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Epidermal proliferation, inflammatory changes and microvascular augmentation are prominent features of chronic cutaneous psoriatic lesions. The objective of this study was the investigation of blood and lymphatic microvascular changes in relation to epidermal changes and inflammatory infiltration in dermis. Immunohistochemical analysis with antibodies to CD34, podoplanin, vascular endothelial growth factors - A and C (VEGF-A and C) and morphometric software were used for quantification of the following parameters: blood and lymphatic vessel area (BVA and LVA), VEGF - A and VEGF-C positive area, inflammatory cell infiltration in dermis (CIA) and epidermal area (EA). In comparison to healthy skin psoriatic lesions showed remarkable elevation of all measured parameters with the following average increase: BVA (2.8-times increased), LVA (2.6-times increased), VEGF-A and VEGF-C area (in epidermis 29-times and 19- times increased, in dermis 25-times and 15- times increased, respectively ), and EA (3-times increased). Statistical analysis revealed significant positive correlation between CIA and EA in psoriatic samples. Blood vessels area and VEGF - A expression in epidermis showed mild positive correlation with epidermal hyperplasia and weak positive correlation with dermal inflammatory infiltration. VEGF - A expression in epidermis also significantly correlated with blood vessels area. As for the lymphatic microcirculation we found a statistically significant positive correlation between lymphatic vessels area and the cellular infiltration in dermis but only weak correlation with epidermal hyperplasia. We hypothesize that angiogenesis in psoriasis is to a greater extent responding to epidermal hyperplasia and in a lesser way to inflammatory infiltration in dermis. However, lymphangiogenesis is significantly related to dermal inflammatory infiltration.

Recent experimental studies revealed that angiogenesis and lymphangiogenesis are closely related to chronic inflammation. The present study aims to evaluate quantitative changes of blood and lymphatic microcirculatory beds in cutaneous lichen planus (CLP) and psoriatic lesions using immunohistochemical analysis with antibodies to CD34, D2-40 and VEGF. Morphometric software was used to determine the area of blood and lymphatic vessels (BVA and LVA) and also the VEGF positive area. Statistical analysis of these parameters confirmed a significant enlargement of both the blood and lymphatic microcirculatory beds in psoriatic and CLP lesions. BVA in CLP lesions was increased by 56% however this augmentation was not as great as in psoriatic lesions where BVA was increased by 123%. Interestingly, LVA in psoriatic and CLP lesions was increased equally by 85%. The strongest VEGF expression was detected in psoriatic lesions, with lower, but still significant, overexpression in CLP lesions. VEGF-C was significantly increased in both psoriatic and CLP lesions in comparable level. Noticeably higher VEGF and VEGF-C expression was observed in the epidermis than in the dermis. Finally, our results indicate that the level of angiogenesis is considerably greater in psoriatic lesions than in CLP lesions, but the level of lymphangiogenesis is equal in both psoriatic and CLP lesions., (Copyright © 2014 Elsevier GmbH. All rights reserved.)

Many things are still not clear in the etiopathogenesis of psoriasis. Health workers in various branches of medicine and even those working in other professions linked with medicine can contribute to gaining more knowledge about its etiology, pathogenesis, diagnosis or treatment. This work presents results from observations of 19 patients with a severe form of psoriasis. Material for immunohistopathological examinations was taken from the margins of chronic psoriatic sites twice from each patient: before treatment and after a 4-week treatment by cyclosporin A. Numeric value of CD4+ T lymphocytes, CD8+ T lymphocytes, their ratios and the values of PASI score were followed. Significant decrease in CD4 T lymphocytes and slight decrease in CD8+ T lymphocytes where observed after treatment. The CD4+:CD8+ ratio dropped from the values of 2.10 to 1.68. A dramatic decrease in PASI score was observed--from the average value of 23.34 to the average value of 11.97. The authors compare and discuss the results of similar cytophotometric studies found in the works of other researchers, but this type of results (CD4+ and CD8+ T lymphocytes subpopulations) is very rare in available literature. The decreases found in all studied parametres correspond with clinically well-known treatment effect of cyclosporin A whose immunomodulating effect is targeted mainly at the T lymphocyte inflammatory population.