Cargando…
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...
Autores principales: | , , , , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1782467396005527552 |
---|---|
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. |
format | Online Article Text |
id | pubmed-5108638 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Derm101.com |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT lallasaimilios dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT argenzianogiuseppe dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT zalaudekiris dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT apallazoe dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT ardigomarco dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT chellinipatricia dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT cordeironatalia dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT guimaraesmariana dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT kyrgidisathanassios dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT lazaridouelizabeth dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT longocaterina dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT moscarellaelvira dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT papadimitriouilias dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT pellacanigiovanni dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT sotiriouelena dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT vakirlisefstratios dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents AT ioannidesdimitrios dermoscopichemorrhagicdotsanearlypredictorofresponseofpsoriasistobiologicagents |