Immunologic Changes in TNF‐alpha, sE‐selectin, sP‐selectin, sICAM‐1, and IL‐8 in Pediatric Patients Treated for Psoriasis with the Goeckerman Regimen

Abstract

Psoriasis is a chronic inflammatory skin disease which is often manifested during childhood. The present study investigated changes in the serum levels of proinflammatory cytokines and soluble forms of adhesion molecules in children with psoriasis. The observed patient group of 26 children was treated with the Goeckerman regimen. This therapy combines dermal application of crude coal tar with ultraviolet radiation. The Psoriasis Area Severity Index decreased significantly after treatment by with the Goeckerman regimen (p < 0.001). Serum levels of the proinflammatory cytokine TNF-alpha and adhesion molecules sICAM-1, sP-selectin and sE-selectin decreased after the Goeckerman regimen. The TNF-alpha and sICAM-1 decreased significantly (p < 0.05). Our findings support the complex role of these immune parameters in the immunopathogenesis of psoriasis in children. The serum level of IL-8 increased after the Goeckerman regimen. This fact indicates that the chemokine pathway of IL-8 activity could be modulated by this treatment, most likely by polycyclic aromatic hydrocarbons.

Serum Level of Antibodies (IgG, IgM) Against Benzo[a]pyrene-7,8-diol-9,10-epoxide-DNA Adducts in Children Dermatologically Exposed to Coal Tar

“…GT is an effective treatment for moderate and severe psoriasis in children (7)(8)(9)(10)(11)(12). In this study, the high effectiveness of the therapy was confirmed by a significant decrease of the PASI score.…”

“…It seems that fundamental mechanism of therapeutic effects of CCT is based on immunosuppression induced by polycyclic aromatic hydrocarbons in coal tar (PAHs) without signs of systemic immuno-toxicity (9,12). Retrospective studies have demonstrated that GT is effective in children and adolescents with moderate to severe psoriasis (7)(8)(9)(10)(11)(12). However, the use of GT has recently decreased for several reasons, including a supposed genotoxicity of CCT/PAHs (13)(14).…”

“…The therapy combines dermal exposure of crude coal tar (CCT) ointment and UV radiation (UVR) (7)(8)(9)(10)(11)(12). It seems that fundamental mechanism of therapeutic effects of CCT is based on immunosuppression induced by polycyclic aromatic hydrocarbons in coal tar (PAHs) without signs of systemic immuno-toxicity (9,12).…”

Treatment of Childhood Psoriasis with Phototherapy and Photochemotherapy

“…They report that remission was sustained for a mean of 2.6 years. 2 prior publications also reported on the use of this treatment modality in children; 1 reported a statistically significant decrease in PASI scores in 26 patients33 and the second publication showed a maximum clearing of >90% in 64% of patients (n = 31) with substantial improvement in others 34…”

Childhood Psoriasis Treatment: Evidence Published Over the Last 5 Years

“…Precipitating factors are more common in childhood than in adult onset psoriasis [2]. Although its pathogenesis remains unclear, it is widely hypothesized to be a complex interaction involving immunologic and environmental factors in a genetically predisposed host.…”