RESUMO
BACKGROUND: Narrow band ultraviolet-B (NB-UVB) is now one of the most widely used modalities in the treatment of psoriasis. However, despite its high efficacy, conventional Goeckerman treatment has fallen out of favor in recent years and some institutions are now using NBUVB with coal tar as their regimen. OBJECTIVE: To evaluate the efficacy of NB-UVB, Goeckerman therapy and the effect of addition of retinoid to the treatment regimen in the treatment of psoriasis,. PATIENTS AND METHODS: A retrospective analysis of 65 patients who underwent 81 courses of treatment in our department was undertaken. The efficacy of NB-UVB and Goeckerman therapy individually, and in combination with acitretin was assessed. Data were analysed to evaluate the contribution of acitretin to these modalities. RESULTS: PASI-75 responses in the NB-UVB, retinoid+NB-UVB (re-NB), Goeckerman and retinoid+Goeckerman (re-Goeckerman) groups were achieved for 12 of 31 patients (39%), 13 of 21 patients (62%), 15 of 17 patients (88%) and 10 of 12 patients, respectively. The addition of acitretin to both modalities reduced both the number of sessions and the cumulative ultraviolet-B dose delivered. LIMITATIONS: This is a retrospective study, the patients were not randomized and the number of patients in the treatment groups were dissimilar. CONCLUSION: Goeckerman therapy is more effective than NB-UVB phototherapy. Although the addition of acitretin to both NB-UVB and Goeckerman therapy did not contribute to treatment outcomes in terms of PASI-75 responses, it enabled a reduction in UV exposures and enhanced efficacy.
Assuntos
Acitretina/uso terapêutico , Ceratolíticos/uso terapêutico , Fotoquimioterapia , Psoríase/tratamento farmacológico , Psoríase/radioterapia , Terapia Ultravioleta , Adolescente , Adulto , Alcatrão/uso terapêutico , Terapia Combinada , Feminino , Humanos , Masculino , Estudos Retrospectivos , Ácido Salicílico/uso terapêutico , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto JovemRESUMO
Reiter's syndrome has characteristically been described in young males and presents with a triad of urethritis, conjunctivitis and arthritis. Reiter's syndrome has been known to affect children, although they usually do not manifest with the typical triad. Only a few such cases have been reported and these have described males predominantly. A case of a six-year-old girl who presented with watery diarrhea, redness of eyes and joint pains followed by skin involvement is reported. She was managed with topical salicylic acid and hydrocortisone, and oral aspirin and showed complete resolution of her clinical features in three weeks.