Response of cutaneous microcirculation to treatment with mometasone furoate in patients with psoriasis

Background. In patients with psoriasis, videocapillaroscopy has been used to visualize the typical modifications in the microcirculatory architecture. Aim. To evaluate the modifications of the superficial capillary bed in a psoriatic plaque and healthy perilesional skin during treatment with a topical steroid. Methods. In total, 24 patients affected with psoriasis vulgaris were enrolled. Each patient was instructed to apply mometasone furoate cream 0.1% once daily to a selected psoriatic lesion for 12 weeks. At baseline (T0) and after 4 (T1), 8 (T2) and 12 (T3) weeks, clinical and capillaroscopic examination was made of the psoriatic plaque and the surrounding skin. Results. At the end of the study, the diameters of dilated and convoluted capillaries in the psoriatic plaque were significantly reduced (baseline, 69.2 mu m; after 12 weeks, 29.3 mu m; P < 0.0001) in all subjects. A marked clinical improvement was also noted (plaque score: baseline, 7.4; after 12 weeks, 0.5; P < 0.0001). The perilesional skin also showed improvement in capillaroscopic alterations, even if the drug had not been applied to those areas. Of the 24 patients, 12 were clinically healed at the end of the treatment period, although the capillaroscopic picture returned to normal in only 2 of them. Conclusions. Mometasone furoate cream proved to be effective in reducing the clinical and capillaroscopic alterations of the psoriatic plaque, but there was no association between clinical improvement and microcirculatory alterations noted. The action of mometasone furoate action on the microcirculation was not limited only to the area of application, but also extended to the surrounding areas.