A retrospective analysis of treatment responses of palmoplantar psoriasis in 114 patients

Background  Treatment options remain unsatisfactory for patients with palmoplantar psoriasis (PP) and palmoplantar pustular psoriasis (PPP). Aim  To evaluate the therapeutic responses of PP and PPP patients that were treated in our psoriasis polyclinic between 2003 and 2007. Methods  This retrospect...

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Veröffentlicht in:Journal of the European Academy of Dermatology and Venereology 2009-07, Vol.23 (7), p.814-819
Hauptverfasser: Adışen, E, Tekin, O, Gülekon, A, Gürer, MA
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container_title Journal of the European Academy of Dermatology and Venereology
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creator Adışen, E
Tekin, O
Gülekon, A
Gürer, MA
description Background  Treatment options remain unsatisfactory for patients with palmoplantar psoriasis (PP) and palmoplantar pustular psoriasis (PPP). Aim  To evaluate the therapeutic responses of PP and PPP patients that were treated in our psoriasis polyclinic between 2003 and 2007. Methods  This retrospective study comprised PP (n = 62) and PPP (n = 52) patients. Treatments were individualized according to patient compliance and associating systemic diseases. The effect of systemic treatments was grouped as follows: ‘no improvement’: patients unresponsive for the present treatment; ‘partial improvement’:  75% decrease of the disease compared to baseline. Results  In the PP group, 17 of 62 patients showed marked improvement to topical agents, while the remaining patients required systemic agents including oral retinoids (n = 24), local psoralen plus ultraviolet A (PUVA; n = 12), methotrexate (n = 9) and cyclosporine (n = 2). Marked improvement was achieved in 53%, 45%, 47% and 100%, respectively. In these patients, two (n = 10), three (n = 5), or four (n = 5) systemic agents were used alternately. In the PPP group, 18 of 52 patients achieved marked improvement by topical agents. Patients that required systemic agents were treated with colchicum (n = 19), local PUVA (n = 8), methotrexate (n = 4), oral retinoids (n = 3) and cyclosporine (n = 2). These treatments achieved a marked improvement in 60%, 33%, 57%, 83%, and 50% of the patients, respectively. In the course of the disease, 18 patients required two and 3 patients required three systemic agents alternately. Conclusions  Although the success rates appeared to be high, the high number of patients who required multiple systemic agents emphasized the fact that localized forms of psoriasis were resistant to therapy. Conflicts of interest None declared
doi_str_mv 10.1111/j.1468-3083.2009.03197.x
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Aim  To evaluate the therapeutic responses of PP and PPP patients that were treated in our psoriasis polyclinic between 2003 and 2007. Methods  This retrospective study comprised PP (n = 62) and PPP (n = 52) patients. Treatments were individualized according to patient compliance and associating systemic diseases. The effect of systemic treatments was grouped as follows: ‘no improvement’: patients unresponsive for the present treatment; ‘partial improvement’: &lt; 50% decrease in severity or affected area; ‘moderate improvement’: 50–75% decrease in severity or affected area, and ‘marked improvement’: &gt; 75% decrease of the disease compared to baseline. Results  In the PP group, 17 of 62 patients showed marked improvement to topical agents, while the remaining patients required systemic agents including oral retinoids (n = 24), local psoralen plus ultraviolet A (PUVA; n = 12), methotrexate (n = 9) and cyclosporine (n = 2). Marked improvement was achieved in 53%, 45%, 47% and 100%, respectively. In these patients, two (n = 10), three (n = 5), or four (n = 5) systemic agents were used alternately. In the PPP group, 18 of 52 patients achieved marked improvement by topical agents. Patients that required systemic agents were treated with colchicum (n = 19), local PUVA (n = 8), methotrexate (n = 4), oral retinoids (n = 3) and cyclosporine (n = 2). These treatments achieved a marked improvement in 60%, 33%, 57%, 83%, and 50% of the patients, respectively. In the course of the disease, 18 patients required two and 3 patients required three systemic agents alternately. Conclusions  Although the success rates appeared to be high, the high number of patients who required multiple systemic agents emphasized the fact that localized forms of psoriasis were resistant to therapy. Conflicts of interest None declared</description><identifier>ISSN: 0926-9959</identifier><identifier>EISSN: 1468-3083</identifier><identifier>DOI: 10.1111/j.1468-3083.2009.03197.x</identifier><identifier>PMID: 19470063</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Child ; Colchicum ; Cyclosporine - therapeutic use ; cyclosporine and retinoids ; Female ; Humans ; Keratoderma, Palmoplantar - drug therapy ; Male ; methotrexate ; Methotrexate - therapeutic use ; Middle Aged ; palmoplantar psoriasis ; palmoplantar pustular psoriasis ; Photochemotherapy ; Psoriasis - drug therapy ; PUVA ; Retinoids - therapeutic use ; Retrospective Studies ; systemic treatment ; topical corticosteroids ; Treatment Outcome ; Young Adult</subject><ispartof>Journal of the European Academy of Dermatology and Venereology, 2009-07, Vol.23 (7), p.814-819</ispartof><rights>2009 The Authors. 