Name: the goeckerman regimen for the treatment of moderate to severe psoriasis
Uploaded: 2013-07-11T14:00:00
Description: Watch this Scientific Journal Video about The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis at JoVE.com

Vi vil gerne takke personalet på UCSF Psoriasis og hud behandling Center for deres arbejde især vores Goeckerman koordinator, Sarah Hulse RN

1.. Evaluering og forberedelse <ol><li> Udfør en komplet historie og fysisk inden behandlingen påbegyndes. I historien og fysisk, dokument vigtige oplysninger såsom de nuværende / tidligere medicin, svar på tidligere psoriasisterapier, enhver historie bivirkninger ved omgivende sollys eller lysbehandling, sværhedsgraden af ​​kløe og søvnkvaliteten. </li><li> Opsæt en klinik værelse med alt det nødvendige materiale for dermal anvendelse af medicin og okklusion [Se Materialer sektion og <...

<ol>
	<li>Parisi, R., Symmons, D. P., Griffiths, C. E., Ashcroft, D. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Global+Epidemiology+of+Psoriasis:+A+Systematic+Review+of+Incidence+and+Prevalence.">Global Epidemiology of Psoriasis: A Systematic Review of Incidence and Prevalence.</a> The Journal of Investigative Dermatology. , (2012).</li><li>H, G. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+treatment+of+psoriasis.">The treatment of psoriasis.</a> Northwest Med. 24, 229-230 (1925).</li><li>Koo, J., Lebwohl, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Duration+of+remission+of+psoriasis+therapies.">Duration of remission of psoriasis therapies.</a> Journal of the American Academy of Dermatology. 41, 51-59 (1999).</li><li>Menter, A., Cram, D. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Goeckerman+regimen+in+two+psoriasis+day+care+centers.">The Goeckerman regimen in two psoriasis day care centers.</a> Journal of the American Academy of Dermatology. 9, 59-65 (1983).</li><li>Lee, E., Koo, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modern+modified+'ultra'+Goeckerman+therapy:+a+PASI+assessment+of+a+very+effective+therapy+for+psoriasis+resistant+to+both+prebiologic+and+biologic+therapies.">Modern modified 'ultra' Goeckerman therapy: a PASI assessment of a very effective therapy for psoriasis resistant to both prebiologic and biologic therapies.</a> The Journal of Dermatological Treatment. 16, 102-107 (2005).</li><li>Kim, I. H., West, C. E., Kwatra, S. G., Feldman, S. R., O'Neill, J. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparative+efficacy+of+biologics+in+psoriasis:+a+review.">Comparative efficacy of biologics in psoriasis: a review.</a> American journal of clinical dermatology. 13, 365-374 (2012).</li><li>Serrao, R., Davis, M. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Goeckerman+treatment+for+remission+of+psoriasis+refractory+to+biologic+therapy.">Goeckerman treatment for remission of psoriasis refractory to biologic therapy.</a> Journal of the American Academy of Dermatology. 60, 348-349 (2009).</li><li>Chern, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Positive+effect+of+modified+Goeckerman+regimen+on+quality+of+life+and+psychosocial+distress+in+moderate+and+severe+psoriasis.">Positive effect of modified Goeckerman regimen on quality of life and psychosocial distress in moderate and severe psoriasis.