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Changes in Microvascular Reactivity and Systemic Vascular Resistance in Patients With Psoriasis

The aim: of this pilot study was to explore local blood flow in psoriatic plaques and normal skin before and after provocations known to alter cutaneous vascular resistance in order to test whether the increased flow was caused by a failure of normal vascular control processes in plaque skin and what association it has with cardiovascular parameters. Material and methods: 11 patients who had a diagnosis of psoriasis vulgaris were enrolled in the study. Cutaneous blood flow was recorded over plaque and clinically normal skin. 10 healthy sex and age matched subjects were selected as controls. Blood flow in psoriatic and normal skin was measured by a single- channel Laser Doppler blood flowmeter (Blood Flow meter, AD Instruments Ltd., Oxford, UK). Post-occlusive reactive hyperaemia was assessed on the plaque and non-plaque site. Cardiovascular parameters: heart rate, systolic and diastolic pressure, cardiac output, and vascular resistance were continuously monitored by a Finapres (FINAPRES Medical Systems, The Netherlands). Results: In patients, basal-LD flow was significantly higher in psoriatic skin compared to nonpsoriatic skin and significantly higher than in the controls. However, the post-occlusive hyperaemia test did not reveal significant differences between the patients and control subjects. Systemic vascular resistance was significantly lower in patients with psoriasis compared to healthy individuals. Conclusions: The results suggest that reduced microvascular resistance is associated with a significant increase in blood flow of psoriatic plaques and with lower systemic vascular resistance.