Analysis Of Changes In Skin And Nailfold Microcirculation Perfusion In Patients With Psoriasis Vulgaris

Background Psoriasis is a common chronic,recurrent,inflammatory skin disease with the characteristic of erythema and scale.The outburst of which is of significant seasonal presence,there is a tendency that the disease recurs or aggravates in autumn and winter,eases in summer.According to clinical features,psoriasis can be divided into four types-psoriasis vulgaris,psoriasis arthropathica,psoriasis pustulosa and psoriasis erythrodermic.Often,the disease is accompanied by metabolic and cardiovascular diseases.Psoriasis vulgaris accounts for more than 99% patients and usually converts into other types.Psoriasis arthropathica can lead to joint damage,severe cases can be teratogenic.In a word,the disease seriously reduces the quality of life in patients,causing huge economic burden on patients and society.The exact pathogenesis of the disease is still keep unknown,that genetic factors,environmental factors and immune factors are involved in the pathophysiological process is widely accepted currently.With the in-depth study and the development of research equipment,the role of skin microcirculation abnormalities in the pathogenesis of psoriasis has gained more and more attention,and is considered to be characteristic in pathological changes,which plays a fundamental role in the occurrence and development of the disease.Foreign studies shows that before the clinical symptoms of psoriasis showed up,skin microcirculation have already been existed,while the abnormalities ease prior to the relief of clinical symptoms with effective treatment.The most prominent and the earliest behavior can be found in skin microcirculation is the change in blood flow perfusion.Therefore,detection of skin microcirculation in patients with psoriasis plays an important role in its diagnosis and treatment.However,domestic research focuses on morphological changes of nailfold microcirculation in psoriasis,there exists no study on absolute value of skin microcirculation perfusion in patients.Objective The aim of this study was to detect the changes of absolute values of skin microcirculation flow in lesion,clinically unaffected skin and nailfold in patients with chronic psoriasis vulgaris whose lesion were typical plaques,erythema and scale,to analyze the difference of absolute values in different sites and periods,and to explore whether there exist a correlation between the skin microcirculation perfusion in lesion and the severity of the disease.Methods 88 patients(52 males and 35 females)with chronic psoriasis vulgaris whose lesion were typical plaques,and 100 controls were included.Values of skin blood perfusion in lesions,clinically unaffected skin of pretibia in patients,middle of pretibia in control,and bank of ring fingertips in both groups were assessed by a full-field perfusion imager(FLPI).And the differences were statistically analyzed by using SPSS 16.0 software(SPSS,Inc.).Results Values on skin blood perfusion in patients were significantly higher than controls,and the values on lesions were higher than clinically unaffected skin(both p<0.05);values on lesions in active stage were higher than stationary and regression stage,stationary stage were higher than regression stage(both p<0.05);values on nailfold microcirculation perfusion in the nail involvement were elevated(p<0.05),values on no nail involvement were lower than control(p<0.05);values of skin blood perfusion in psoriasis lesions were strongly positive correlation to PASI scores(r=0.744,p=1.07×10-19).Conclusion Microcirculation perfusion in skin and nailfold in the patients with psoriasis vulgaris are abnormal,the extent of the disorder in lesion is associate with the severity of the disease.