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A Journal on Dermatology and Sexually Transmitted Diseases

Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2015 Sep 17

language: English

Videodermatoscopy evaluation of the distinct vascular pattern of psoriasis improves diagnostic capability for inverse psoriasis: a paired-comparison study

Musumeci M. L. 1, Lacarrubba F. 1, Catalfo P. 1, Scilletta B. 2, Micali G. 1

1 Dermatology Clinic, University of Catania, Italy;
2 Department of General Surgery, University of Catania, Italy


Identification of “bushy” capillaries via videodermatoscopy has been reported to assist the diagnosis of psoriasis in unusual anatomic sites and/or presentation. The aim of this study was to determine if high magnification videodermatoscopy may enhance diagnostic capability for inverse psoriasis. Thirty patients with erythematous lesions localized to cutaneous body folds were enrolled: Group A consisted of 10 patients with typical plaque psoriasis and concomitant involvement of body folds; Group B included 20 subjects with erythematous lesions localized exclusively to folds and with negative history for psoriasis. Videodermatoscopy at X150 showed the presence of typical homogenously distributed ‘‘bushy’’ capillaries in all examined fields for 100% of lesions of Group A thus confirming the diagnosis of inverse psoriasis. The same bushy capillary pattern was observed in 12 subjects in Group B, suggesting inverse psoriasis, later confirmed by histopathology examination; in the remaining 8 subjects, normal-looking, slightly dilated, linear and only isolated “bushy” capillaries were observed. In these cases histopathology as well as other laboratory tests excluded psoriasis. In summary, videodermatoscopy may in real time be expected to assist in the confirmation or exclusion of the diagnosis of inverse psoriasis, thereby allowing a less invasive, less labor-intensive as well as less expensive approach.

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