In vivo imaging of lesions of psoriasis vulgaris with confocal laser scanning microscopy

Abstract

Objective To observe the lesions of psoriasis vulgaris by confocal laser scanning microscopy (CLSM).Methods The typical lesions of 120 patients with psoriasis vulgaris were observed by CLSM,and scanning results were recorded.Results Of the 120 patients with psoriasis vulgaris,all (100％)had dilated and twisted capillaries in dermal papillae,113 (94.17％) acanthosis,106 (88.33％) parakeratosis,86 (71.67％) Munro microabscesses at the level of stratum corneum,71 (59.17％) diminished or disappeared stratum granulosum.There were a few (1 to 2) dilated capillary lumens in papillary dermis,with no obvious reduction in the distance between dermal papillae.Some dermal papillary rings lost their integrity or brightness slightly in 24 of the 27 patients with psoriasis guttata.The height of stratum spinosum was 96.85 ± 17.88 μm (ranged:80-150 μm) in patients with psoriasis guttata,lower than that in those with plaque psoriasis (average:143.45 ± 23.19 μm,range:100-190 μm).In lesions of plaque psoriasis,the capillaries in dermal papillae were apparently dilated with hyperemia,showing a characteristic 'S' shape or horseshoe appearance; the diameter of dermal papillae was increased and the distance between dermal papillae was reduced,giving a 'transverse section of lotus roots' appearance.Dermal papillary rings completely disappeared in 25 of the 29 patients with plaque psoriasis.Conclusion CLSM may serve as an aid in the diagnosis of psoriasis vulgaris.