Angiogenesis in psoriasis: An immunohistochemical study of VEGF and microvessel density

Context: Psoriasis is a chronic, immune-mediated inflammatory disorder of the skin in which angiogenesis is a key pathological event. Vascular endothelial growth factor (VEGF), a potent endothelial cell mitogen, is a principal mediator of this. The present study was undertaken to evaluate VEGF expression and quantify microvessel density (MVD) in psoriasis to elucidate the role of angiogenesis in disease pathogenesis. Aims: To evaluate VEGF expression and MVD in psoriatic skin and compare findings with healthy controls. Settings and Design: Cross-sectional, observational, comparative study conducted at a tertiary-care teaching hospital. Materials and Methods: Formalin-fixed, paraffin-embedded skin biopsies from clinically diagnosed psoriasis patients and matched controls were subjected to immunohistochemical staining for VEGF. MVD was assessed histologically using H and E-stained sections. VEGF expression was evaluated using immunohistochemistry and scored semiquantitatively. Statistical Analysis Used: Data were analyzed using Student’s t -test for continuous variables and Chi-square test for categorical data. A P < 0.05 was considered statistically significant. Results: VEGF expression was significantly higher in psoriatic lesions than in control skin, with intense immunoreactivity noted in basal and suprabasal keratinocytes, dermal endothelial cells, and inflammatory infiltrates. MVD was markedly elevated in psoriasis compared with controls, demonstrating a positive correlation with VEGF expression. Conclusions: Psoriasis is characterized by enhanced VEGF expression and increased MVD, supporting the pivotal role of angiogenesis in its pathogenesis.