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Updated: Jun 22, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
11:39

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

Severely photosensitive psoriasis: a phenotypically defined patient subset.

Kirsty J Rutter1, Rachel E B Watson, Lindsey F Cotterell

  • 1Department of Dermatological Sciences, School of Translational Medicine, University of Manchester, Manchester M6 8HD, UK.

The Journal of Investigative Dermatology
|June 19, 2009
PubMed
Summary

Severely photosensitive psoriasis (PP) is a distinct subtype characterized by early onset and a specific response to ultraviolet A (UVA) light. This study reveals UVA can rapidly induce psoriasis features, suggesting a role for T cells.

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Area of Science:

  • Dermatology
  • Immunology
  • Genetics

Background:

  • A subset of chronic plaque psoriasis patients exhibit photosensitive psoriasis (PP) with a seasonal pattern.
  • The underlying pathomechanism of PP remains poorly understood.

Purpose of the Study:

  • To clinically characterize PP and investigate its pathomechanisms.
  • To explore the role of ultraviolet A (UVA) light in inducing psoriasis onset.

Main Methods:

  • Clinical characterization of 20 PP patients.
  • Controlled photoprovocation study with UVA on 10 PP patients, 9 non-PP patients, and 11 healthy volunteers.
  • Serial skin biopsies for histological analysis.

Main Results:

  • PP patients showed female predominance, early onset (mean 11 years), and strong HLA-Cw*0602 association.
  • UVA challenge induced early psoriasis-like histological changes in 40% of PP patients but not controls.
  • Significant dermal infiltration of neutrophils and T cells (CD4+, CD8+, CD45RO+) observed within 24 hours.

Conclusions:

  • PP represents a phenotypically distinct psoriasis subset.
  • UVA can rapidly induce psoriasiform features de novo, implicating memory effector T cells in the early phase.