High Capillary Diameter In Psoriatic Plaques Of The Lower Legs

We read with interest the study conducted by Hjuler et al. on 146 psoriatic patients' partial responders (PASI=1-5) to biologics, in which the most common recalcitrant sites were the anterior and posterior part of the lower legs, elbows, and scalp [1]. Other reports indicate the distal lower extremities as notoriously treatment resistant [2]. A recent non-invasive diagnostic technique in psoriasis is represented by videodermatoscopy (VD) which is able to reveal a typical vascular pattern consisting of dilated and convoluted capillaries ("bushy pattern") homogeneously distributed on the lesions, with a mean diameter of 70-80 µm, compared to 25 µm of the capillary loops of healthy skin [3].