Objective. To determine if weekly oral 2-chlorodeoxyadenosine (2-CdA) can induce selective lymphocytopenia, and reduce inflammation, in patients with refractory psoriatic arthritis.Methods. Seven patients with psoriatic arthritis were treated with oral 2-CdA at weekly dosages of 0.3 mg/kg to 0.45 mgkg for 12 weeks, followed by monthly maintenance therapy. The patients were evaluated after 6 months.Results. The drug treatment produced selective lymphocytopenia, and reduced lymphocyte infiltration into involved skin. One patient did not complete 12 weeks of therapy because of perceived lack of efficacy. Four of the 6 remaining patients had improved joint disease, and 5 of 6 had improved psoriasis.Conclusion. Weekly oral 2-CdA appears to be a well-tolerated regimen for the inducement of peripheral lymphocytopenia in patients with psoriatic arthritis. Larger-scale, controlled trials may be warranted.Psoriasis is a common inflammatory skin disease, characterized by abnormal keratinocyte proliferation and local vascular changes. Psoriatic skin lesions contain activated CD4+ T helper cells and macrophages (1). Adhesion molecules and other skin cell Supported in part by NIH grants AR-40770 and RR-00827.

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