Evaluation of dermoscopic evaluation as a Prognostic Tool in plaque psoriasis

Jun Zhao; L. Yang; H. Huang

doi:10.5281/zenodo.22814352

Authors

Jun Zhao Department of Cosmetic and Aesthetic Surgery, Murray Institute for Advanced Cosmetic and Aesthetic Surgery Author https://orcid.org/4461-7780-8279-0013
L. Yang Department of Cosmetic and Aesthetic Surgery, Columbia Academy of Cosmetic and Aesthetic Surgery Author https://orcid.org/1211-2784-2004-8420
H. Huang Department of Clinical Dermatology, Mekong Institute of Dermatology Author https://orcid.org/9336-5345-9835-0299

DOI:

https://doi.org/10.5281/zenodo.22814352

Keywords:

dermoscopy, plaque psoriasis, prognosis, vascular pattern, treatment response

Abstract

Graphical abstract

Background: Chronic plaque psoriasis is diagnosed and monitored largely by unaided inspection, an approach that performs poorly for thin plaques, darker phototypes, and distinguishing psoriasis from its papulosquamous mimics.

Objective: This review evaluates the evidence on dermoscopic examination of plaque psoriasis as a prognostic tool, covering its correlation with severity, its use in monitoring biologic therapy response, and its role in differential diagnosis.

Methods: We synthesized diagnostic-accuracy studies, cross-sectional severity-correlation cohorts, and serial imaging studies addressing dermoscopic vascular and scale patterns in chronic plaque psoriasis.

Findings: A reproducible pattern of regularly distributed dotted vessels, diffuse white scale, and a light red background separates psoriasis from lichen planus, dermatitis, and pityriasis rosea, with vessel density correlating with clinical severity and, on serial imaging during biologic therapy, falling ahead of clinical response.

Conclusions: Dermoscopy adds a reproducible axis to severity assessment and shows promise as an early readout of treatment response, but the field still lacks the large, outcome-anchored studies needed to validate it as a standardized prognostic instrument.

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