A clinico - histopathological outcome of 4 weeks methotrexate pulse therapy in psoriasis

Abstract

A clinico - histopathological study was carried out In 50 patients of psoriasis to see clinical and histological outcome and/or correlation of weekly methotrexate pulse therapy. Clinically, results of therapy were evalutated by estimating the percentage of total body coverage with psoriasis. Prior to therapy, average involvement was 47.5% which after 4 weeks methotrexate therapy reduced to 8.3%. A complete clearing of psoriasis occurred in 40% of patients after methotrexate therapy. The clinical response started as early as 1 week in most of patients. Only 2 patients failed to respond even after 4 weeks of therapy. Histopathologically in pretreatment biopsy, 34 showed classical psoriatic pathology while in 16 biopsy was suggestive of psoriasis but not confirmative. Histopathological examination after 4 weeks treatment showed that 41 still showed one or more histological evidence of psoriasis, although only two patients had classical, psoriatic pathology, in rest 9 patients there were complete regression. Thus, with methotrexate, clinical clearance was much faster than histopathological clearance.