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Phototherapy with Ultraviolet B
Published in Henry W. Lim, Nicholas A. Soter, Clinical Photomedicine, 2018
Serge A. Coopman, Robert S. Stern
Numerous different treatment regimens exist. In one classic approach, anthralin is usually applied on psoriatic plaques for 6–8 hr in a hard or soft paste formulation with concentrations that increase gradually from 0.05% or 0.1%. Then the paste is removed with mineral oil. A tar bath is given and the patient is exposed to increasing doses of UVB. The Ingram approach has been found superior to a modified Goeckerman therapy in terms of rapidity of response, but it induced comparable remission times (36).
Current Recommendations for the Treatment of Psoriasis
Published in Siba P. Raychaudhuri, Smriti K. Raychaudhuri, Debasis Bagchi, Psoriasis and Psoriatic Arthritis, 2017
The history of psoriasis treatment spans over a century, with the first modern treatment consisting of anthralin in the late 1800s. In 1925, dermatologist William H. Goeckerman discovered an adjunctive effect of coal tar and ultraviolet radiation on psoriasis plaques.1 In terms of effectiveness, Goeckerman therapy was the gold standard treatment regimen for several decades, although therapy sessions are time-consuming and require patients to attend day centers. In 1952, 2 years after the Nobel Prize was awarded for the development of cortisone, topical hydrocortisone was found to successfully treat inflammatory skin conditions. This revolutionized the treatment of psoriasis and remains the mainstay of topical treatments today. Other topical therapies, including retinoids and vitamin D, were later developed in the 1980s.
Phototherapy and photochemotherapy
Published in M. Alan Menter, Caitriona Ryan, Psoriasis, 2017
Farhaad R. Riyaz, Henry W. Lim
Goeckerman therapy1 and the Ingram regimen49 combine UV therapy with topical tar and anthralin, respectively. The observation that suberythemogenic doses of UVB therapy are effective when used in combination with crude coal tar50 paved the way for the use of less aggressive UVB therapy regimens by using a combination of treatments.
Evidence-based clinical practice guidelines for the management of psoriasis: systematic review, critical appraisal, and quality assessment with the AGREE II instrument
Published in Journal of Dermatological Treatment, 2022
Mohamed Ali Babiker Mohamed, Ahmed M. El-Malky, Wael Ahmed Abdelwahab Abdelkarim, Mohamed Abdulmonem Salih Aabdeen, Tarig Hassan Elobid Ahmed, Hassan H. H. Sarsour, Munirah Mohammed Mosa, Yasser S. Amer, Abdulrahman Ali M. Khormi, Abdulmajeed Alajlan
Management of psoriasis aims at stopping skin cells to over grow, remove the scales and crusts, however, treatment modalities varied through the time to pass via many development stages which was approved by international agencies and scientific communities (6,7). Topical therapy; corticosteroids, vitamin D analogs, retinoids, calcineurin inhibitors, salicylic acid, coal tar, anthralin, and Goeckerman therapy. Light therapy; sunlight, ultraviolet radiation, and Excimer laser. Oral or injected medications; Methotrexate, Cyclosporine, and biologics (8). Various treatment modalities for managing psoriasis have been established by societies, academies, and organizations. However, inconsistencies have led to confusion and discrepancies among schools and care givers (9,10). This situation has motivated the scientific community to establish guidelines for reducing variations in treatment, and thus, eliminating the possibility of errors. Currently, there is no national Clinical Practice Guideline (CPG) in Saudi Arabia for the care of patients with psoriasis (11–13).
Mineral oil in food, cosmetic products, and in products regulated by other legislations
Published in Critical Reviews in Toxicology, 2019
Ralph Pirow, Annegret Blume, Nicole Hellwig, Matthias Herzler, Bettina Huhse, Christoph Hutzler, Karla Pfaff, Hermann-Josef Thierse, Tewes Tralau, Bärbel Vieth, Andreas Luch
A US retrospective study on the incidence rates of skin cancer was conducted in patients with psoriasis that had received an initial Goeckerman therapy (combination of crude coal tar and artificial ultraviolet radiation) and of which many continued to use coal tar regularly on an outpatient basis (Pittelkow et al. 1981). The 25-year follow-up analysis of the initial patient population revealed that 19 out of 260 patients reported the incident of non-melanoma skin cancer (NMSC), and one patient reported the development of a malignant melanoma. Expected incidence rates of NMSC for the study population were calculated from annual age-specific incidence rates for four US areas, which were available from the 3rd National Cancer Survey. In a study group of 260 patients the number of subjects expected to develop skin cancer was 49 for Dallas, 16 for Iowa, 19 for Minneapolis and 23 for San Francisco. This suggests that the incidence of skin cancer is not appreciably increased above the expected incidence.
Safety considerations with combination therapies for psoriasis
Published in Expert Opinion on Drug Safety, 2020
Unfortunately, given the extensive resources required by medical facilities to conduct the Goeckerman regimen, combined with the time commitment required for patients (all day treatments for approximately four to 6 weeks), Goeckerman therapy is rarely available today [52]. An alternative to the Goeckerman regimen is the use of liquor carbonis detergens (LCD) or gold tar at home in conjunction with outpatient NB-UVB, which is shown to be more effective than NB-UVB alone [53].