Background: Histological structures of the skin are often irregular in size and shape. Euclidean geometry and fractal analysis are complementary for assessing distinct aspects of their dimensions. Objective: To determine and compare the variations in shape of the dermo-epidermal junction and the size of the superficial vessels in psoriatic lesions. Method: The relative microvasculature area and the fractal dimension D of the dermo-epidermal interface were measured inside and outside growth-stunted guttate lesions (n = 22) and expanding plaques (n = 37) in psoriasis of the trunk. Results: The median D values of the dermo-epidermal interface were significantly larger (p < 0.01) in psoriatic plaques (D = 1.15) than in guttate lesions (D = 1.08), and these D values on lesional skin were significantly larger (p < 0.01) than in the uninvolved skin (D = 1.03). The microvasculature was significantly (p < 0.01) more developed in lesional (plaque: 13%, guttate: 8.20%) than in uninvolved skin (3.60 and 3.85%). No correlations were found between the relative microvasculature areas and the D values of the dermo-epidermal interface, both in the uninvolved and lesional skins of each psoriatic type. Conclusion: The absence of a relationship between modulations of the dermo-epidermal junction and vascular hyperplasia, both in expanding and stable psoriasis lesions, suggests that these events are regulated by different mechanisms and do not depend on each other.

Cross SS, Cotton DWK: The fractal dimension may be a useful morphometric discriminant in histopathology. J Pathol 1992;166:409–411.
Ragaz A, Ackerman AB: Evolution, maturation, and regression of lesions of psoriasis: New observations and correlation of clinical and histologic findings. Am J Dermatopathol 1979;1:199–214.
Piérard GE, Piérard-Franchimont C: Formation de l’hyperplasie dermo-épidermique dans le psoriasis. Ann Dermatol Vénéréol 1983;110:891–897.
Mordovtsev VN, Albanova VI: Morphology of skin microvasculature in psoriasis. Am J Dermatopathol 1989;11:33–42.
Lowe PM, Lee ML, Jackson CJ, To SS, Cooper AJ, Schrieber L: The endothelium in psoriasis. Br J Dermatol 1995;132:497–505.
Hern S, Stanton AW, Mellor R, Levick JR, Mortimer PS: Control of cutaneous blood vessels in psoriatic plaques. J Invest Dermatol 1999;113:127–132.
Piérard GE, Piérard-Franchimont C, Lapière ChM: Proliferation and hyperplasia of vascular endothelium in human skin. Am J Dermatopathol 1985;7:477–488.
Creamer D, Allen MH, Sousa A, Poston R, Barker JN: Localization of endothelial proliferation and microvascular expansion in active plaque psoriasis. Br J Dermatol 1997;136:859–865.
De Angelis R, Bugatti L, Del Medico P, Nicolini M, Filosa G: Videocapillaroscopic findings in the microcirculation of the psoriatic plaque. Dermatology 2002;204:236–239.
Malhotra R, Stenn KS, Fernandez LA, Braverman IM: Angiogenic properties of normal and psoriatic skin associate with epidermis, not dermis. Lab Invest 1989;61:162–165.
Wolf JE: Angiogenesis in normal and psoriatic skin. Lab Invest 1989;61:139–142.
Creamer JD, Barker JNWN: Vascular proliferation and angiogenic factors in psoriasis. Clin Exp Dermatol 1995;20:6–9.
Bacharach-Buhles M, El Gammal S, Panz B, Altmeyer P: The pseudo-elongation of capillaries in psoriatic plaques. Acta Derm Venereol 1994;suppl 186:133–137.
Khan A, Schall LM, Tur E, Maibach HI, Guy RH: Blood flow in psoriatic skin lesions: The effect of treatment. Br J Dermatol 1987;117:193–201.
Hull SM, Goodfield M, Wood EJ, Cunliffe WJ: Active and inactive edges of psoriatic plaques: Identification by tracing and investigation by laser-Doppler flowmetry and immunocytochemical techniques. J Invest Dermatol 1989;92:782–785.