</a> Acta Dermato-venereologica. 91, 447-451 (2011).</li><li>Dennis, M., Bhutani, T., Koo, J., Liao, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Goeckerman+therapy+for+the+treatment+of+eczema:+a+practical+guide+and+review+of+efficacy.">Goeckerman therapy for the treatment of eczema: a practical guide and review of efficacy.</a> The Journal of Dermatological Treatment. , (2011).</li><li>Papp, K. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biologic+therapy+in+psoriasis:+perspectives+on+associated+risks+and+patient+management.">Biologic therapy in psoriasis: perspectives on associated risks and patient management.</a> Journal of Cutaneous Medicine and Surgery. 16, 153-168 (2012).</li><li>Menter, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Guidelines+of+care+for+the+management+of+psoriasis+and+psoriatic+arthritis:+Section+5.+Guidelines+of+care+for+the+treatment+of+psoriasis+with+phototherapy+and+photochemotherapy.">Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy.</a> Journal of the American Academy of Dermatology. 62, 114-135 (2010).</li><li>de Miguel, R., el-Azhary, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy,+safety,+and+cost+of+Goeckerman+therapy+compared+with+biologics+in+the+treatment+of+moderate+to+severe+psoriasis.">Efficacy, safety, and cost of Goeckerman therapy compared with biologics in the treatment of moderate to severe psoriasis.</a> International Journal of Dermatology. 48, 653-658 (2009).</li><li>Busse, K., Koo, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Introducing+the+delayed+retinoid+burn:+a+case+report+and+discussion+of+this+potential+risk+of+retinoid-phototherapy+combination+management.">Introducing the delayed retinoid burn: a case report and discussion of this potential risk of retinoid-phototherapy combination management.</a> Journal of the American Academy of Dermatology. 64, 1011-1012 (2011).</li><li>Maughan, W. Z., Muller, S. A., Perry, H. O., Pittelkow, M. R., O'Brien, P. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Incidence+of+skin+cancers+in+patients+with+atopic+dermatitis+treated+with+ocal+tar.+A+25-year+follow-up+study.">Incidence of skin cancers in patients with atopic dermatitis treated with ocal tar. A 25-year follow-up study.</a> Journal of the American Academy of Dermatology. 3, 612-615 (1980).</li><li>Pittelkow, M. R., Perry, H. O., Muller, S. A., Maughan, W. Z., O'Brien, P. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Skin+cancer+in+patients+with+psoriasis+treated+with+coal+tar.+A+25-year+follow-up+study.">Skin cancer in patients with psoriasis treated with coal tar. A 25-year follow-up study.</a> Archives of Dermatology. 117, 465-468 (1981).</li><li>Roelofzen, J. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=No+increased+risk+of+cancer+after+coal+tar+treatment+in+patients+with+psoriasis+or+eczema.">No increased risk of cancer after coal tar treatment in patients with psoriasis or eczema.</a> The Journal of Investigative Dermatology. 130, 953-961 (2010).</li></ol>

