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Updated: Jun 8, 2026
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Sequential clinico-histological studies in psoriasis following methotrexate therapy
S Talwar1, V D Tiwari, R Lakhtakia
1Departments of Dermatology and Pathology, Base Hospital, Lucknow, India, .
Indian Journal of Dermatology, Venereology and Leprology
|October 19, 2010
Summary
This study tracked psoriasis histological changes during methotrexate therapy. Methotrexate effectively resolved scaling, induration, and erythema, but some histological features persisted post-treatment.
Area of Science:
- Dermatology
- Histopathology
- Pharmacology
Background:
- Psoriasis is a chronic inflammatory skin condition.
- Methotrexate is a common systemic treatment for psoriasis.
- Understanding the histological resolution patterns is crucial for treatment evaluation.
Purpose of the Study:
- To investigate the histological resolution patterns in psoriasis patients treated with weekly methotrexate.
- To evaluate the correlation between clinical and histological changes during methotrexate therapy.
Main Methods:
- Ten patients with psoriasis were enrolled.
- Sequential skin biopsies were performed on each patient.
- Histological analysis focused on epidermal and dermal changes over time.
Main Results:
- Clinical symptoms like scaling, induration, and erythema resolved progressively over weeks.
- Histological improvements included normalization of the granular layer, stratum corneum, and mitotic activity within days to weeks.
- Mild acanthosis, cellular infiltrate, and vascular dilatation persisted post-clinical resolution.
- An initial increase in cellular infiltrate and edema was observed in 50% of patients after the first methotrexate dose.
Conclusions:
- Weekly methotrexate therapy leads to significant histological improvements in psoriasis.
- Complete histological resolution may lag behind clinical improvement.
- Transient inflammatory changes can occur after initial methotrexate administration.
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