Publication: Combination Topical PUVAsol with Methotrexate Versus Methotrexate in the Treatment of Palmoplantar Psoriasis
Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Non-pustular palmoplantar psoriasis (PPP) is chronic and disabling dermatosis.
Topical psoralen and solar ultraviolet - A therapy (PUVAsol) is efficacious and safe
therapy in psoriasis management.
Objective
To study the efficacy and adverse clinical effect profile of topical PUVAsol along with
methotrexate in PPP.
Method
This is a prospective, randomized, clinical trial conducted among 54 patients with
moderate to severe PPP. Patients were grouped into two categories. Group I was
treated with weekly oral methotrexate only while group II had additional soak
PUVAsol therapy twice weekly for a total of three months. Modified palmoplantar
psoriasis area severity index (mPPPASI) score was used for quantification of severity.
Patients were followed up monthly for the efficacy and adverse clinical event profile
for 3 months; additionally patients were followed up monthly for next three months
for assessment of relapse.
Result
The mean age of patients with PPP was found to be 38.7 ± 13 years and male:
female ratio was 1.1:1. In comparison to group I patients, statistically significant
improvement was observed among group II patients in the third month follow
up (p= 0.039). Fifteen patients (35%) achieved mPPPASI 75 during the treatment
period. No significant difference was noted among the mPPPASI score during relapse
assessment. Eleven (29%) patients had evidence of relapse (mPPPASI more than 25%
of baseline) during follow up period. No statistically significant adverse clinical events
were noted.
Conclusion
Topical PUVAsol is an efficacious, safe and cost effective modality in moderate to
severe PPP. It could be employed in rotational or maintenance therapy of psoriasis.
KEY WORDS
Palm, psoriasis, PUVA therapy
Description
Karn D, KC S
Department of Dermatology
Dhulikhel Hospital, Kathmandu University Hospital
Dhulikhel, Kavre, Nepal
Keywords
Palm, psoriasis, PUVA therapy