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Aim  To evaluate the therapeutic responses of PP and PPP patients that were treated in our psoriasis polyclinic between 2003 and 2007. Methods  This retrospective study comprised PP (n = 62) and PPP (n = 52) patients. Treatments were individualized according to patient compliance and associating systemic diseases. The effect of systemic treatments was grouped as follows: ‘no improvement’: patients unresponsive for the present treatment; ‘partial improvement’: &lt; 50% decrease in severity or affected area; ‘moderate improvement’: 50–75% decrease in severity or affected area, and ‘marked improvement’: &gt; 75% decrease of the disease compared to baseline. Results  In the PP group, 17 of 62 patients showed marked improvement to topical agents, while the remaining patients required systemic agents including oral retinoids (n = 24), local psoralen plus ultraviolet A (PUVA; n = 12), methotrexate (n = 9) and cyclosporine (n = 2). Marked improvement was achieved in 53%, 45%, 47% and 100%, respectively. In these patients, two (n = 10), three (n = 5), or four (n = 5) systemic agents were used alternately. In the PPP group, 18 of 52 patients achieved marked improvement by topical agents. Patients that required systemic agents were treated with colchicum (n = 19), local PUVA (n = 8), methotrexate (n = 4), oral retinoids (n = 3) and cyclosporine (n = 2). These treatments achieved a marked improvement in 60%, 33%, 57%, 83%, and 50% of the patients, respectively. In the course of the disease, 18 patients required two and 3 patients required three systemic agents alternately. Conclusions  Although the success rates appeared to be high, the high number of patients who required multiple systemic agents emphasized the fact that localized forms of psoriasis were resistant to therapy. 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Aim  To evaluate the therapeutic responses of PP and PPP patients that were treated in our psoriasis polyclinic between 2003 and 2007. Methods  This retrospective study comprised PP (n = 62) and PPP (n = 52) patients. Treatments were individualized according to patient compliance and associating systemic diseases. The effect of systemic treatments was grouped as follows: ‘no improvement’: patients unresponsive for the present treatment; ‘partial improvement’: &lt; 50% decrease in severity or affected area; ‘moderate improvement’: 50–75% decrease in severity or affected area, and ‘marked improvement’: &gt; 75% decrease of the disease compared to baseline. Results  In the PP group, 17 of 62 patients showed marked improvement to topical agents, while the remaining patients required systemic agents including oral retinoids (n = 24), local psoralen plus ultraviolet A (PUVA; n = 12), methotrexate (n = 9) and cyclosporine (n = 2). Marked improvement was achieved in 53%, 45%, 47% and 100%, respectively. In these patients, two (n = 10), three (n = 5), or four (n = 5) systemic agents were used alternately. In the PPP group, 18 of 52 patients achieved marked improvement by topical agents. Patients that required systemic agents were treated with colchicum (n = 19), local PUVA (n = 8), methotrexate (n = 4), oral retinoids (n = 3) and cyclosporine (n = 2). These treatments achieved a marked improvement in 60%, 33%, 57%, 83%, and 50% of the patients, respectively. In the course of the disease, 18 patients required two and 3 patients required three systemic agents alternately. Conclusions  Although the success rates appeared to be high, the high number of patients who required multiple systemic agents emphasized the fact that localized forms of psoriasis were resistant to therapy. Conflicts of interest None declared</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>19470063</pmid><doi>10.1111/j.1468-3083.2009.03197.x</doi><tpages>6</tpages></addata></record>
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subjects Adolescent
Adult
Aged
Child
Colchicum
Cyclosporine - therapeutic use
cyclosporine and retinoids
Female
Humans
Keratoderma, Palmoplantar - drug therapy
Male
methotrexate
Methotrexate - therapeutic use
Middle Aged
palmoplantar psoriasis
palmoplantar pustular psoriasis
Photochemotherapy
Psoriasis - drug therapy
PUVA
Retinoids - therapeutic use
Retrospective Studies
systemic treatment
topical corticosteroids
Treatment Outcome
Young Adult
title A retrospective analysis of treatment responses of palmoplantar psoriasis in 114 patients
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