Psoriatic microangiopathy modifications induced by PUVA and etretinate therapy. A nail-fold capillary microscopic...

Histological and capillaroscopy alterations of capillary circulation in psoriasis are well known: the most common of them are the increase of "minor dystrophies", the higher haematic flux in the psoriatic plaques and the abnormal visibility of the venous subpapillary plexus (in arthropathic less than 65-year-old patients). The predisposition of psoriatic patients to a vascular damage has often been stressed in literature. In the present study, we have evaluated the effects of systemic etretinate or PUVA therapy on capillary functions. We examined the nail-folds of 30 patients (ranging 15-64 years) affected by diffuse psoriasis for less than three years. This study has been performed by using a Leitz capillary microscopy. We evaluated the percentage of capillary minor dystrophies (type I-IV) and the flow rate before and after 1 month of treatment. These parameters were assessed by means of a 1-4 rating scale. Our results underline that a significant percentage of 1st type dystrophies is a prognostic rather than a diagnostic parameter in the capillaroscopic evaluation of psoriasis.