{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:21:02Z","timestamp":1783974062868,"version":"3.55.0"},"reference-count":34,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T00:00:00Z","timestamp":1715040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy \u201cIuliu Hatieganu\u201d Cluj-Napoca"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>(1) Background: the aim of the study was to demonstrate its usefulness in the field of imaging evaluation of plaque morphology in psoriasis vulgaris, with an emphasis on the use of confocal microscopy and other advanced skin-imaging techniques. (2) Methods: we conducted a prospective study over two years (July 2022\u2013April 2024), on patients diagnosed with moderate or severe psoriasis vulgaris, treated in the dermatology department of our institution. We selected 30 patients, of whom 15 became eligible according to the inclusion and the exclusion criteria. A total of 60 psoriasis plaques were analyzed by dermatoscopy using a Delta 30 dermatoscope and Vidix 4.0 videodermoscope (VD), by cutaneous ultrasound (US) using a high-resolution 20 MHz linear probe, and by confocal microscopy, along with histopathological analysis. (3) Results: the study included fifteen patients with vulgar psoriasis, diagnosed histopathologically, of whom six were women and nine were men, with an average age of 55. Between two and six plaques per patient were selected and a total of sixty psoriasis plaques were analyzed by non-invasive imaging techniques. Twelve lesions were analyzed with ex vivo fluorescence confocal microscopy (FCM), compared to histology. US showed that the hyperechoic band and the lack of damage to the subcutaneous tissue were the most common criteria. The epidermis and dermis were found to be thicker in the area of psoriasis plaques compared to healthy skin. Dermatoscopy showed that the specific aspect of psoriasis plaques localized on the limbs and trunk was a lesion with an erythematous background, with dotted vessels with regular distribution on the surface and covered by white scales with diffuse distribution. The presence of bushy vessels with medium condensation was the most frequently identified pattern on VD. Good correlations were identified between the histological criteria and those obtained through confocal microscopy. (4) Conclusions: the assessment and monitoring of patients with psoriasis vulgaris can be conducted in a more complete and all-encompassing manner by incorporating dermatoscopy, ultrasonography, and confocal microscopy in clinical practice.<\/jats:p>","DOI":"10.3390\/diagnostics14100969","type":"journal-article","created":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T06:53:27Z","timestamp":1715064807000},"page":"969","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Imaging Approach in the Diagnostics and Evaluation of the Psoriasis Plaque: A Preliminary Study and Literature Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Mircea","family":"Negrutiu","sequence":"first","affiliation":[{"name":"Department of Dermatology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0968-4026","authenticated-orcid":false,"given":"Sorina","family":"Danescu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodor","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6735-5146","authenticated-orcid":false,"given":"Monica","family":"Focsan","sequence":"additional","affiliation":[{"name":"Nanobiophotonics and Laser Microspectroscopy Center, Interdisciplinary Research Institute on Bio-Nano-Sciences, Babes-Bolyai University, 400271 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4549-3526","authenticated-orcid":false,"given":"Stefan Cristian","family":"Vesa","sequence":"additional","affiliation":[{"name":"Department of Functional Sciences, Discipline of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florin","family":"Szasz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4116-6459","authenticated-orcid":false,"given":"Adrian","family":"Baican","sequence":"additional","affiliation":[{"name":"Department of Dermatology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.autrev.2014.01.008","article-title":"Diagnosis and Classification of Psoriasis","volume":"13","author":"Raychaudhuri","year":"2014","journal-title":"Autoimmun. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1111\/jdv.13854","article-title":"A Systematic Review of Worldwide Epidemiology of Psoriasis","volume":"31","author":"Michalek","year":"2017","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s40257-020-00585-1","article-title":"HLA-Cw1 and Psoriasis","volume":"22","author":"Huang","year":"2021","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/bjd.19169","article-title":"Systematic Review Examining Changes over Time and Variation in the Incidence and Prevalence of Psoriasis by Age and Gender","volume":"184","author":"Iskandar","year":"2021","journal-title":"Br. J. Dermatol."},{"key":"ref_5","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_6","doi-asserted-by":"crossref","first-page":"a015354","DOI":"10.1101\/cshperspect.a015354","article-title":"Psoriasis","volume":"4","author":"Villanova","year":"2014","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1007\/s12325-020-01346-6","article-title":"Psoriasis and Cardiovascular Risk: A Comprehensive Review","volume":"37","author":"Masson","year":"2020","journal-title":"Adv. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1007\/s12016-012-8305-3","article-title":"Clinical and Histologic Diagnostic Guidelines for Psoriasis: A Critical Review","volume":"44","author":"Johnson","year":"2013","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_9","first-page":"4974","article-title":"Imaging Techniques in the Diagnosis and Monitoring of Psoriasis (Review)","volume":"18","author":"Grajdeanu","year":"2019","journal-title":"Exp. Ther. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s13555-016-0141-6","article-title":"Dermoscopy in General Dermatology: A Practical Overview","volume":"6","author":"Errichetti","year":"2016","journal-title":"Dermatol. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"27","DOI":"10.2147\/PTT.S107514","article-title":"Monitoring Treatment Response in Psoriasis: Current Perspectives on the Clinical Utility of Reflectance Confocal Microscopy","volume":"7","author":"Agozzino","year":"2017","journal-title":"Psoriasis Targets Ther."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lee, H.J., and Kim, M. (2023). Challenges and Future Trends in the Treatment of Psoriasis. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241713313"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1111\/j.1365-2133.2012.10868.x","article-title":"Accuracy of Dermoscopic Criteria for the Diagnosis of Psoriasis, Dermatitis, Lichen Planus and Pityriasis Rosea","volume":"166","author":"Lallas","year":"2012","journal-title":"Br. J. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1111\/srt.12933","article-title":"Dermoscopy of Plaque Psoriasis Differs with Plaque Location, Its Duration, and Patient\u2019s Sex","volume":"27","author":"Rudnicka","year":"2021","journal-title":"Skin Res. Technol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1111\/exd.13754","article-title":"Ex Vivo Fluorescence Confocal Microscopy for Intraoperative, Real-Time Diagnosis of Cutaneous Inflammatory Diseases: A Preliminary Study","volume":"27","author":"Bertoni","year":"2018","journal-title":"Exp. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.7863\/jum.2009.28.11.1569","article-title":"High-Frequency Sonography in the Evaluation of Psoriasis Nail and Skin Involvement","volume":"28","author":"Gutierrez","year":"2009","journal-title":"J. Ultrasound Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1177\/1534734620972815","article-title":"The Application of Ultra-High-Frequency Ultrasound in Dermatology and Wound Management","volume":"19","author":"Izzetti","year":"2020","journal-title":"Int. J. Low. Extrem. Wounds"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1177\/039463201302600425","article-title":"Combined Clinical, Capillaroscopic and Ultrasound Evaluation during Treatment of Plaque Psoriasis with Oral Cyclosporine","volume":"26","author":"Musumeci","year":"2013","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1111\/j.1529-8019.2009.01267.x","article-title":"Ultrasound Evaluation of Clobetasol Propionate 0.05% Foam Application in Psoriatic and Healthy Skin: A Pilot Study","volume":"22","author":"Lacarrubba","year":"2009","journal-title":"Dermatol. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"107","DOI":"10.11152\/mu.2013.2066.162.mc1mc2","article-title":"Conventional Ultrasonography and Sonoelastography in the Assessment of Plaque Psoriasis under Topical Corticosteroid Treatment\u2013Work in Progress","volume":"16","author":"Lenghel","year":"2014","journal-title":"Med. Ultrason."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"509","DOI":"10.23736\/S0392-0488.19.06190-X","article-title":"Ultrasound Assessment of the Keratolytic Effect of a 50% Urea Anhydrous Paste on Psoriasis Plaques: A Prospective Study","volume":"154","author":"Micali","year":"2019","journal-title":"G. Ital. Dermatol. Venereol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/srt.12942","article-title":"Ultra-High-Frequency Ultrasound Monitoring of Plaque Psoriasis during Ixekizumab Treatment","volume":"27","author":"Dini","year":"2021","journal-title":"Skin Res. Technol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1111\/jdv.15344","article-title":"Dermoscopic Features of Psoriasis of the Skin, Scalp and Nails\u2014A Systematic Review","volume":"33","author":"Rudnicka","year":"2019","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s13555-020-00406-7","article-title":"Plaque-Type Psoriasis Treated with Calcipotriene Plus Betamethasone Dipropionate Aerosol Foam: A Prospective Study on Clinical and Dermoscopic Predictor Factors in Response Achievement and Retention","volume":"10","author":"Margherita","year":"2020","journal-title":"Dermatol. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"7","DOI":"10.5826\/dpc.0604a02","article-title":"Dermoscopic Hemorrhagic Dots: An Early Predictor of Response of Psoriasis to Biologic Agents","volume":"6","author":"Lallas","year":"2016","journal-title":"Dermatol. Pract. Concept."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1684\/ejd.2018.3396","article-title":"The Value of (Video)Dermoscopy in the Diagnosis and Monitoring of Common Inflammatory Skin Diseases: A Systematic Review","volume":"28","author":"Vos","year":"2018","journal-title":"Eur. J. Dermatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1111\/srt.12271","article-title":"Clinical, Ultrasound, and Videodermatoscopy Monitoring of Psoriatic Patients Following Biological Treatment","volume":"22","author":"Micali","year":"2016","journal-title":"Skin Res. Technol."},{"key":"ref_28","first-page":"e15332","article-title":"Ixekizumab in Scalp Psoriasis: Clinical, Dermoscopical, and in Vivo Reflectance Confocal Microscopy Evaluation","volume":"35","author":"Villani","year":"2022","journal-title":"Dermatol. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1111\/j.1365-2133.2012.10988.x","article-title":"Reflectance Confocal Microscopy: An Effective Tool for Monitoring Ultraviolet B Phototherapy in Psoriasis","volume":"167","author":"Wolberink","year":"2012","journal-title":"Br. J. Dermatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1111\/jdv.16559","article-title":"Non-Invasive Clinical and Microscopic Evaluation of the Response to Treatment with Clobetasol Cream vs. Calcipotriol\/Betamethasone Dipropionate Foam in Mild to Moderate Plaque Psoriasis: An Investigator-Initiated, Phase IV, Unicentric, Open, Randomized Clinical Trial","volume":"35","author":"Alejo","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1111\/jdv.13627","article-title":"A Four-Phase Strategy for the Implementation of Reflectance Confocal Microscopy in Dermatology","volume":"30","author":"Hoogedoorn","year":"2016","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1111\/j.1468-3083.2009.03134.x","article-title":"Concordance between In Vivo Reflectance Confocal Microscopy and Histology in the Evaluation of Plaque Psoriasis","volume":"23","author":"Ardigo","year":"2009","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/srt.12150","article-title":"Evaluation of the Response to Treatment of Psoriasis Vulgaris with Reflectance Confocal Microscopy","volume":"21","author":"Erdemir","year":"2015","journal-title":"Skin Res. Technol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/jid.2012.429","article-title":"Introduction to Confocal Microscopy","volume":"132","author":"Nwaneshiudu","year":"2012","journal-title":"J. Investig. Dermatol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/10\/969\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:40:37Z","timestamp":1760107237000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/10\/969"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,7]]},"references-count":34,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["diagnostics14100969"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14100969","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,7]]}}}