Surgical treatment of psoriasis

24 patients with plaque psoriasis were treated by serial dermatome shaving of the affected skin. Depth of excision was to the middle of the reticular dermis. Postoperatively the wound was treated as for a skin-graft donor site and healed satisfactorily in all cases. Follow-up extended from 3 to 36 months. In 17 patients, the shaved areas healed to give normal skin and appendages and remained free from psoriasis during the period of observation. 7 patients had minor recurrences along the margin of the shaved area; in 1 a further shaving was followed by recurrence-free healing of the area. In plaque psoriasis, therefore, excision of the superficial skin layers appears to be an effective and easy alternative to medical treatment.