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Psoriasis treated with dithranol: a pilot study on in vivo reflectance confocal microscopy
Julia K Winkler1, Ferdinand Toberer1, Astrid Schirra-Hoffmann1
1Department of Dermatology, University of Heidelberg, Heidelberg, Germany.
Summary
Topical dithranol rapidly reduces psoriatic skin lesion features. In vivo reflectance confocal microscopy (RCM) showed significant reductions in epidermal and dermal changes, indicating treatment effectiveness.
Area of Science:
- Dermatology
- Medical Imaging
- Pharmacology
Background:
- Limited histomorphological data exists for topical dithranol's effect on psoriatic skin.
- In vivo reflectance confocal microscopy (RCM) correlates with histopathology and allows non-invasive monitoring of psoriatic skin treatments.
Purpose of the Study:
- To investigate the histomorphological changes in psoriatic lesions treated with topical dithranol using RCM.
- To assess the efficacy of dithranol in reducing key psoriatic skin features non-invasively.
Main Methods:
- Prospective, single-center pilot study involving 20 patients with psoriatic lesions.
- Lesions were assessed using RCM at baseline, day 4, and day 8 of dithranol treatment.
Main Results:
- RCM revealed significant reductions in hyperkeratosis (45.0%), acanthosis (38.2%), and epidermal thickness (66.5%) by day 8.
- Significant decreases were observed in dermal papillae diameter (32.1%), papillary vessel diameter (16.9%), and inflammatory infiltrate.
- Parakeratosis also showed a significant reduction by day 8.
Conclusions:
- Topical dithranol treatment rapidly and significantly reduces pathological epidermal and dermal features in psoriatic lesions.
- RCM is a valuable tool for non-invasively monitoring treatment response at a cellular level.
