INTRODUCTION
Roflumilast is a topical phosphodiesterase-4 inhibitor (PDE-4i) approved by the Food and Drug Administration (FDA) for treating dermatological conditions, including plaque psoriasis and atopic dermatitis. The 0.15% formulation was approved for atopic dermatitis less than two months ago, while the 0.3% formulation is used for psoriasis. It reduces inflammation by suppressing PDE-4, preventing cyclic adenosine monophosphate (cAMP) degradation, and reducing pro-inflammatory mediators.1 Psoriasis is assessed using a 5-point Investigator Global Assessment (IGA) scale, ranging from 0 (clear, no active psoriasis) to 4 (severe). In two 8-week phase 3 trials, 39.9% of patients treated with roflumilast achieved at least a 75% improvement from baseline by week 8, versus 6.5% on the vehicle (P<0.01).2 Roflumilast was well tolerated, with the most common side effects being diarrhea (3.1%), headache (2.4%), and insomnia (1.4%).2 Other studies used Psoriasis Area and Severity Index (PASI) scores, assessing induration, erythema, and scaling.1 One study found 35% of participants using oral roflumilast met the PASI75 endpoint at 12 weeks, versus 0% in the placebo group. At 24 weeks, 75% achieved PASI75.3
Recent advances in non-invasive imaging have contributed immensely to enhancing the investigation of skin conditions, without the inconvenience, scarring, bleeding, or infection associated with traditional biopsy methods.4 Line-field confocal optical coherence tomography (LC-OCT) is a non-invasive imaging method introduced in 2018 (DAMAE Medical, Paris, France). It combines principles of optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) to produce real-time, high-resolution (~1 μm) images with cellular and structural detail of the epidermis and dermis layers of the skin.5 Respectively, LC-OCT has superior resolution compared to OCT and higher penetration depth than RCM, allowing for visualization of skin surface and underlying tissue morphology
Recent advances in non-invasive imaging have contributed immensely to enhancing the investigation of skin conditions, without the inconvenience, scarring, bleeding, or infection associated with traditional biopsy methods.4 Line-field confocal optical coherence tomography (LC-OCT) is a non-invasive imaging method introduced in 2018 (DAMAE Medical, Paris, France). It combines principles of optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) to produce real-time, high-resolution (~1 μm) images with cellular and structural detail of the epidermis and dermis layers of the skin.5 Respectively, LC-OCT has superior resolution compared to OCT and higher penetration depth than RCM, allowing for visualization of skin surface and underlying tissue morphology
