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Dermoscopic hemorrhagic dots: an early predictor of response of psoriasis to biologic agents

BACKGROUND: Biologic agents are routinely used in the treatment of severe psoriasis. The evaluation of treatment response is mainly based on the physician’s global clinical assessment. OBJECTIVE: To investigate whether dermoscopy might enhance the assessment of response of psoriasis to treatment wit...

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Autores principales: Lallas, Aimilios, Argenziano, Giuseppe, Zalaudek, Iris, Apalla, Zoe, Ardigo, Marco, Chellini, Patricia, Cordeiro, Natalia, Guimaraes, Mariana, Kyrgidis, Athanassios, Lazaridou, Elizabeth, Longo, Caterina, Moscarella, Elvira, Papadimitriou, Ilias, Pellacani, Giovanni, Sotiriou, Elena, Vakirlis, Efstratios, Ioannides, Dimitrios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Derm101.com 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5108638/
https://www.ncbi.nlm.nih.gov/pubmed/27867739
http://dx.doi.org/10.5826/dpc.0604a02
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author Lallas, Aimilios
Argenziano, Giuseppe
Zalaudek, Iris
Apalla, Zoe
Ardigo, Marco
Chellini, Patricia
Cordeiro, Natalia
Guimaraes, Mariana
Kyrgidis, Athanassios
Lazaridou, Elizabeth
Longo, Caterina
Moscarella, Elvira
Papadimitriou, Ilias
Pellacani, Giovanni
Sotiriou, Elena
Vakirlis, Efstratios
Ioannides, Dimitrios
author_facet Lallas, Aimilios
Argenziano, Giuseppe
Zalaudek, Iris
Apalla, Zoe
Ardigo, Marco
Chellini, Patricia
Cordeiro, Natalia
Guimaraes, Mariana
Kyrgidis, Athanassios
Lazaridou, Elizabeth
Longo, Caterina
Moscarella, Elvira
Papadimitriou, Ilias
Pellacani, Giovanni
Sotiriou, Elena
Vakirlis, Efstratios
Ioannides, Dimitrios
author_sort Lallas, Aimilios
collection PubMed
description BACKGROUND: Biologic agents are routinely used in the treatment of severe psoriasis. The evaluation of treatment response is mainly based on the physician’s global clinical assessment. OBJECTIVE: To investigate whether dermoscopy might enhance the assessment of response of psoriasis to treatment with biologic agents. METHODS: Patients with severe psoriasis scheduled to receive a biologic agent were enrolled in the study. A target lesion from each patient was clinically and dermoscopically documented at baseline and after one, two and six months. The clinical response was evaluated by the recruiting clinicians at all visits, while dermoscopic images were evaluated by two independent investigators, blinded to the clinical information. Chi Square test was used for cross-tabulation comparisons, while odds ratios, 95% confidence intervals and p values were calculated using univariate logistic regression. RESULTS: Overall, there was a significant correlation between clinical response and vessel distribution at all time points: a regular vessel distribution correlated with no response, a clustered distribution with partial response, and the dermoscopic absence of vessels with complete response. The presence of dermoscopic hemorrhagic dots was a potent predictor of favorable clinical response at the subsequent visit at all time points. Among lesions initially clinically responding and later recurring, 87.5% displayed dermoscopic dotted vessels despite the macroscopic remission. CONCLUSION: Dermoscopy might be a useful additional tool for evaluating the response of psoriatic patients to biologic agents. Hemorrhagic dots represent an early predictor of clinical response, while the persistence or reappearance of dotted vessels might predict clinical persistence or recurrence, respectively.
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spelling pubmed-51086382016-11-18 Dermoscopic hemorrhagic dots: an early predictor of response of psoriasis to biologic agents Lallas, Aimilios Argenziano, Giuseppe Zalaudek, Iris Apalla, Zoe Ardigo, Marco Chellini, Patricia Cordeiro, Natalia Guimaraes, Mariana Kyrgidis, Athanassios Lazaridou, Elizabeth Longo, Caterina Moscarella, Elvira Papadimitriou, Ilias Pellacani, Giovanni Sotiriou, Elena Vakirlis, Efstratios Ioannides, Dimitrios Dermatol Pract Concept Articles BACKGROUND: Biologic agents are routinely used in the treatment of severe psoriasis. The evaluation of treatment response is mainly based on the physician’s global clinical assessment. OBJECTIVE: To investigate whether dermoscopy might enhance the assessment of response of psoriasis to treatment with biologic agents. METHODS: Patients with severe psoriasis scheduled to receive a biologic agent were enrolled in the study. A target lesion from each patient was clinically and dermoscopically documented at baseline and after one, two and six months. The clinical response was evaluated by the recruiting clinicians at all visits, while dermoscopic images were evaluated by two independent investigators, blinded to the clinical information. Chi Square test was used for cross-tabulation comparisons, while odds ratios, 95% confidence intervals and p values were calculated using univariate logistic regression. RESULTS: Overall, there was a significant correlation between clinical response and vessel distribution at all time points: a regular vessel distribution correlated with no response, a clustered distribution with partial response, and the dermoscopic absence of vessels with complete response. The presence of dermoscopic hemorrhagic dots was a potent predictor of favorable clinical response at the subsequent visit at all time points. Among lesions initially clinically responding and later recurring, 87.5% displayed dermoscopic dotted vessels despite the macroscopic remission. CONCLUSION: Dermoscopy might be a useful additional tool for evaluating the response of psoriatic patients to biologic agents. Hemorrhagic dots represent an early predictor of clinical response, while the persistence or reappearance of dotted vessels might predict clinical persistence or recurrence, respectively. Derm101.com 2016-10-31 /pmc/articles/PMC5108638/ /pubmed/27867739 http://dx.doi.org/10.5826/dpc.0604a02 Text en ©2016 Lallas et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Articles
Lallas, Aimilios
Argenziano, Giuseppe
Zalaudek, Iris
Apalla, Zoe
Ardigo, Marco
Chellini, Patricia
Cordeiro, Natalia
Guimaraes, Mariana
Kyrgidis, Athanassios
Lazaridou, Elizabeth
Longo, Caterina
Moscarella, Elvira
Papadimitriou, Ilias
Pellacani, Giovanni
Sotiriou, Elena
Vakirlis, Efstratios
Ioannides, Dimitrios
Dermoscopic hemorrhagic dots: an early predictor of response of psoriasis to biologic agents
title Dermoscopic hemorrhagic dots: an early predictor of response of psoriasis to biologic agents
title_full Dermoscopic hemorrhagic dots: an early predictor of response of psoriasis to biologic agents
title_fullStr Dermoscopic hemorrhagic dots: an early predictor of response of psoriasis to biologic agents
title_full_unstemmed Dermoscopic hemorrhagic dots: an early predictor of response of psoriasis to biologic agents
title_short Dermoscopic hemorrhagic dots: an early predictor of response of psoriasis to biologic agents
title_sort dermoscopic hemorrhagic dots: an early predictor of response of psoriasis to biologic agents
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5108638/
https://www.ncbi.nlm.nih.gov/pubmed/27867739
http://dx.doi.org/10.5826/dpc.0604a02
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