The Effectiveness and Remission Time of Retinoid - Modified Ingram Therapy for Psoriasis

Kim, Byoung Kook; Youn, Jai Il; Chang, Seung Ho

Abstract

BACKGRUOND: Although treatment with etretinate or modified Ingram method is effective for psoriasis, both regimens have limitations beeause of the risk of long-term toxicity.
OBJECTIVE
We performed retinoid-modified Ingram combination therapy expecting greater therapeutic efficacy and less side effect.
METHODS
Thirty three plaque-form psoriasis patients were included. Pretreatment with etretinate for 1 to 2 weeks was followed by modified Ingram therapy in combination with etretinate.
RESULTS
l. Among 33 patients, clearing was shown in 26 patients(78.8%), 4 patients(12.1%) was improved, and 3 patients(9.1%) showed failure. The number of cleared patient was 13/15 (86.7% ) in moderate group, and 13/18 (72.2%) in severe group. 2. In cleared patients, the mean numbers, duration, and total dose of UVB therapy reaching grade 4 were 11.9, 24.5 days, 1348.5 mJ/cm in trunk, and 13.5, 29.1 days, 1733.3 mJ/cm in extremities. Their differences between trunk and extremities were not statistically significant (p>0.05). 3. In cleared patients, the mean numbers, duration, total dose of phototherapy, and total close of etretinate reaching grade 4 in severe group were not significantly higher than them in moderate group (p>0.05). 4. There were some side effects of etretinate such as cheilitis, dry mouth, and side effects of modified Ingram therapy such as erythema, pruritus. But there was no discontinuation of therapy due to side effect. 5. In 22 patients who were followed up at least,one year, the mean remission time was 149 months in moderate group and 6.9 months in severe group.
CONCLUSION
Our study suggests that retinoid-modified Ingram regimen is effective and tolerable in the treatment of psoriasis, especially in severe group.