Transforming the treatment of psoriasis to the 21st century: Detecting subclinical therapeutic response to secukinumab using optical coherence tomography as a prognostic indicator

Background Optical coherence tomography (OCT) is a noninvasive imaging device that scans the skin up to 2 mm in depth. OCT can capture real‐time epidermal thickness (ET) measurements and detect subclinical changes in inflammatory skin diseases like eczema and psoriasis. © 2022 Wiley Periodicals LLC. Objective To determine if measuring ET with OCT can detect a subclinical therapeutic response in psoriasis treated with the biological therapy, secukinumab (an IL‐17A antagonist). Design Phase IV, single‐center, open‐label, and single‐arm study. Participants Twenty‐six consecutive patients with moderate to severe plaque psoriasis. Measurements Clinical, dermoscopic, and OCT images were obtained at each visit. The clinician measured disease severity with the Investigator's Global Assessment (IGA) and Psoriasis Area And Severity Index (PASI). OCT was used to scan the ET at the center of lesional skin (ET‐L), along the border, and normal skin (ET‐N) on the same body plane; their difference was noted as ΔET. Results Initially, ET‐L was greater than ET‐N (p