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Updated: Sep 30, 2026
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Effects of systemic treatment with liarozole on cutaneous inflammation, epidermal proliferation and differentiation
J P van Pelt1, E M de Jong, E S de Bakker
1Department of Dermatology, University Hospital Nijmegen, The Netherlands. J.vanPelt@Derma.AZN.NL
Abstract:
Liarozole is a novel inhibitor of the enzyme cytochrome P450 which has inhibitory effects on the 4-hydroxylation of retinoic acid. Previous studies have shown that liarozole is effective in the treatment of psoriasis. We performed an immunohistochemical study on the lesional skin from 7 patients with extensive plaque psoriasis, who were treated with systemic liarozole 75 mg BID for a period of at least 2 months. The effects of liarozole treatment on clinical and histological parameters were investigated. In particular, the effect of liarozole on the integrin markers CD11b and CD18 was studied. For immunohistochemistry, three consecutive biopsies were taken: before treatment, after 4, and after 8 weeks of treatment. Clinical scores and side effects were recorded before and during treatment. The medication was well tolerated and only mild side effects were reported, which were comparable with hypervitaminosis A. After 2 months of treatment a statistically significant decrease of the extent of body involvement was observed. In the psoriatic plaque, markers for epidermal proliferation and cutaneous inflammation decreased, and markers for epidermal differentiation increased to values comparable to normal skin. The first therapeutic effects in the psoriatic plaque occurred after 4 weeks of treatment, and consisted of a decreased induration, accompanied by a decrease of the total number of inflammatory infiltrate cells and a decreased epidermal ICAM-1 expression. Already after 4 weeks of treatment, a decrease of CD11b-positive cells was observed. Subsequently, after 8 weeks of treatment recruitment of cycling epidermal cells and the number of involucrin-positive cell layers decreased. The present study demonstrates that liarozole treatment of psoriasis results in a reduction of aspects of cutaneous inflammation and subsequently a reduction of epidermal proliferation and promotion of differentiation. After 4 weeks of treatment, effects are observed on the epidermal ICAM-1 expression and on the CD11b-positive cell population.
Insights
Liarozole effectively treats psoriasis by reducing skin inflammation and proliferation while promoting differentiation. This cytochrome P450 inhibitor shows therapeutic effects within 4 weeks, improving clinical scores and histological markers with minimal side effects.
Area of Science:
- Dermatology
- Pharmacology
- Immunohistochemistry
Background:
- Liarozole inhibits cytochrome P450, affecting retinoic acid metabolism.
- Previous research indicates liarozole's efficacy in psoriasis treatment.
- Psoriasis involves epidermal proliferation and cutaneous inflammation.
Purpose of the Study:
- To investigate the clinical and histological effects of systemic liarozole in plaque psoriasis patients.
- To assess liarozole's impact on integrin markers CD11b and CD18.
- To evaluate therapeutic effects and side effects of liarozole treatment.
Main Methods:
- Immunohistochemical analysis of skin biopsies from 7 psoriasis patients before, during, and after 8 weeks of liarozole treatment (75 mg BID).
- Monitoring of clinical scores, body surface area involvement, and side effects.
- Quantification of epidermal proliferation, differentiation, inflammation markers, and integrin expression (CD11b, CD18, ICAM-1).
Main Results:
- Liarozole treatment was well-tolerated with mild, hypervitaminosis A-like side effects.
- Significant reduction in body surface area involvement after 2 months.
- Decreased epidermal proliferation and inflammation markers, increased differentiation markers.
- Early therapeutic effects observed at 4 weeks, including reduced induration, inflammatory infiltrate, and ICAM-1 expression.
- Reduced CD11b-positive cells noted after 4 weeks, with decreased cycling epidermal cells and increased involucrin-positive layers after 8 weeks.
Conclusions:
- Liarozole treatment reduces cutaneous inflammation, epidermal proliferation, and promotes differentiation in psoriasis.
- Therapeutic effects manifest within 4 weeks, impacting ICAM-1 and CD11b-positive cells.
- Liarozole demonstrates a favorable safety profile for psoriasis management.
