{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:27:29Z","timestamp":1791829649324,"version":"4.3.4"},"reference-count":33,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Objectives: To evaluate the impact of non-invasive imaging techniques such as dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) to monitor the efficacy of risankizumab on plaque psoriasis of the legs by analyzing morpho-histological changes. Materials and Methods: Multicentre, real-world retrospective study involving 37 adults with moderate-to-severe plaque psoriasis. Assessments performed during routine visits at baseline, Week 4 and Week 12 included clinical response, dermoscopy, RCM and OCT. Results: Thirty-seven patients were included (mean age 52.1 years; 54% male; mean BMI 27.0 kg\/m2). Dermoscopy showed progressive vascular normalization: at Week 12, 94.29% of lesions had minimal or no vascular pattern. White and yellow scales decreased significantly. On RCM, dilated vessels, inflammatory infiltrate, and papillomatosis progressively normalized. OCT showed reduction in epidermal and stratum corneum thickness and a decline in vascular intensity at multiple depths. Baseline haemorrhagic dots predicted early complete response: 44.8% of lesions with dots achieved complete clearance at Week 4 versus 0% without. Conclusions: Risankizumab induced rapid, significant regression of psoriatic changes, normalizing vascular patterns and skin architecture and reducing epidermal thickness. Findings support its efficacy and rapid onset of action in difficult-to-treat areas and highlight the value of non-invasive imaging for monitoring.<\/jats:p>","DOI":"10.3390\/clinpract16030046","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T10:59:16Z","timestamp":1772017156000},"page":"46","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Psoriasis in Difficult-to-Treat Areas: A Multicentre, Real-World Retrospective Study Analyzing the Impact of Non-Invasive Imaging Techniques (Dermoscopy, Reflectance Confocal Microscopy and Optical Coherence Tomography) to Monitor the Effectiveness of Risankizumab in the Treatment of Plaque Psoriasis of the Legs"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9504-5882","authenticated-orcid":false,"given":"Annunziata","family":"Dattola","sequence":"first","affiliation":[{"name":"Dermatology Unit, Department of Medical and Cardiovascular Sciences, University of \u201cLa Sapienza\u201d, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimondo","family":"Rossi","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medical and Cardiovascular Sciences, University of \u201cLa Sapienza\u201d, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4367-0341","authenticated-orcid":false,"given":"Giuseppe","family":"Rizzuto","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medical and Cardiovascular Sciences, University of \u201cLa Sapienza\u201d, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8837-9232","authenticated-orcid":false,"given":"Giacomo","family":"Caldarola","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli\u2014IRCCS, 00168 Rome, Italy"},{"name":"Dermatology Unit, Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"De Luca","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli\u2014IRCCS, 00168 Rome, Italy"},{"name":"Dermatology Unit, Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviana","family":"Lora","sequence":"additional","affiliation":[{"name":"Clinical Dermatology Unit, San Gallicano Dermatological Institute (IRCCS), 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Giordano","sequence":"additional","affiliation":[{"name":"Dermatology Unit, NESMOS Departement, Sant\u2019Andrea Hospital, University of Rome Sapienza, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Severino","family":"Persechino","sequence":"additional","affiliation":[{"name":"Dermatology Unit, NESMOS Departement, Sant\u2019Andrea Hospital, University of Rome Sapienza, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Bonifati","sequence":"additional","affiliation":[{"name":"Clinical Dermatology Unit, San Gallicano Dermatological Institute (IRCCS), 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Orsini","sequence":"additional","affiliation":[{"name":"Departmental Faculty of Medicine, UniCamillus\u2014\u201cSaint Camillus International University of Health and Medical Sciences\u201d, 00131 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Graceffa","sequence":"additional","affiliation":[{"name":"Clinical Dermatology Unit, San Gallicano Dermatological Institute (IRCCS), 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Zangrilli","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Semplice Dipartimentale di Dermatologia, Dipartimento di Scienze Mediche, Azienda Ospedaliera Universitaria Policlinico Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Pagnanelli","sequence":"additional","affiliation":[{"name":"Department of Dermatology, IDI-IRCCS, 00167 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Tribuzi","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Semplice Dipartimentale Ospedale Belcolle ASL Viterbo, 01100 Viterbo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Mazzotta","sequence":"additional","affiliation":[{"name":"Azienda OspedalieraSan Camillo Forlanini of Rome Cir.ne Gianicolense, 00152 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8839-5961","authenticated-orcid":false,"given":"Gaia","family":"Moretta","sequence":"additional","affiliation":[{"name":"Department of Dermatology, IDI-IRCCS, 00167 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Micheli","sequence":"additional","affiliation":[{"name":"Unit\u00e0 di Dermatologia, Ospedale Nuovo Regina Margherita, 00153 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Provini","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale Roma 2, Ospedale S. Pertini, 00157 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Zanframundo","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Panasiti","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7222-2951","authenticated-orcid":false,"given":"Giovanni","family":"Pellacani","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medical and Cardiovascular Sciences, University of \u201cLa Sapienza\u201d, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetta","family":"Potenza","sequence":"additional","affiliation":[{"name":"Dermatology Unit \u201cDaniele Innocenzi\u201d, Department of Medical-Surgical Sciences and Biotechnologies, La Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8755-9178","authenticated-orcid":false,"given":"Antonio Giovanni","family":"Richetta","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medical and Cardiovascular Sciences, University of \u201cLa Sapienza\u201d, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6295-3574","authenticated-orcid":false,"given":"Nicoletta","family":"Bernardini","sequence":"additional","affiliation":[{"name":"Dermatology Unit \u201cDaniele Innocenzi\u201d, Department of Medical-Surgical Sciences and Biotechnologies, La Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1016\/S0140-6736(20)32549-6","article-title":"Psoriasis","volume":"397","author":"Griffiths","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/S0140-6736(14)61909-7","article-title":"Psoriasis","volume":"386","author":"Boehncke","year":"2015","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1001\/jama.2020.4006","article-title":"Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review","volume":"323","author":"Armstrong","year":"2020","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.jaci.2017.07.004","article-title":"Psoriasis pathogenesis and the development of novel targeted immune therapies","volume":"140","author":"Hawkes","year":"2017","journal-title":"J. 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