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The treatment of psoriasis vulgaris: 1% topical methotrexate gel.

AbstractBACKGROUND: In general, 70% of patients with psoriasis prefer topical therapy as the treatment of choice. AIM: To evaluate the efficacy and tolerability of 1% topical methotrexate gel vs. placebo (vaseline ointment) as treatment for psoriasis. METHODS: Forty patients (20 females and 20 males) with chronic plaque-type psoriasis joined the study. Each patient was allocated to apply 1% methotrexate gel and placebo topically to their two target lesions, equal in area and disease severity, twice daily for 8 weeks. Lesions were scored at baseline and after 2, 4, 6, and 8 weeks of treatment for erythema, scale, and infiltration. The global improvement and histopathologic features were also assessed after methotrexate treatment. RESULTS: At the end of treatment, erythema was cleared totally in 47.5% of patients treated with methotrexate vs. 7.5% of those treated with placebo, and infiltration in 22% of patients treated with methotrexate vs. 2.5% of those treated with placebo (P<0.01). Clinical improvement was almost the same for the two groups with regard to scale (P<0.5). The global improvement was 97% for patients treated with methotrexate vs. 60% for those treated with placebo, and a significant difference was found between the groups (P<0.01). Histopathologic improvement was achieved in the methotrexate group (P<0.01). No side-effects were observed. CONCLUSION: The findings of this study suggest that methotrexate 1% in a hydrophilic gel is well tolerated and significantly more effective than placebo as a topical medication for the treatment of psoriasis vulgaris.
AuthorsBuket Eskicirak, Ebru Zemheri, Arzu Cerkezoglu (Affiliation: Uskudar Government Hospital, Istanbul, Turkey. beskicirak at hotmail.com)
JournalInternational journal of dermatology (Int J Dermatol) Vol. 45 Issue 8 Pg. 965-9 (Aug 2006) ISSN: 0011-9059 United States
PMID16911386 (Publication Type: Controlled Clinical Trial, Journal Article)
Chemical References
  • Dermatologic Agents
  • Gels
  • Methotrexate
Topics
  • Administration, Cutaneous
  • Adolescent
  • Adult
  • Dermatologic Agents (administration & dosage, adverse effects, therapeutic use)
  • Female
  • Gels
  • Humans
  • Male
  • Methotrexate (administration & dosage, adverse effects, therapeutic use)
  • Middle Aged
  • Psoriasis (drug therapy, pathology)
  • Single-Blind Method