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Evaluation of intralesional 5% 5-fluorouracil in resistant localized plaque psoriasis

BACKGROUND: Psoriasis is a chronic, autoimmune, inflammatory papulosquamous disorder, the treatment of which remains challenging. A variety of therapeutic modalities have been used with varying degree of success. But, there is no such therapeutic modality till date that can prevent the relapse in ps...

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Autores principales: Mahajan, Bharat Bhushan, Singla, Monika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4144213/
https://www.ncbi.nlm.nih.gov/pubmed/25165645
http://dx.doi.org/10.4103/2229-5178.137779
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author Mahajan, Bharat Bhushan
Singla, Monika
author_facet Mahajan, Bharat Bhushan
Singla, Monika
author_sort Mahajan, Bharat Bhushan
collection PubMed
description BACKGROUND: Psoriasis is a chronic, autoimmune, inflammatory papulosquamous disorder, the treatment of which remains challenging. A variety of therapeutic modalities have been used with varying degree of success. But, there is no such therapeutic modality till date that can prevent the relapse in psoriasis. AIMS: The present study is being undertaken to evaluate the therapeutic efficacy of intralesional 5% 5-fluorouracil (5-FU) as well as its role in preventing relapse in resistant localized plaque psoriasis. STUDY DESIGN: An open, prospective, randomized-controlled study. MATERIALS AND METHODS: A total of 40 patients of resistant localized plaque psoriasis were enrolled for the study. Intralesional injection of 5% 5-FU was given in a dosage of 0.1 mL/cm(2) of each plaque using an insulin syringe. In all patients, a single plaque was kept as control and was given intralesional injection of distilled water. A total of three injections were given in each plaque at weekly intervals. After that, patients were followed-up regularly at the interval of 2 weeks up to 12 weeks. All the lesions (both treated and control) were assessed clinically as well as photographically at each visit and graded using psoriasis severity index scoring. Results were analyzed statistically at the end of the follow-up period. RESULTS: At 12 weeks follow-up, out of 40 patients treated, 4 (10%) patients had clearance (>90% resolution), 19 (47.5%) had excellent (70%-90%) improvement, whereas 12 (30%) patients were moderately (30%-70%) improved, and only 5 (12.5%) patients had mild or no improvement. Results were statistically significant in treated group in comparison to control group. Almost all patients complained of pain at the site of injection which subsided within 1-2 h. A total of 10 (25%) patients had necrosis after one or two injections which healed during the follow-up period within 6-8 weeks. CONCLUSION: Intralesional 5% 5-FU is found to be an effective therapeutic modality in resistant localized plaque psoriasis without much side effects.
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spelling pubmed-41442132014-08-27 Evaluation of intralesional 5% 5-fluorouracil in resistant localized plaque psoriasis Mahajan, Bharat Bhushan Singla, Monika Indian Dermatol Online J Original Article BACKGROUND: Psoriasis is a chronic, autoimmune, inflammatory papulosquamous disorder, the treatment of which remains challenging. A variety of therapeutic modalities have been used with varying degree of success. But, there is no such therapeutic modality till date that can prevent the relapse in psoriasis. AIMS: The present study is being undertaken to evaluate the therapeutic efficacy of intralesional 5% 5-fluorouracil (5-FU) as well as its role in preventing relapse in resistant localized plaque psoriasis. STUDY DESIGN: An open, prospective, randomized-controlled study. MATERIALS AND METHODS: A total of 40 patients of resistant localized plaque psoriasis were enrolled for the study. Intralesional injection of 5% 5-FU was given in a dosage of 0.1 mL/cm(2) of each plaque using an insulin syringe. In all patients, a single plaque was kept as control and was given intralesional injection of distilled water. A total of three injections were given in each plaque at weekly intervals. After that, patients were followed-up regularly at the interval of 2 weeks up to 12 weeks. All the lesions (both treated and control) were assessed clinically as well as photographically at each visit and graded using psoriasis severity index scoring. Results were analyzed statistically at the end of the follow-up period. RESULTS: At 12 weeks follow-up, out of 40 patients treated, 4 (10%) patients had clearance (>90% resolution), 19 (47.5%) had excellent (70%-90%) improvement, whereas 12 (30%) patients were moderately (30%-70%) improved, and only 5 (12.5%) patients had mild or no improvement. Results were statistically significant in treated group in comparison to control group. Almost all patients complained of pain at the site of injection which subsided within 1-2 h. A total of 10 (25%) patients had necrosis after one or two injections which healed during the follow-up period within 6-8 weeks. CONCLUSION: Intralesional 5% 5-FU is found to be an effective therapeutic modality in resistant localized plaque psoriasis without much side effects. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC4144213/ /pubmed/25165645 http://dx.doi.org/10.4103/2229-5178.137779 Text en Copyright: © Indian Dermatology Online Journal http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Mahajan, Bharat Bhushan
Singla, Monika
Evaluation of intralesional 5% 5-fluorouracil in resistant localized plaque psoriasis
title Evaluation of intralesional 5% 5-fluorouracil in resistant localized plaque psoriasis
title_full Evaluation of intralesional 5% 5-fluorouracil in resistant localized plaque psoriasis
title_fullStr Evaluation of intralesional 5% 5-fluorouracil in resistant localized plaque psoriasis
title_full_unstemmed Evaluation of intralesional 5% 5-fluorouracil in resistant localized plaque psoriasis
title_short Evaluation of intralesional 5% 5-fluorouracil in resistant localized plaque psoriasis
title_sort evaluation of intralesional 5% 5-fluorouracil in resistant localized plaque psoriasis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4144213/
https://www.ncbi.nlm.nih.gov/pubmed/25165645
http://dx.doi.org/10.4103/2229-5178.137779
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