Efficacy of oral methotrexate monotherapy vs oral methotrexate plus narrow band UV-B phototherapy in palmo plantar psoriasis.

Ara, Shamim; Mowla, Mohammad Rafiqul; Alam, Mansurul; Khan, Md Ismail

Palmoplantar psoriasis (PPP) is a chronic, inflammatory dermatosis of the palms and/or soles with significant morbidity. It is notoriously difficult to treat and unresponsive to traditional topical agents. To compare the effect of oral Methotrexate (MTX) monotherapy vs Methotrexate plus Narrowband UVB (NB-UVB) in treatment of recalcitrant PPP. This was a comparative clinical trial involving 90 patients of PPP. Eligible patients were randomly assigned to one of the two treatment groups. Patients in Group A received 10 mg oral MTX weekly, and patients in Group B received oral MTX 10 mg weekly and NB-UVB sessions twice weekly for 12 weeks. There was a statistically significant difference in reduction of m-PPPASI of patients in MTX plus NB-UVB at weeks 12. The mean m-PPPASI at week 12 was 3.66 ± 2.11 in MTX plus NB-UVB group and 6.51 ± 2.04 in MTX only group (P < 0.001). Marked improvement (m-PPPASI 75) was achieved in 20 (44.44%) patients in MTX plus NB-UVB group compared with 6 (13.3%) in MTX monotherapy group (P < 0.001). Combination of MTX and NB-UVB phototherapy helps to attain a better clinical response (reduction in m-PPPASI score) than MTX monotherapy in the treatment of recalcitrant PPP. This article is protected by copyright. All rights reserved.