title: Positive effect of modified Goeckerman regimen on quality of life and psychosocial distress in moderate and severe psoriasis.
abstract: Psoriasis is a chronic inflammatory skin disease with a profound effect on quality of life and psychosocial stress. The relationship between clinical improvement and psycho-social impact after treatment is complex. The objective of this study was to compare changes in quality of life and psychosocial distress, and overall cost-effectiveness, in patients with psoriasis receiving the modified Goeckerman regimen (UV irradiation and coal tar) with those receiving conventional treatment. Patients with moderate/severe psoriasis receiving the Goeckerman regimen were followed from admission to discharge. Clinical severity, was evaluated weekly using the Psoriasis Area and Severity Index (PASI). Psoriasis Disability Index (PDI) and Hospital Anxiety and Depression Scale (HADS) questionnaires were applied at admission and one month after discharge. Thirty-six patients with psoriasis receiving conventional treatment and 48 patients receiving the Goeckerman regimen were recruited to the study. The mean PASI score in the Goeckerman group decreased from 27.1 to 6.9 and PDI scores decreased from 25.3 to 13.8. HADS scores for anxiety and depression decreased significantly from 9.8 to 6.3 and 9.1 to 6.8, respectively. In comparison with conventional therapy, the modified Goeckerman regime showed similar clinical efficacy, with additional benefits in improving overall quality of life and psychosocial distress in patients with moderate/severe psoriasis, and more cost-effectiveness.
authors.affiliation: Department of Dermatology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Niao-Sung Hsiang, Kaohsiung, Taiwan. erickchern@cgmh.org.tw
authors.forename: Erick
authors.initials: E
authors.lastname: Chern
authors.forename: Diana
authors.initials: D
authors.lastname: Yau
authors.forename: Ji-Chen
authors.initials: JC
authors.lastname: Ho
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Wu
authors.forename: Cheng-Yu
authors.initials: CY
authors.lastname: Wang
authors.forename: Hsueh-Wen
authors.initials: HW
authors.lastname: Chang
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Cheng
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D016022:Case-Control Studies; D003033:Coal Tar / Q000191:economics / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D003863:Depression / Q000209:etiology / Q000517:prevention & control; D004185:Disability Evaluation; D005260:Female; D017048:Health Care Costs; D006801:Humans; D053208:Kaplan-Meier Estimate; D007641:Keratolytic Agents / Q000191:economics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000175:diagnosis / Q000191:economics / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000191:economics
chemical_list: D007641:Keratolytic Agents; D003033:Coal Tar