Modern modified 'ultra' Goeckerman therapy: a PASI assessment of a very effective therapy for psoriasis resistant to both prebiologic and biologic therapies.
BACKGROUND
Compared with the original Goeckerman therapy devised by Dr Goeckerman in the 1930s, modern modified Goeckerman therapy in the second millennium shows significantly enhanced efficacy by improvements in technology (e.g. narrowband UVB) and the possibility of adding other relatively safe therapeutic options for more resistant cases to enhance efficacy without compromising the basic safety profile.


METHODS
For approximately 6 months, psoriasis patients undergoing Goeckerman therapy at the UCSF Psoriasis Center were followed from admission to discharge. A total of 25 consecutive psoriasis patients were treated with the Goeckerman regimen until (near-) clearance or for a maximum period of 3 months, and their weekly improvements in terms of PASI (psoriasis area and severity index) were recorded.


RESULTS
In all, 100% reached PASI 75 by 12 weeks of treatment. In fact, by 8 weeks, 95% reached PASI 75 and most of the patients were discharged within 2 months.


CONCLUSIONS
The onset of treatment effect was rapid. Goeckerman therapy is still a valuable and important part of the psoriatic armamentarium.
Lee
E
E
Indiana School of Medicine, Department of Dermatology, Regenstrief Health Center, Indianapolis, IN 46202, USA. ernlee@iupui.edu
Koo
J
J
D017255:Acitretin / Q000627:therapeutic use; D000875:Anthralin / Q000627:therapeutic use; D002117:Calcitriol / Q000031:analogs & derivatives / Q000627:therapeutic use; D003033:Coal Tar / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007641:Keratolytic Agents / Q000008:administration & dosage*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009539:Nicotinic Acids / Q000627:therapeutic use; D010789:Phototherapy; D011565:Psoriasis / Q000628:therapy*; D020156:Salicylic Acid / Q000627:therapeutic use; D012720:Severity of Illness Index; D013997:Time Factors; D014467:Ultraviolet Therapy; D012176:Retinoids
D017255:Acitretin; D000875:Anthralin; D002117:Calcitriol; D003033:Coal Tar; D007641:Keratolytic Agents; D008727:Methotrexate; D009539:Nicotinic Acids; D020156:Salicylic Acid; C055085:calcipotriene; C086827:tazarotene; D012176:Retinoids