Background: Secukinumab is a highly effective treatment for chronic plaque psoriasis (CPP). We treated a 48-year-old male with chronic stable plaque psoriasis that was refractory to other systemic therapies with Secukinumab. Over the course of 8 weeks, his PASI score went from 55 at Baseline to 0. We used the Vectra WB360 3-dimensional (3D) whole-body photography system to provide highly detailed images to monitor the skin disease resolution over time at weekly intervals. The Vectra WB360 3D images allow the total surface area to be monitored as well as the morphology of individual lesions with respect to scale, erythema and also thickness.
Observation: We found that during the resolution of psoriasis, the scale was the first parameter to improve, followed by thickness and followed by erythema. The reduction in surface area was the last parameter to reduce. We also noticed a cephalocaudal pattern in the resolution of psoriasis, with the lesions on the head resolving twice as fast as the lesions below the knees. This is consistent with clinical observation that psoriasis plaques below the knees are often refractory to therapy.
Key message: This is the first known report of a 3D visual representation of the resolution of severe CPP treated with Secukinumab over an 8-week period. The Vectra WB360 3-dimensional (3D) imaging provides new information on the sequence of resolution of psoriasis plaques as well as the pattern of resolution of psoriasis plaques over the body.