Evaluation of the vascular pattern in psoriatic plaques in children using videodermatoscopy: an open comparative study.

Psoriasis is a common erythematous desquamative dermatosis. The diagnosis may sometimes be troublesome in children, especially if clinical presentation is mild or atypical. Videodermatoscopy has been suggested as a new noninvasive aid for the diagnosis of psoriasis, prognostic evaluation, and treatment monitoring. An open comparative study in children aimed at assessing the correlation between the vascular pattern evaluated using videodermatoscopy and the clinical diagnosis of psoriasis and other erythematous desquamative disorders was designed and performed. Sixty Caucasian children were enrolled and subdivided into two groups: group A, 24 patients with multiple plaque psoriasis; group B, 36 patients with other erythematous desquamative disorders. At least two lesions were examined in each patient using videodermatoscopy at 150× magnification and the superficial vascular pattern of each lesion was evaluated in three different fields. In group A, the presence of dilated capillaries with a "bushy" aspect, homogeneously distributed in all examined fields, was seen in all considered plaques. In group B, videodermatoscopic findings were not specific, showing normal-looking capillaries, slightly dilated vessels, or a few isolated "bushes." Videodermatoscopy may be considered an important adjunct diagnostic tool in clinically doubtful erythematous desquamative lesions in children, allowing a psoriatic vascular pattern to be confirmed or excluded, with some distinct advantages over skin biopsy.