Related Experiment Video
Updated: May 10, 2026
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Immunological changes in psoriasis patients under long-term treatment with fumaric acid esters: risk of Kaposi
Sandra Philipp1, Georgios Kokolakis1, Martina Hund2
1Psoriasis Research and Treatment Center,, Interdisciplinary Group of Molecular Immunopathology, Dermatology / Medical Immunology.
Background:
Psoriasis is a chronic skin disorder. The most frequently used systemic anti-psoriatic therapy in Germany is fumaric acid esters (FAE).
Objectives:
We aimed to characterize immunological changes in psoriasis patients under FAE treatment.
Methods And Materials:
Over 200 flow-cytometry analyses of blood from 27 psoriasis patients and histological, molecular, and serological analyses of samples from a patient who developed Kaposi sarcoma (KS) during FAE therapy were performed.
Results:
The patients receiving FAE showed decreased CD8+ T cell counts, in particular during the first six months. The CD4+ T cell decline was less pronounced and delayed in time. In a patient with KS, we found a profound CD4 and CD8 lymphocytopenia, as well as a NK cell number reduction, although leukocyte and lymphocyte counts were within the recommended limits. The patient was HIV negative, but positive for HHV8. After cessation of FAE therapy, KS regressed.
Discussion:
HHV8 infection and iatrogenic T cell reduction, prominently of CD8+ T cells, could have contributed to KS development in this patient. Therefore, we suggest a control of CD4+ and CD8+ T cell counts in addition to the commonly-used differential blood counts in patients with a higher HHV8 prevalence or at high risk of other latent viral infections.