In vivo study of skin mechanical properties in psoriasis vulgaris

The aim of this study was to investigate the mechanical properties of the skin in psoriatic plaques before and after treatment with dithranol and in clinically uninvolved psoriatic skin in comparison with the skin of healthy controls. In total, 82 psoriatic plaques in 19 in-patients and 51 age-matched control subjects were studied with a non-invasive suction device (Cutometer). The plaques were characterized by statistically significant lower skin distensibility and elasticity, and a higher viscoelastic to elastic ratio compared with adjacent apparently normal skin. Delayed distension and hysteresis measured using a 2-mm diameter probe were decreased, but were increased when measured by a 8-mm diameter probe. These differences can be explained by the increased skin thickness in psoriasis and by the different aspects of skin mechanics determined by the 2 measuring probes. After treatment, the mechanical parameters of psoriatic plaques approached the values of adjacent control skin. The uninvolved volar forearm skin in psoriatic patients (2-mm diameter probe) showed statistically significant lower values of skin distensibility and higher values of viscoelasticity parameters compared with the skin of healthy control subjects. This suggests that the normal-appearing psoriatic skin is not entirely normal. The non-invasive method applied can be used for objective and quantitative evaluation of the effect of therapy in patients with psoriasis.