title: Sulfasalazine and pentoxifylline in psoriasis: a possible safe alternative.
abstract: BACKGROUND
  Conventional therapy of extensive psoriasis is effective but has complications. Biologics are safer but expensive.
  
  
  OBJECTIVE
  To assess the efficacy of sulfasalazine and pentoxifylline, which have TNF antagonizing and anti-proliferative action in the treatment of psoriasis.
  
  
  METHODS
  In this randomized controlled trial, 32 patients with extensive psoriasis were divided into four groups: group A received sulfasalazine; group B received pentoxifylline; group C received both drugs; and group D received methotrexate. The Psoriasis Area and Severity Index (PASI) score was done at weeks 0, 2, 4, 6 and 8.
  
  
  RESULTS
  A significant reduction in PASI score occurred in groups C and D (p = 0.043 and 0.018, respectively). A significantly higher percentage of PASI score reduction occurred in group D compared with groups A, B and C (p = 0.006, 0.003 and 0.030, respectively). An excellent response occurred in one patient (14.3%) in group D. A very good response occurred in two patients (22.2%) in group C, and in five patients (71.4%) in group D. A moderate response occurred in three patients (37.5%) in group A, one patient (12.5%) in group B, and one patient (14.3%) in group D.
  
  
  CONCLUSIONS
  Although incomparable to methotrexate, combined sulfasalazine and pentoxifylline produced a good response in cases of extensive psoriasis. Multicentre studies are needed to validate these results.
authors.affiliation: The Department of Dermatology, Kasr El-Aini University Hospital, Cairo University, Cairo, Egypt.
authors.forename: Medhat
authors.initials: M
authors.lastname: el-Mofty
authors.forename: Mohamed
authors.initials: M
authors.lastname: el-Darouti
authors.forename: Hoda
authors.initials: H
authors.lastname: Rasheed
authors.forename: Dalia Ahmed
authors.initials: DA
authors.lastname: Bassiouny
authors.forename: Mona
authors.initials: M
authors.lastname: Abdel-Halim
authors.forename: Naglaa Sameh
authors.initials: NS
authors.lastname: Zaki
authors.forename: Ghada
authors.initials: G
authors.lastname: el-Hanafy
authors.forename: Heba
authors.initials: H
authors.lastname: el-Hadidi
authors.forename: Omar
authors.initials: O
authors.lastname: Azzam
authors.forename: Amany
authors.initials: A
authors.lastname: el-Ramly
authors.forename: Marwa
authors.initials: M
authors.lastname: Fawzy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010431:Pentoxifylline / Q000627:therapeutic use*; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D011565:Psoriasis / Q000188:drug therapy*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D012460:Sulfasalazine / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010726:Phosphodiesterase Inhibitors; D012460:Sulfasalazine; D010431:Pentoxifylline