MedWire News: Use of the Goeckerman regimen to treat psoriasis in children may increase their risk of genotoxicity, warn researchers.
The Goeckerman regimen combines dermal application of 2% crude coal tar with daily broadband ultraviolet B radiation.
Children are often more sensitive than adults to chemical treatments, so Lenka Borska (Charles University in Prague, Czech Republic) and colleagues studied 42 children with psoriasis who were receiving Goeckerman regimen therapy.
The Goeckerman regimen was effective in these patients, causing a reduction in average Psoriasis Area and Severity Index score from 26.21 to 5.08.
However, the prevalence of cells with chromosomal aberrations rose from 1.21% before treatment to 2.33% after treatment. The reference range for healthy Czech children is 0–1.71%, say the researchers, so the post-treatment rate in the psoriasis patients represents a significant increase.
Also, levels of heat shock protein 70, which is upregulated by cellular stress, rose from 3.68 ng/ml before treatment to 5.31 ng/ml after treatment.
“Our data suggest that Goeckerman regimen therapy is very probably associated with increased genotoxic risk for pediatric patients,” Borska et al conclude in the journal Pediatric Dermatology.
“This has potentially greater importance in paediatric patients because of greater risk of cumulative genotoxic risk over a whole lifetime.”
They add: “The identification of psoriasis patients with greater sensitivity to genotoxic damage and determination of theoretical cumulative genotoxic risk could be of real clinical significance for patients receiving Goeckerman regimen.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009