Psoriasis remission

MTX is part of curative therapeutic schedules for acute lymphoblastic leukemias (ALL), Burkitt s lymphoma, and choriocarcinoma. It was also used in adjuvant therapy of breast cancer. High dose MTX with leucovorin rescue can induce about 30% remissions in patients with metastatic osteogenic sarcoma. MTX is one of the few antineoplastic drugs that can be safely administered intrathecally for the treatment of meningeal metastases and leukemic infiltrations (routine prophylaxis in ALL). In addition, MTX can be used as an immunosuppressive agent for the treatment of severe rheumatoid arthritis and psoriasis. 

Psoriasis is a common chronic inflammatory disease characterized by recurrent exacerbations and remissions of thickened, erythematous, and scaling plaques. 

Psoriasis is a common chronic inflammatory skin disorder characterized by recurrent exacerbations and remissions of thickened, erythematous, and seating plaques. The clinical appearance of psoriasis may be cosmetically disfiguring, and the disease may be physically and emotionally debilitating, especially for patients with severe disease. 

Outpatient costs for a patient with mild to moderate psoriasis may run as high as 4,000 per patient per year. Psoriasis is a chronic disease with patients either requiring treatment or being in remission. Patients with severe psoriasis may be disabled. A patient with early onset of psoriasis may require treatment for more than 50 years. 

Krueger GG, Elhs CN. Alefacept therapy produces remission for patients with chronic plaque psoriasis. Br J Dermatol 2003 148 784-788. 

After about 20 years of searching, Meade met with success. He refused to further identify the plant, but passed out free samples of the brownish, viscous fluid obtained. Skin cancers of every type go into remission, rashes disappear as does psoriasis, black moles, the raised, blackened welts caused by childhood strep infections also tick, mosquito and other insect bites and stings. Meade was given encouragement by some in the local medical community, with the opinion that perhaps 98% of all plants have not yet been checked out for medicinal properties. Karen McMahon, a biological science professor at the nearby University of Tulsa and coauthor of a botany textbook, noted that most plants have not yet been identified by science, and the quest continues for new medicinal plants, which contain chemicals no scientist could dream up. Inasmuch as a plant cannot be patented, about all Meade could do at this time was give samples away. 

Methotrexate (amethopterin Rheumatrex, trexall, others) has been used in the treatment of severe, disabling psoriasis in doses of 2.5 mg orally for 5 days, followed by a rest period of at least 2 days, or 10-25 mg intravenously weekly. It also is used intermittently at low dosage to induce remission in rheumatoid arthritis. 

Patients who have psoriasis are treated with antipsoriatic medications that loosen er5hhematous papules and plaques. However, patients usually experience periods of exacerbation and remission. 

Vitamin A (retinol) (Fig. 7.12) and its metabolic oxidation products assume a critical physiological role in growth, development and differentiation of epithelial tissue, the maintenance of vision, and as well in spermatogenesis and the normal development of the placenta and the foetus. (allE)-Retinoic acid and (13Z)-retinoic acid are important medicaments for the treatment of acne and psoriasis the former has also demonstrated complete remission in most cases of acute promyelocytic leukemia (APL). 

Forty-two patients with palmoplantar pustulosis, including 21 with psoriasis elsewhere on the body, responded well to etretinate at an initial dosage of 75 mg/ day. Pustules healed within 2 weeks but recurred in some patients within 2 weeks of stopping therapy. Other patients with complete remissions had prolonged remissions lasting as long as 6 months (Thune, 1982). 

Etretinate at dosages of 0.5-1 mg/kg/day enhanced ultraviolet light (UVB) phototherapy of psoriasis. In one study, 66% of patients who had previously failed to respond to UVB phototherapy could be maintained successfully on etretinate and UVB treatments given once a week or less (Orfanos et al., 1979). In a multicenter double-blind trial, etretinate in initial doses of 0.5-0.66 mg/kg/ day was found to produce still better results if used in conjunction with a topical corticosteroid (0.1% triamcinolone acetonide). Thirty-one patients were maintained in complete remission for over 2 years by use of a low-maintenance dose of etretinate (25 mg/day) in addition to the topical corticosteroid (van der Rhee and Polano, 1981). 

Patients with the dry, brown, hyperkeratotic type of Darier s disease respond better and may have more prolonged remissions than those with the red, inflamed, infected variety of Darier s disease who also have marked intertrigenous involvement. These latter patients are much more difficult to treat and relapse very quickly after therapy is stopped. Although there was no initial worsening of disease, as occasionally occurs with psoriasis, isomorphic reactions did occur in... 

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