Miruna-Ioana MIRON1,2, Elena GAVRILITA1,2, Camelia Cristina DIACONU3,4,5, Laura Gabriela GAVRIL6, Alin Laurentiu TATU1, 2,7
Abstract. Psoriasis is a chronic, immune-mediated inflammatory disease that may present unique clinical and diagnostic challenges in pediatric patients. In children, invasive diagnostic procedures such as skin biopsy are often avoided because of pain, anxiety, and cosmetic concerns, prompting interest in non-invasive imaging modalities. We report the case of a 9-year-old boy presenting with erythematous, scaly plaques on the scalp and knees, clinically and dermoscopically suggestive of psoriasis. Reflectance confocal microscopy (RCM) revealed parakeratosis with bright polygonal keratinocytes, preserved honeycomb pattern of the epidermis, and dilated dermal capillaries with visible leukocyte flow. Optical coherence tomography (OCT) demonstrated hyperkeratosis, papillomatosis, and vertically oriented dilated capillaries. These findings supported the clinical diagnosis of psoriasis without the need for histopathological confirmation. This case highlights the diagnostic value of multimodal non-invasive imaging, particularly RCM and OCT, in pediatric psoriasis. Such approaches improve diagnostic confidence, reduce patient discomfort, and may represent viable alternatives to skin biopsy in children.
Keywords: pediatric psoriasis, reflectance confocal microscopy (RCM), optical coherence tomography (OCT), non-invasive imaging.
DOI 10.56082/annalsarscimed.2025.2.33
1Department of Dermatology, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galati, Romania
2Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, Galati, Romania
3Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, Bucharest, Romania
4“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
5Academy of Romanian Scientists
6Department of Anaesthesiology and Intensive Care, Regional Institute of Oncology, ”Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
7Multidisciplinary Integrative Center for Dermatologic Interface Research MIC-DIR, Galati, Romania
Correspondence: Miruna-Ioana Miron, Department of Dermatology, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galati, Romania; e-mail: miruna.miron97@gmail.com
PUBLISHED in Annals of the Academy of Romanian Scientists Series of Medicine, Volume 6, Issue 2