title: Preatrophy: covert sign of thinned skin.
abstract: Overt iatrogenic cutaneous atrophy is easily recognized; however, the earliest signs of such an adverse event may be covert. Preatrophy is proposed as a term to describe the subtle unmasking or normally covert subpapillary vascular channels found by the use of enhanced skin surface magnification techniques. We conducted a randomized double-blind, bilaterally paired comparison clinical trial in patients with chronic plaque psoriasis treated with twice-daily (nonoccluded) superpotent topical steroids for 2 weeks. Occult reversible delicate networks of horizontally oriented vascular channels were found within and surrounding 20% (23/118) of the involved psoriatic plaques during the course of the study. The use of a hand-held magnifying lens (8X), mineral oil, a coverglass, and adequate illumination allow recognition of preatrophy. Preatrophy was more frequently found in women than in men.
authors.affiliation: Department of Dermatology, Minnesota Clinical Study Center, Fridley 55432.
authors.forename: H I
authors.initials: HI
authors.lastname: Katz
authors.forename: S E
authors.initials: SE
authors.lastname: Prawer
authors.forename: J J
authors.initials: JJ
authors.lastname: Mooney
authors.forename: C R
authors.initials: CR
authors.lastname: Samson
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy / Q000139:chemically induced; D001623:Betamethasone / Q000009:adverse effects / Q000031:analogs & derivatives*; D002986:Clinical Trials as Topic; D002990:Clobetasol / Q000009:adverse effects / Q000031:analogs & derivatives*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009824:Ointments; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy*; D011897:Random Allocation; D012867:Skin / Q000098:blood supply / Q000473:pathology*
chemical_list: D009824:Ointments; C011175:betamethasone-17,21-dipropionate; D001623:Betamethasone; D002990:Clobetasol