title: Evaluation of intralesional 5% 5-fluorouracil in resistant localized plaque psoriasis.
abstract: BACKGROUND
  Psoriasis is a chronic, autoimmune, inflammatory papulosquamous disorder, the treatment of which remains challenging. A variety of therapeutic modalities have been used with varying degree of success. But, there is no such therapeutic modality till date that can prevent the relapse in psoriasis.
  
  
  OBJECTIVE
  The present study is being undertaken to evaluate the therapeutic efficacy of intralesional 5% 5-fluorouracil (5-FU) as well as its role in preventing relapse in resistant localized plaque psoriasis.
  
  
  METHODS
  An open, prospective, randomized-controlled study.
  
  
  METHODS
  A total of 40 patients of resistant localized plaque psoriasis were enrolled for the study. Intralesional injection of 5% 5-FU was given in a dosage of 0.1 mL/cm(2) of each plaque using an insulin syringe. In all patients, a single plaque was kept as control and was given intralesional injection of distilled water. A total of three injections were given in each plaque at weekly intervals. After that, patients were followed-up regularly at the interval of 2 weeks up to 12 weeks. All the lesions (both treated and control) were assessed clinically as well as photographically at each visit and graded using psoriasis severity index scoring. Results were analyzed statistically at the end of the follow-up period.
  
  
  RESULTS
  At 12 weeks follow-up, out of 40 patients treated, 4 (10%) patients had clearance (>90% resolution), 19 (47.5%) had excellent (70%-90%) improvement, whereas 12 (30%) patients were moderately (30%-70%) improved, and only 5 (12.5%) patients had mild or no improvement. Results were statistically significant in treated group in comparison to control group. Almost all patients complained of pain at the site of injection which subsided within 1-2 h. A total of 10 (25%) patients had necrosis after one or two injections which healed during the follow-up period within 6-8 weeks.
  
  
  CONCLUSIONS
  Intralesional 5% 5-FU is found to be an effective therapeutic modality in resistant localized plaque psoriasis without much side effects.
authors.affiliation: Department of Dermatology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.
authors.forename: Bharat Bhushan
authors.initials: BB
authors.lastname: Mahajan
authors.affiliation: Department of Dermatology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.
authors.forename: Monika
authors.initials: M
authors.lastname: Singla
keywords: 5-fluorouracil; intralesional; plaque psoriasis