title: Psoriasis plaque test with confocal microscopy: evaluation of different microscopic response pathways in NSAID and steroid treated lesions.
abstract: BACKGROUND
  Pathophysiology of psoriasis is complex and characterized by microscopic, specific changes. In vivo reflectance confocal microscopy (RCM) provides tissue and cell morphology information in non-invasive way, generating quasi-histologic resolution. Concerning plaque psoriasis, confocal criteria have been described disclosing high agreement between RCM and conventional histology.
  
  
  OBJECTIVE
  We sought to evaluate the in vivo microscopic changes in plaque psoriasis occurring during treatment with two distinct actives (aceclofenac and betamethason).
  
  
  METHODS
  A total of 32 patients with psoriasis were recruited. Two lesions from the same body area or symmetrical were evaluated at baseline and after 3-6 weeks by RCM.
  
  
  RESULTS
  Aceclofenac induced clinical improvement in 32% of patients after 3 weeks and in 76% after 6 weeks. With betamethason, at the end of the 3rd week, the 45% of patients showed improvement that increased to 81% at the end of the study. Single confocal criteria was evaluated and results underwent to statistical analysis considering the modification of the microscopical changes during the two treatments.
  
  
  CONCLUSIONS
  RCM followed the microscopic changes during treatment and enabled to differentiate effects of different actives. Although data are preliminary and based on a limited sample, aceclofenac seems to be effective in the treatment for psoriasis.
authors.affiliation: San Gallicano Dermatological Institute, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ardigò
authors.forename: Marina
authors.initials: M
authors.lastname: Agozzino
authors.forename: Caterina
authors.initials: C
authors.lastname: Longo
authors.forename: Andrea
authors.initials: A
authors.lastname: Conti
authors.forename: Vito
authors.initials: V
authors.lastname: Di Lernia
authors.forename: Enzo
authors.initials: E
authors.lastname: Berardesca
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pellacani
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D001623:Betamethasone / Q000008:administration & dosage*; D046169:Dermoscopy / Q000379:methods*; D004008:Diclofenac / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016903:Drug Monitoring / Q000379:methods; D004817:Epidermis / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D004008:Diclofenac; D001623:Betamethasone; C056498:aceclofenac
keywords: plaque psoriasis; reflectance confocal microscopy; therapeutical follow-up; topical treatments