title: Reflectance confocal microscopy for plaque psoriasis therapeutic follow-up during an anti-TNF-α monoclonal antibody: an observational multicenter study.
abstract: BACKGROUND
  Psoriasis is a chronic recurrent inflammatory skin disease that affects 2-3% of the world population. Biologics are relatively new systemic treatments that block molecular steps important in the pathogenesis of psoriasis. In vivo Reflectance confocal microscopy (RCM) is a non-invasive, imaging technique already reported to be useful in the evaluation of the follow-up of PP under treatment with topical actives and phototherapy. No reports on systemic treatments have been proposed in literature so far.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the feasibility of RCM in the monitoring of microscopic response to a subcutaneous anti-TNF treatment, Adalimumab.
  
  
  METHODS
  One target lesion with typical clinical aspect, from 48 psoriatic patients, was evaluated using RCM at baseline, after 4 and 8 weeks of treatment.
  
  
  RESULTS
  Microscopic confocal changes were followed up during treatment. Results disclosed identification of early microscopic evidence of the anti-inflammatory activity of Adalimumab not detected at clinical examination. Confocal feature related to the effect of TNF-α on melanocytes activity has been also identified.
  
  
  CONCLUSIONS
  Early detected RCM parameters related to Adalimumab activity could be used to identify an early response to the treatment. RCM seems to be able to give useful and practical information about follow-up in patients with PP under treatment with Adalimumab.
authors: Department of Clinical Dermatology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy.
authors: M
authors: M
authors: Ardigò
authors: Department of Clinical Dermatology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy.
authors: M
authors: M
authors: Agozzino
authors: Dermatology Unit, Arcispedale ASMN, Reggio Emilia, Italy.
authors: C
authors: C
authors: Longo
authors: Dermatology Unit, Arcispedale ASMN, Reggio Emilia, Italy.
authors: A
authors: A
authors: Lallas
authors: Dermatology Unit, Arcispedale ASMN, Reggio Emilia, Italy.
authors: V
authors: V
authors: Di Lernia
authors: Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy.
authors: A
authors: A
authors: Fabiano
authors: Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy.
authors: A
authors: A
authors: Conti
authors: Biostatistical Unit, Scientific Direction, San Gallicano Dermatological Institute-IRCCS, Rome, Italy.
authors: I
authors: I
authors: Sperduti
authors: Dermatology Unit, Second University of Naples, Naples, Italy.
authors: G
authors: G
authors: Argenziano
authors: Department of Clinical Dermatology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy.
authors: E
authors: E
authors: Berardesca
authors: Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy.
authors: G
authors: G
authors: Pellacani
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D020405:Dermis / Q000473:pathology; D004817:Epidermis / Q000473:pathology; D005260:Female; D006801:Humans; D000069416:Intravital Microscopy; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab