Effıcacy of Subcutaneous Methotrexate in Symmetrıcal Psorıatıc Plauqes

Year 2019, Volume: 11 Issue: 2, 44 - 49, 29.03.2019

Ulaş Güvenc

Abstract

Abstract

Introduction: Psoriasis is a chronic and recurrent skindisease characterized by inflammation and hyperproliferation, the etiology of which is unknown. Generally; In caseswhere more than 10% of body surface area is affected or not responding sufficiently with local treatments, systemic treatment agents are applied. Methotrexate is the most com-monly used systemic agent in the treatment of psoriasis.

Aim: In our study, we aimed to evaluate the effectiveness of methotrexate applied SK in the symmetrically lo-cated psoriasis lesions, the response of the applied bodyside and under the applied lesion to the symmetry side andlesion.

Materials and Methods: 22 psoriasis patients (15 E,7 K) who presented with symmetric plaque type psoriasislesions were included in the study. Patients received subcutaneous methotrexate treatment at a dose of 20 mg / weekfor a total of 8 weeks. The applied side of the body and theother side; The ’psoriasis field intensity score (PASI) before and after treatment was calculated and recorded.

Results: When PASI scores were examined, it was10.98 pretreatment (PASI 1), 2.36 after the treatment andthe body side (PASI 2) at the symmetry of the body (PASI2) before the treatment and 10.66 after the treatment, and 2.68 after the treatment. There was a statistically signifi-cant decrease in PASI score before the treatment in bothgroups (p <0.0001). The mean decrease in PASI 1 was71.79% and PASI 2 was 66.90%. There was a statistically  significant difference between PASI scores before and after treatment (p <0.0001).

Conclusion: In conclusion, in the presence of systemictreatment resistant plaques, we believe that application ofSC methotrexate may be one of the primary steps in the treatment, and that application of the application under resistant lesions will increase the response to treatment and further studies should be performed in this respect.

Keywords

Psoriasis, subcutaneous injection, methotrexate

Simetrik Psoriatik Plaklarda Subkutan Metotrexatın Etkinliği

Abstract

Öz

Giriş: Psoriazis etiyolojisi tam olarak bilinmeyen, inflamasyon ve hiperproliferasyon ile karakterize kronik ve tekrarlayıcı bir deri hastalığıdır. Genel olarak; lokal tedaviler ile yeterli yanıt alınamayan veya vücut yüzey alanının %10’undan fazlasının etkilendiği durumlarda, sistemik tedavi ajanları uygulanmaktadır. Metotreksat psoriazis tedavisinde en yaygın kullanılan sistemik ajandır.

Amaç: Çalışmamızda simetrik yerleşimli psoriazis lezyonlarında SK uygulanan me-totreksat etkinliğini, uygulama yapılan vücut tarafının ve altına uygulama yapılan lezyonun simetriğindeki tarafa ve lezyona göre yanıtını değerlendirmeği amaçladık.

Materyal-Metod: Çalışmaya simetrik yerleşimli plak tipi psoriazis lezyonları ile başvuran 22 psoriazis hastası (15 E,7 K) dahil edildi. Hastalara 20 mg/hafta dozunda, toplam 8 hafta lezyon altına subkutan metotreksat tedavisi uygulandı. Uygulama yapılan vücut tarafının ve diğer tarafın; tedavi öncesinde ve sonrasındaki ‘psoriazis alan şiddet indeksi’ (PASİ) skoru hesaplandı ve kaydedildi.

Sonuçlar: PASİ skorları incelendiğinde enjeksiyon yapılan vücut tarafında (PASİ1) tedavi öncesi 10.98, tedavi sonrası 2.36 ve simetriğindeki vücut tarafında (PASİ 2)tedavi öncesi 10.66, tedavi sonrası 2.68 idi. Her iki grupta tedavi öncesi PASİ skoru yüksek iken tedavi sonrası istatistiksel olarak anlamlı bulunan azalma vardı (p<0.0001). PASİ1‘de ortalama azalma %71.79, PASİ 2‘de %66.90 olarak hesaplandı. Tedavi öncesi ve sonrası PASİ skorları açısından enjeksiyon yapılan vücut tarafı ve simetriğindeki tarafarasında istatistiksel olarak anlamlı fark saptandı (p<0.0001).

Sonuç: Sonuç olarak sistemik tedavilere dirençli plakların varlığında, SK metotreksat uygulamasının tedavide öncelikli basamaklardan biri olabileceğini, uygulamanın dirençli lezyonların altına yapılmasının tedaviye yanıtı arttıracağını ve bu açıdan daha ileri çalışmalar yapılması gerektiğini düşünmekteyiz.

Keywords

Psoriasis, subcutan injeksiyon, metotreksat

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