Results of Goeckerman Treatment for Psoriasis in Children: A 21-Year Retrospective Review

Abstract

Goeckerman treatment has been used for the management of widespread psoriasis in children for several decades at Mayo Clinic. We aimed to review our institutional experience with the effectiveness of Goeckerman treatment for psoriasis in children. We retrospectively reviewed the records of pediatric patients who underwent Goeckerman treatment over a 21-year period (1983-2003). The main outcome measure was improvement in psoriasis. During the study period, 65 children received Goeckerman treatment for predominantly widespread, recalcitrant psoriasis. The mean age was 11.6 years (range, 3 mos to 18 yrs), and the female-to-male ratio was 2:1. Psoriasis improved in all patients: 55 patients (85%) had >80% clearance of their psoriasis. The only adverse effect was folliculitis, occurring in 27 patients (42%). Mean duration of follow-up was 2.6 years (range, 17 days-18.2 yrs); average duration of remission was 2.6 years (range, 2 mos-12.79 yrs). Goeckerman treatment is an effective treatment for widespread psoriasis in children.

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).…”

“…Goeckerman therapy (GT) represents a treatment of plaque psoriasis in children (7). The therapy combines dermal exposure of crude coal tar (CCT) ointment and UV radiation (UVR) (7)(8)(9)(10)(11)(12).…”

The Number of Immunoregulatory T Cells is Increased in Patients with Psoriasis after Goeckerman Therapy

“…coal tar consists of largely undefined aliphatic and aromatic hydrocarbons which in combination with immunomodulatory effect of Uv irradiation are responsible for diminished hyperproliferation of epidermal cells (12,22). the combination of coal tar and Uv light has been reported to be more effective than either therapy alone (19). coal tar displays anti-inflammatory, antibacterial and antipruritic effects.…”