Parent D, Bernard BA, Desbas C, Heenen M, Darmon MY: Spreading of psoriatic plaques: Alteration of epidermal differentiation precedes capillary leakiness and anomalies in vascular morphology. J Invest Dermatol 1990;95:333–340.
Barton SP, Abdullah MS, Marks R: Quantification of microvascular changes in the skin in patients with psoriasis. Br J Dermatol 1992;126:569–574.
Bull RH, Bates DO, Mortimer PS: Intravital video-capillaroscopy for the study of the microcirculation in psoriasis. Br J Dermatol 1992;126:436–445.
Goodfield M, Hull SM, Holland D, Roberts G, Wood E, Reid S, Cunliffe W: Investigations of the ‘active’ edge of plaque psoriasis: Vascular proliferation precedes changes in epidermal keratin. Br J Dermatol 1994;131:808–813.
Cross SS, Cotton DWK, Underwood JCE: Measuring fractal dimensions: Sensitivity to edge-processing functions. Anal Quant Cytol Histol 1994;16:375–379.
Vico PG, Boyer H, Cartilier LH: New concepts in the study of tissue vascularization: A mathematical model of skin vascularization. Plast Reconstr Surg 1994;94:174–179.
Goldberger AL: Non-linear dynamics for clinicians: Chaos theory, fractals, and complexity at the bedside. Lancet 1996;347:1312–1313.
Losa GA, Nonnenmacher TF: Self-similarity and fractal irregularity in pathological tissues. Mod Pathol 1996;9:174–182.
Heymans O, Blacher S, Brouers F, Piérard GE: Fractal quantification of the heterogeneity in cutaneous melanoma. Dermatology 1999;198:212–217.
Arrese JE, Fogouang L, Piérard-Franchimont C, Piérard GE: Euclidean and fractal computer-assisted corneofungimetry: A comparison of 2% ketoconazole and 1% terbinafine topical formulations. Dermatology 2002;204:222–227.
Robert C, Kupper TS: Inflammatory skin diseases, T cells, and immune surveillance. N Engl J Med 1999;341:1817–1828.
Prinz JC: Psoriasis vulgaris – A sterile antibacterial skin reaction mediated by cross-reactive T cells? An immunological view of the pathophysiology of psoriasis. Clin Exp Dermatol 2001;26:326–332.
Detmar M, Brown LF, Claffey KP, Yeo KT, Kocher O, Jackman RW, Berse B, Dvorak HF: Overexpression of vascular permeability factor/vascular endothelial growth factor and its receptors in psoriasis. J Exp Med 1994;180:1141–1146.
de la Brassinne M, Piérard GE: Interprétation pathogénique de l’extension des placards de psoriasis: analyse histogéométrique et étude autoradiographique. Dermatologica 1973;147:161–173.
Piérard GE, Piérard-Franchimont C, de la Brassinne M: Impetigo herpetiformis and pustular psoriasis during pregnancy. Am J Dermatopathol 1983;22:300–304.
Piérard-Franchimont C, Piérard GE: Stereotyped distribution of proliferating keratinocytes in disorders affecting the epidermis. Am J Dermatopathol 1989;11:233–237.
True LD: Morphometric applications in anatomic pathology. Hum Pathol 1996;27:450–467.
Claridge E, Hall PN, Keefe M, Allen JP: Shape analysis for classification of malignant melanoma. J Biomed Eng 1992;14:229–234.
Cross SS: The application of fractal geometric analysis to microscopic images. Micron 1994;25:101–113.
Buczkowski S, Kyriacos S, Nekka F, Cartilier LH: Some guidelines for estimating fractal dimension with a box-counting method in image analysis. Patt Recog 1998;31:411–418.
Vico PG, Kyriacos S, Heymans O, Louryan S, Cartilier L: Dynamic study of the extra embryonic vascular network of the chick embryo by fractal analysis. J Theor Biol 1998;195:525–532.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.