidermal interface were measured inside and outside growth-stunted guttate lesions (n = 22) and expanding plaques (n = 37) in psoriasis of the trunk. Results: The median D values of the dermo-epidermal interface were significantly larger (p < 0.01) in psoriatic plaques (D = 1.15) than in guttate lesions (D = 1.08), and these D values on lesional skin were significantly larger (p < 0.01) than in the uninvolved skin (D = 1.03). The microvasculature was significantly (p < 0.01) more developed in lesional (plaque: 13%, guttate: 8.20%) than in uninvolved skin (3.60 and 3.85%). No correlations were found between the relative microvasculature areas and the D values of the dermo-epidermal interface, both in the uninvolved and lesional skins of each psoriatic type. Conclusion: The absence of a relationship between modulations of the dermo-epidermal junction and vascular hyperplasia, both in expanding and stable psoriasis lesions, suggests that these events are regulated by different mechanisms and do not depend on each other.

Ustekinumab Biotherapy and Real-Time Psoriasis Capacitance Mapping: A Pilot Study

“…Approximately 25% of individuals with psoriasis develop moderate-to-severe disease with widely disseminated lesions [2]. During psoriasis progression, it is not infrequent to see new early papular lesions that are much more active than the larger stable plaques [1]. The present study focused on such guttate papular lesions because it was expected that they could represent more sensitive models for evolving psoriasis.…”

“…This specific chronic, immuno-inflammatory dermatosis is characterized by the combination of increased keratinocyte proliferation and defective keratinocyte maturation (parakeratosis), associated with angiogenesis and inflammatory cell recruitment [1–3]. The clinicopathological presentations vary according to the type of psoriasis and the body locations [4].…”

“…Psoriatic lesions are far less uniform in their histopathological structure than the uninvolved surrounding skin [1]. The density of the inflammatory cell infiltrate, the vascular hyperplasia, the epidermal thickening, and the extent in hyperkeratosis and parakeratosis indeed show large inter- and intraindividual variations [1, 4, 7].…”

“…The density of the inflammatory cell infiltrate, the vascular hyperplasia, the epidermal thickening, and the extent in hyperkeratosis and parakeratosis indeed show large inter- and intraindividual variations [1, 4, 7]. The regular clinical examination possibly detects some of the variations, but dermoscopy and a few other specific noninvasive bioengineering methods help identifying the clinical heterogeneity with increased specificity and sensitivity [15, 16].…”

From Shape to Pathogenesis: Fractal Formation of Lichen Planus

“…The shape reflects the structure and the properties of the tissue constituting the object. Shape evolution is a physical process, and a large amount of evidence has been accumulated showing that fractal patterns could be observed even in biomedical sciences [1,2] .…”