Comparison of the Efficacy of the Systemic Treatments by Immunohistochemical Method in Psoriasis

Abstract

Psoriasis is a chronic, inflammatory, T cell mediated hyperproliferative skin disease. Although the disease requires systemic treatment in about 20% -30% of psoriatic patients, studies about the comparison between the efficacy of the systemic treatment modalities are few. Narrowband ultraviolet B (UVB), acitretin and methotrexate are being used as traditional treatments for years. It is aimed to compare the efficacy of these common treatments with the psoriasis area and severity index (PASI) and Ki 67 which is a marker expresses proliferation. Patients were divided into three groups; 13 patient who received narrowband UVB (3 days a week), 10 patient who received acitretin (1 mg/kg/day oral) and 11 patient wo received methotrexate (25 mg/week intramuscular), PASI and biopsies were assessed before and at the third month of the treatment. The reduction in the PASI and immunohistochemically Ki 67 ekspressions, were statistically significant in three treatment groups (p<0.001). But results were not statistically different between groups (p>0.05). Clearence rate was found statistically higher in PASI than Ki 67 ekspression. We conclude that efficacy of narrowband UVB, asitretin and methotrexate therapies did not have any predominance to each other clinically and immunohistochemically. But these results showed that clinical improvement (PASI) may not play a significant role in determining therapy period because it is not correlated directly with cell proliferation immunohistochemically. © 2012 OMU.