Psoriasis remains an independent cardiovascular risk factor, leading to atherosclerosis but changes in the microvasculature of non-lesional skin in psoriasis patients are lesser-known. 

A study systematically examined capillary pathologies in psoriasis patients utilizing digital video nail fold capillaroscopy.

It was a prospective study that contrasted nail fold capillaries of psoriasis patients with healthy controls. 

Nailfold capillaries underwent evaluation for 21 parameters and results were compared with characteristics of patients and psoriatic disease, laboratory parameters, and measurements of carotid intima-media thickness.

The observations were as follows-

• 77 and 71 psoriasis patients (24 patients with additional psoriatic arthritis) and controls respectively were well-matched for demographic features and appropriate confounding factors leading to microangiopathy.
• Psoriasis patients demonstrated a significant loss of capillaries, capillary expansion with increased ramifications and tortuosity, capillary irregularities contrasting the controls.
• Psoriasis patients demonstrated a significantly elevated serum marker of inflammation and intima-media-thickness measurements. Disease duration or disease activity did not affect capillary changes.

It was thus concluded that marked microvascular abnormalities accompanied by increased markers of systemic inflammation and atherosclerosis are seen in the Nailfold capillaries of psoriasis patients. Nail fold capillaroscopy should be further studied to predict the cardiovascular risk of psoriasis patients.

Source: J Dtsch Dermatol Ges. 2021 Nov 18. doi: 10.1111/ddg.14606. Epub ahead of print. PMID: 34792866.