Ultra-high-frequency ultrasound monitoring of plaque psoriasis during ixekizumab treatment

Background: High-frequency ultrasound (HFUS) is a non-invasive method that detects superficial skin features. Ultra-high frequencies (50-100 MHz) can reveal epidermis and dermis structures. Objectives: In this study, we describe the psoriatic plaque using a new device equipped with a 70 MHz probe (VEVO® MD, Fujifilm, VisualSonics) and we assess the lesion before and after ixekizumab. Methods: We examined the superficial hyperechoic band, the subepidermal hypoechoic band (SLEB), and the vascularization of the plaque in ten patients affected by plaque psoriasis. Results: The average superficial hyperechoic band thickness was 0.2157 mm before treatment, 0.1611 mm after 15 days, and 0.1354 mm (P <.05) after 30 days. The SLEB thickness was 0.7535 mm at baseline, 0.3300 mm after 15 days (P <.05), and 0.2007 mm (P <.05) after 30 days. The average percentage vascularization was 50.21% at baseline, 13.15% after 15 days (P <.05), and 5.97% after 30 days. UHFUS assessment highlighted the rapid action of the drug in terms of the decrease in vascularization after 15 days. It revealed a statistically significant reduction in SLEB thickness after 15 days and a significant reduction in the hyperechoic superficial band after 30 days. Conclusions: VEVO® MD provides physicians with high-resolution details of the psoriatic plaque, thus enabling tailored-made treatments.