Cutaneous vascular structure and perfusion in patients with chronic plaque psoriasis.

Background: Vascular dysfunction is a significant contributor to the pathophysiology of psoriasis. Some individuals have variation within the VEGF gene which confers an increased risk of developing psoriasis, a severe disease phenotype and may determine responsiveness to treatment.

Objective: To determine whether patients with psoriasis have alterations in cutaneous microvascular anatomy and physiology due to expression of VEGF and whether laser doppler imaging has utility in the assessment of this.

Methods: Twelve adult volunteers with Type 1 chronic plaque psoriasis had laser doppler imaging of plaque and uninvolved skin. Skin biopsies were taken from the areas imaged for immunohistochemistry, including blood and lymphatic vessel markers, and VEGF-A isotype analysis (VEGF-A121, VEGF-A165, and VEGF-D). Venous blood was collected for DNA extraction, VEGF-A genotyping and peripheral blood mononuclear cell culture.

Results: Mean blood vessel area (p=0.003), numbers of blood (p
Conclusion: Non-invasive imaging of blood flow may help determine the cutaneous vascular signature for individual patients. This may be a useful prognostic indicator of psoriasis susceptibility and severity, and support selection of treatments.