A three-cohort comparison with videodermatoscopic evidence of the distinct homogeneous bushy capillary microvascular pattern in psoriasis vs atopic dermatitis and contact dermatitis

In recent years, some studies have suggested that the diagnosis of psoriasis may be enhanced by videocapillaroscopy (VC) and videodermatoscopy (VD), non-invasive techniques able to ‘in vivo’ identify modifications of microvascular skin architecture. Our study demonstrates that the ‘bushy’ capillary pattern is typically present in psoriatic plaques and is therefore a feature with high disease specificity. ‘Bushy’ capillary diameter in the psoriatic plaques seems to be not affected by anatomical area. In addition, identification of this vascular pattern by VD may allow to rule out other inflammatory erythematous–desquamative disorders such as atopic and contact dermatitis that may sometimes show clinical features that may resemble psoriasis. In conclusion, evaluation of the vascular pattern by VD represents a non-invasive and affordable approach that may be useful in daily clinical practice.