Ali Asilian; Fariba Iraji; Saba Khalilian; Zabihollah Shahmoradi; Mina Saber
Abstract
Background: Psoriasis is an immune-mediated inflammatory disease with unclear pathophysiology. Although diverse medications have been applied, a paucity of knowledge is accessible regarding the use of corticosteroids for psoriasis management. We evaluated the efficacy of corticosteroid pulse therapy ...
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Background: Psoriasis is an immune-mediated inflammatory disease with unclear pathophysiology. Although diverse medications have been applied, a paucity of knowledge is accessible regarding the use of corticosteroids for psoriasis management. We evaluated the efficacy of corticosteroid pulse therapy in combination with methotrexate versus methotrexate alone for psoriasis treatment.Methods: This cohort study was conducted on 51 hospitalized patients with erythrodermic or pustular psoriasis who were assigned to one of the therapeutic interventions of subcutaneous methotrexate alone (n = 33) or in combination with betamethasone pulse therapy (n = 18). The first group was treated with weekly 15 mg subcutaneous methotrexate for six weeks, and the second group received a similar dose of methotrexate plus 3 mg oral betamethasone weekly. The patients were followed for six months and assessed regarding the disease remission, relapses, the interval between the medication and relapse incidence, and patient satisfaction with the regimens.Results: The studied groups were similar regarding gender (P = 0.296), age(P = 0.561), and the type of cutaneous lesions (P = 0.807). Six months follow-up of the two therapeutic interventions revealed insignificant differences in terms of early response to the treatment (P = 0.993), the incidence (P = 0.142) and frequency of relapses (P = 0.928), and the interval period between the treatment and relapse (P = 0.213). Besides, the patients’ treatment satisfaction did not differ between the groups (P = 0.453).Conclusion: Based on this study, combining methotrexate and lowdose corticosteroid pulse therapy does not lead to better outcomes than methotrexate alone for managing pustular and erythrodermic psoriasis. Further studies are strongly recommended.
Soheila Taheri; Ali Asilian; Gita Faghihi
Volume 12, Issue 2 , 2009, , Pages 36-41
Abstract
Background: Many efforts are made to find new and more effective treatments for psoriasis. Intralesional 5-Fluorouracil (5-FU) +epinephrine is a cheap option which can be administered with long intervals. The effectiveness of Pulse Dye Laser (PDL) on psoriasis has been already assessed. We decided to ...
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Background: Many efforts are made to find new and more effective treatments for psoriasis. Intralesional 5-Fluorouracil (5-FU) +epinephrine is a cheap option which can be administered with long intervals. The effectiveness of Pulse Dye Laser (PDL) on psoriasis has been already assessed. We decided to evaluate the effectiveness of 5-FU+epinephrine and compare it to betamethasone and PDL.Methods: A group of 22 patients with chronic stable plaque psoriasis were included. Three plaques on each patient were treated with 5- FU+epinephrine, PDL and betamethasone, respectively. Psoriasis Severity Index (PSI) scoring was applied to assess each plaque before treatment and in weeks 2, 4, 6, 12, and 24. Photos of each plaque were taken before treatment and at each treatment and follow-up session. They were finally compared and scored by a dermatologist.Results: Decline in mean Psoriasis Severity Index (PSI) in week 6 (2 weeks after treatment) and in week 24 (the last follow-up session) was statistically significant as compared to baseline in all groups. (P<0.001) The highest decline in mean PSI score was in the 5-FU+epinephrine group while the lowest belonged to the PDL group (80% vs. 27%).The mean period of remission in the 5-FU+epinephrine group was significantly longer in comparison to the two other groups. (P<0.001) In photographic evaluation, the best response was observed in the 5- FU+epinephrine group.Conclusion: 5-FU+epinephrine is a cheap option which can provide a rapid response and long remission .With respect to limited effectiveness, short remission and high cost; PDL dose not seem to be a preferred choice in the treatment of psoriasis.
Muhammad Munir Rashid; Uzire Azam Khan; Md Akramullah Sikder; Eakub Ali; Nargis Akhtar
Volume 11, Issue 3 , 2008, , Pages 99-102
Abstract
Background: Lichen planus is a common dermatological condition. Many treatment options have been discussed in literature, each with its own risk profile. Betamethasone pulse therapy is one of the effective therapies mentioned.The objective of this study was to find out whether oral betamethasone mini ...
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Background: Lichen planus is a common dermatological condition. Many treatment options have been discussed in literature, each with its own risk profile. Betamethasone pulse therapy is one of the effective therapies mentioned.The objective of this study was to find out whether oral betamethasone mini pulse therapy is effective in lichen planus.Methods: A total of 40 patients were enrolled in the study. Twenty patients received 5mg of oral betamethasone daily for two consecutive days in a week for 6 weeks along with loratadine and the other twenty patients received a loratadine tablet daily for the same period.Results: The flattening of the existing lesions, appearance of the new lesions and persistence of itching were considered as the parameters of clinical evaluation. It was clearly observable that the number of lichen planus lesions were drastically decreasing in group A and only slightly increasing in group B during the follow-ups.Conclusion: Betamethasone oral mini-pulse therapy was found to be more effective than loratadine in the treatment of lichen planus.
