Videocapillaroscopic study in psoriatic patients treated with tacalcitol

Aim. An analysis was made of the modifications of the superficial capillary bed in a psoriatic plaque and the perilesional healthy skin during treatment with tacalcitol by means of video-capillaroscopy (VC). Methods. Twenty-four patients suffering from psoriasis vulgaris over no more than 15% of the body were studied for a period of 3 months during treatment with 4 mg/g tacalcitol ointment Once a psoriatic plaque had been selected, a visual clinical assessment was made and capillaroscopic measurements were taken with VC at the time of recruitment (TO), after 4 weeks (T1), after 8 (T2) and after 12 weeks (T3). Results. The lesions studied gradually improved and at the end of the study the psoriatic plaques had disappeared in 12 patients. Even the diameter of the "basket" type capillaries had reduced significantly (average diameter: 67.64 at the beginning of the study; 34.08 at the end of the study), but only in 4 patients did the surface capillary plexus reappear with altered capillary loops. In the apparently healthy perilesional skin, 14 patients had abnormally elongated capillary loops. At the end of treatment, only 4 patients still had altered capillary loops. Conclusion. Tacalcitol proved to be effective in reducing the clinical and capillaroscopic alterations. Nevertheless, the microcirculatory improvement does not perfectly follow the clinical improvement. We also noted that the tacalcitol action on the microcirculation is not only limited to the area of application, but also extends to the surrounding areas.