Microvascular alterations in nonlesional psoriatic skin versus healthy control skin: insights from optical coherence tomography angiography in psoriasis and atopic dermatitis.

BACKGROUND

Microvascular changes and angiogenesis play a key role in psoriasis and atopic dermatitis (AD), affecting lesional and, in AD, also nonlesional skin. Studies on nonlesional psoriatic skin show conflicting results. Both diseases involve inflammation-driven vascular changes. Optical coherence tomography angiography (OCTA) is a noninvasive tool for assessing capillary morphology and disease progression.

OBJECTIVES

To examine microvascular alterations in psoriasis and AD using OCTA, assessing differences in lesional and nonlesional skin compared with healthy control skin; and to examine the potential of laser speckle contrast imaging (LSCI)-guided OCTA in monitoring skin in the same populations.

METHODS

Ten patients with psoriasis, 10 patients with AD and 5 healthy control participants were recruited. OCTA was used to measure microvascular parameters, including capillary loop depth, superficial plexus depth, vessel diameter, vessel density, vessel length and fractal dimension. LSCI-guided OCTA identified areas with the highest degree of inflammation within lesional skin. Comparisons were made between lesional and nonlesional skin in patients with psoriasis and AD.

RESULTS

Significant differences in microvascularity were found between lesional and nonlesional skin in patients with psoriasis and AD, as well as in comparison with healthy control participants. Differences in microvascular morphology were also identified in nonlesional skin of patients with psoriasis and healthy control participants, indicating systemic capillary changes. LSCI-guided OCTA did not enhance capillary detection.

CONCLUSIONS

Our results suggest that psoriasis may involve systemic microvascular changes beyond local inflammation. While OCTA is a promising noninvasive tool, further research is needed to elucidate its clinical value.