Doppler versus Histopathology in the Assessment of Egyptian Patients with Psoriasis Treated with Acitretin.

Psoriasis is one of the most common chronic inflammatory skin diseases, characterized by erythema and the formation of plaques. The diagnosis of psoriasis is based on clinical examination, and its severity is assessed by the Psoriasis Area and Severity Index. Histologic examination is still the standard method for the final diagnosis. Sonography has proved to be a suitable noninvasive imaging method for studying soft tissue in dermatologic diseases such as psoriasis. This study evaluated the effect of Doppler sonography in the assessment of psoriasis in comparison with histopathology. Clinical, multifrequency sonography, and histological examinations were completed in 30 patients with chronic plaque psoriasis before and after acitertin treatment. After a 12-week treatment period, there was a notable decrease of psoriatic plaques in 28 patients with Psoriasis Area and Severity Index-1 severity and in two patients with Psoriasis Area and Severity Index-2 severity. Multifrequency sonography results after treatment of the same plaques showed normal finding in five patients, mild sonographic changes in 24 patients, and moderate sonographic changes in one patient. Histopathology findings after treatment were normal epidermis and dermis in six patients, mild histopathological changes in 22 patients, and moderate changes in two patients. In conclusion, there were significant correlations between sonography and histopathology in the diagnosis and evaluation of a psoriatic skin treatment regimen.