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Updated: Jul 9, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Severe deterioration of psoriasis due to an insulinoma
1Department of Dermatology, The Adelaide and Meath Hospital Incorporating the National Children's Hospital, Dublin, Ireland. sineadfield@hotmail.com
Abstract:
We report a case of a 56-year-old woman who presented with a severe exacerbation of psoriasis with concurrent hypoglycaemic episodes. Methotrexate 17.5 mg weekly was required to control her psoriasis. Investigation of her hypoglycaemia showed raised levels of insulin, C-peptide and proinsulin. Radiological investigation showed a tumour at the tail of the pancreas and the diagnosis was insulinoma. A spleen-preserving distal pancreatectomy was performed and the hypoglycaemic symptoms resolved. Immediately following the pancreatectomy, methotrexate was stopped and the patient's psoriasis went into remission. During a 2-year follow-up, she has required only minimal topical treatment for her skin.
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