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Shear wave elastography and microvascular ultrasound in response evaluation to calcipotriol+betamethasone foam in plaque psoriasis
  1. Manlio Guazzaroni1,
  2. Donatella Ferrari2,
  3. Feliciana Lamacchia2,
  4. Vanessa Marisi3,
  5. Doriana Tatulli2,
  6. Salvatore Marsico2,
  7. Antonio Orlacchio1,
  8. Roberto Floris2,
  9. Luca Bianchi3,
  10. Annunziata Dattola3
  1. 1Department of Surgical Science, University of Rome Tor Vergata, Roma, Italy
  2. 2Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome Tor Vergata, Roma, Italy
  3. 3Department of Dermatology, University of Rome Tor Vergata, Roma, Italy
  1. Correspondence to Donatella Ferrari, Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome ‘Tor Vergata’, Viale Oxford 81, Rome, Italy; Donatella.ferrari91{at}gmail.com

Abstract

Psoriasis (PsO) is a chronic skin disease. This study aims to evaluate clinical and subclinical response to calcipotriol+betamethasone foam, in patients with PsO, comparing, for the first time, data from microvascular ultrasound (MicroV) and shear wave elastography (SWE) with Psoriasis Area and Severity Index (PASI).

Methods Between November 2018 and April 2019 in Tor Vergata Hospital (Roma, Italy), we enrolled 26 patients with PsO who were ageds 20–75 years, with PASI score ≥4, candidated for calcipotriol+betamethasone foam treatment. They underwent MicroV and SWE evaluation at baseline (T0) and after 4 weeks of treatment (T4). Clinical follow-up was carried on at T4, T8 and T12. Student’s t-test (p values<0.05 statistically significant) was used to compare SWE and PASI values.

Results At T0, SWE stiffness values of target plaques (61.5% on elbows, 23% knees, 7.7% sacrum,7.7% legs) were significantly higher than values under healthy skin. At T4, all patients showed a significant reduction of PASI; MicroV showed reduction in vascularisation of responsive plaques in 85% of cases, only in 15%, the vascularisation degree remained stable; and SWE values of target plaques were significantly lower compared with T0. Only in 7.7%, there was a relapse at T12.

Conclusions Calcipotriol+betamethasone foam is a very effective topical treatment in a short-medium term follow-up in patients with PsO. MicroV and SWE evaluate response to treatment (in term of plaque vascularisation and stiffness), so they could represent promising early indicators of therapeutic response and help the physician to establish a better clinical-therapeutic management of patients with PsO.

  • Dermatology
  • Psoriasis
  • Radiology & imaging
  • Ultrasound
  • Therapeutics
  • Diagnostic radiology
  • Dermatopathology
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Footnotes

  • Contributors MG planned the study, conducted the study and supervised the work. DF planned the study, conducted the study, reported the manuscript and submitted the study. FL conducted the study and reported the manuscript. VM reported the manuscript. DT conducted the study. SM planned the study. AO supervised the work. RF supervised the work. LB supervised the work. AD planned the study, recruited patients and reported the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Consent obtained directly from patient(s).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

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