AbstractBackgroundHigh‐frequency ultrasound (HFUS) is a non‐invasive method that detects superficial skin features. Ultra‐high frequencies (50‐100 MHz) can reveal epidermis and dermis structures.ObjectivesIn this study, we describe the psoriatic plaque using a new device equipped with a 70 MHz probe (VEVO® MD, Fujifilm, VisualSonics) and we assess the lesion before and after ixekizumab.MethodsWe examined the superficial hyperechoic band, the subepidermal hypoechoic band (SLEB), and the vascularization of the plaque in ten patients affected by plaque psoriasis.ResultsThe average superficial hyperechoic band thickness was 0.2157 mm before treatment, 0.1611 mm after 15 days, and 0.1354 mm (P < .05) after 30 days. The SLEB thickness was 0.7535 mm at baseline, 0.3300 mm after 15 days (P < .05), and 0.2007 mm (P < .05) after 30 days. The average percentage vascularization was 50.21% at baseline, 13.15% after 15 days (P < .05), and 5.97% after 30 days. UHFUS assessment highlighted the rapid action of the drug in terms of the decrease in vascularization after 15 days. It revealed a statistically significant reduction in SLEB thickness after 15 days and a significant reduction in the hyperechoic superficial band after 30 days.ConclusionsVEVO® MD provides physicians with high‐resolution details of the psoriatic plaque, thus enabling tailored‐made treatments.