4.3 Article

Perfusion measured by laser speckle contrast imaging as a predictor for expansion of psoriasis lesions

Journal

SKIN RESEARCH AND TECHNOLOGY
Volume 28, Issue 1, Pages 104-110

Publisher

WILEY
DOI: 10.1111/srt.13098

Keywords

angiogenesis; disease stability; inflammatory skin disease; LSCI; microvasculature

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Funding

  1. NWO DomainApplied and Engineering Sciences (AES) [14538]

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This study demonstrated the potential of noninvasive whole field laser speckle contrast imaging in visualizing increased perilesional perfusion and perfusion inhomogeneity for predicting psoriatic lesion expansion. Patients found HAPI measurements to be fast, user-friendly, and important.
Background Skin microvasculature changes are crucial in psoriasis development and correlate with perfusion. The noninvasive Handheld Perfusion Imager (HAPI) examines microvascular skin perfusion in large body areas using laser speckle contrast imaging (LSCI). Objectives To (i) assess whether increased perilesional perfusion and perfusion inhomogeneity are predictors for expansion of psoriasis lesions and (ii) assess feasibility of the HAPI system in a mounted modality. Methods In this interventional pilot study in adults with unstable plaque psoriasis, HAPI measurements and color photographs were performed for lesions present on one body region at week 0, 2, 4, 6 and 8. The presence of increased perilesional perfusion and perfusion inhomogeneity was determined. Clinical outcome was categorized as increased, stable or decreased lesion surface between visits. Patient feedback was collected on a 10-point scale. Results In total, 110 lesions with a median follow-up of 6 (IQR 6.0) weeks were assessed in 6 patients with unstable plaque psoriasis. Perfusion data was matched to 281 clinical outcomes after two weeks. A mixed multinomial logistic regression model revealed a predictive value of perilesional increased perfusion (OR 9.90; p < 0.001) and perfusion inhomogeneity (OR 2.39; p = 0.027) on lesion expansion after two weeks compared to lesion stability. HAPI measurements were considered fast, patient-friendly and important by patients. Conclusion Visualization of increased perilesional perfusion and perfusion inhomogeneity by noninvasive whole field LSCI holds potential for prediction of psoriatic lesion expansion. Furthermore, the HAPI is a feasible and patient-friendly tool.

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