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6-Thioguanine treatment of psoriasis: experience in 81 patients
H S Zackheim1, R G Glogau, D A Fisher
1Department of Dermatology, University of California, San Francisco.
Background:
Despite recent innovations a considerable number of patients with psoriasis cannot be successfully treated by current therapies.
Objective:
Our purpose was to summarize our 18-year experience with the antimetabolite 6-thioguanine in the management of patients with psoriasis.
Methods:
We retrospectively studied 81 patients who were treated with 6-thioguanine. A variety of schedules were used to find the optimal schedule. Forty-eight percent of the patients either had been treated with methotrexate or were excluded from receiving methotrexate because of liver or kidney disease.
Results:
Forty-nine percent of patients with plaques were effectively maintained with 6-thioguanine for a median of 33 months. Four of five patients with palmoplantar pustular psoriasis experienced substantial benefit. The most common side effect was myelosuppression.
Conclusion:
6-Thioguanine is an effective therapy for psoriasis and should be considered for patients who have failed to respond to other systemic agents.