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Goeckerman Method Effective and Safe For Pediatric Psoriasis, Mayo Researchers Report: Presented at AAD

By Bruce Sylvester

WASHINGTON, DC -- February 6, 2007 -- A review of 20 years of data from the Mayo Clinic shows that the Goeckerman method used for treating severe psoriasis in children produces high clearance and remission rates with minimal adverse effects.

Researchers presented these findings here on February 5^th at the 65^th annual meeting of the American Academy of Dermatology (AAD). The research was highlighted by the AAD in a special session of distinguished research poster presentations.

The Goeckerman method involves a combination of coal tar ointment with ultraviolet light exposure.

"The Goeckerman method has been used at the Mayo Clinic for many years with adults and children suffering from widespread psoriasis, but there has been a paucity of analysis of data on treatment effects with children," said presenter and lead investigator Kimberly Kortuem, MD, practicing dermatologist and clinical researcher, Mayo Clinic, Rochester, Minnesota.

The investigators reviewed the charts of all Mayo Clinic pediatric patients who received treatment of psoriasis with the Goeckerman method between 1983 and 2003. All patients underwent coal tar ointment smears 3 times a day plus daily ultraviolet light exposure using the traditional hot quartz lamp.

The investigators analyzed data on 65 patients aged 4 months to 18 years (mean 11.6 years). The female-to-male ratio was 3:2.

Familial history of psoriasis was identified in 62% of the cases, and 35% of the subjects had a culture-proven strep throat infection before the onset of disease or associated with a severe flare of disease.

Prior to Goeckerman therapy, the subjects had a mean duration of disease of 3.1 years (range, 0-15 years). The majority of patients showed an estimated 25% to 50% body surface involvement (77%) at treatment; psoriatic arthritis was rare.

Most subjects (91%) had undergone prior treatment, including topical steroids (86%), tars (40%), ultraviolet B (34%), or psoralen/ultraviolet A (5%) phototherapy, tanning beds (8%), or systemic steroids (9%).

Average treatment duration was 20 days (range, 8-37 days).

Pooled data showed that response to treatment was excellent, with 62% of subjects showing 90% clearance or greater and an additional 23% showing 80% to 89% clearance of lesions.

The only immediate adverse event was folliculitis, which was seen in 42% of patients.

Of the 29 patients (45%) who received follow-up through remission, the average duration of remission was 2.61 years (median 1.89; range, 0.19-12.79 years). A total of 20 of the patients (31%) underwent Goeckerman therapy again.

Dr. Kortuem added, "The follow-up data was a problem in this study. Only 29 of the 65 patients had documented follow-up. But we can say from the analysis that Goeckerman is an effective, safe and non-systemic treatment for psoriasis in children."


[Presentation title: Results of Goeckerman Treatment for Psoriasis in Children: a 20-Year Retrospective Review. Poster 33]

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