Den Goeckerman Regimen-protokollen skitseret ovenfor er udnyttet på UCSF, og kan varieres på flere måder i henhold til patientens respons på behandlingen. Da patienten ses og undersøgt hver dag, kan protokollen individualiseres for hver enkelt patient for at sikre maksimal effektivitet. Den traditionelle Goeckerman behandling alene bestod af brugen af FTT og UVB lysbehandling. 2 har dog regime blevet ændret til at omfatte brugen af topikale kortikosteroider (og til tider andre aktuelle medikamenter sås...

Psoriasis er en kronisk, immun-medieret inflammatorisk hudsygdom, som rammer ca 2-3% af befolkningen. 1. En tredjedel af patienterne oplever generaliseret psoriasis, som forårsager invaliderende fysiske og psykiske virkninger. Den Goeckerman regime, først udgivet i 1925 til behandling af generaliseret psoriasis, består af udsættelse for ultraviolet B (UVB) lys og anvendelse af rå stenkulstjære (FTT). 2. Selv nyere interne midler, såsom biologics har forbedret behandlingen af psoriasis, Goeckerman terapi forbliver som en yderst effektiv løsning, men samtidig give en lang varighed af remission. 3,4 I en offentliggjort undersøgelse foretaget på UCSF, 100% af de patienter, Goeckerman behandling opnåede PASI75 (75% forbedring af Psoriasis Vurdering af Severity Index [PASI] fra baseline) med 3 måneder. 5. Til sammenligning (dog ikke hoved til hoved), opnåede patienterne på de mest potente biologiske kun 67-68% PASI75 i 3 mdrths. 6 Goeckerman regime har en hurtig debut og er blevet udnyttet med succes hos patienter med behandlingsresistente psoriasis refraktære til lysbehandling eller interne medicin. 7 Goeckerman regime har også en yderst sikker toksicitetsprofil med væsentlige ingen interne bivirkninger, som er de mere alvorlige risici forbundet med andre psoriasisbehandlingsforløb. Endvidere har terapi vist sig at have en betydelig og positiv indvirkning på livskvaliteten for patienter med generaliseret psoriasis. 8. Goeckerman regime var tidligere administreret 24 timer en dag på en indlæggelse facilitet indtil patienten blev ryddet deres psoriasis. Men på grund af ændringer i refusioner og forvaltes pleje, patienter behandles nu i daginstitutioner i minimum 4-8 hr / dag og 5 dage / uge, indtil deres sygdom rydder. Goeckerman terapi blev oprindeligt formuleret til behandling af psoriasis, men en modificeret versioner for nylig blevet anvendt til behandling af andre hudsygdomme såsom eksem med succes. Følgende protokol er udnyttet på UCSF specifikt til psoriasis, men små ændringer i procedurerne kan skræddersys til eksem, generaliseret pruritus, prurigo Nodularis, Pityriasis lichenoides chronica, erythroderma, og andre relaterede hudlidelser. 9. Selv om det er en af ​​de ældste behandlinger til rådighed for psoriasis, der er en mangel af offentliggjorte videoer, der viser processen. En video kan have en bred appel, da det kan bruges som en ressource for at henvise sundhedsydelser praktiserende læger (praktiserende læger og dermatologer) for at forstå processen og føler sig trygge anbefale behandlingen. En video demonstrerer Goeckerman processen vil også være medvirkende til at uddanne beboere og medicinstuderende, der ikke er udsat for regime, da der kun er få institutioner tilbage, at fortsætte med at yde denne form for jegntensive terapi. En video vil også være til gavn for potentielle patienter, der er interesseret i at modtage Goeckerman terapi.

<table border="1">
	<tbody>
		<tr>
			<td>Name of Medication </td>
			<td>Company</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>2% Crude Coal Tar in White Petrolatum or Cetaphil</td>
			<td>Compounded at Pharmacy</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>5% Crude Coal Tar in White Petrolatum or Cetaphil</td>
			<td>Compounded at Pharmacy</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>10% Crude Coal Tar in White Petrolatum +/- 2/5/10% Salicyclic Acid</td>
			<td>Compounded at Pharmacy</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>10% Crude Coal Tar in Cetaphil</td>
			<td>Compounded at Pharmacy</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>20% Liquid Carbonis Detergenis in Nutraderm</td>
			<td>Compounded at Pharmacy</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>20% Liquid Carbonis Detergenis in Aquaphor or Cetaphil</td>
			<td>Compounded at Pharmacy</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Triamcinolone 0.1% ointment/cream/lotion</td>
			<td>Prescription Medication - Generic</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Desonide 0.05% cream/ointment</td>
			<td>Prescription Medication - Generic</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Fluocinolone 0.01% oil</td>
			<td>Prescription Medication - Generic</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Clobetasol 0.05% ointment/cream</td>
			<td>Prescription Medication - Generic</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Hydrophillic Ointment</td>
			<td>Over the Counter - Generic</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Mineral Oil</td>
			<td>Over the Counter - Generic</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Name of Equipment </td>
			<td>Company</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Narrow-Band Phototherapy Unit</td>
			<td>National Biologic Corporation</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Broad-Band Phototherapy Unit</td>
			<td>National Biologic Corporation</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
	</tbody>
</table>

the goeckerman regimen for the treatment of moderate to severe psoriasis

Psoriasis er en kronisk, immun-medieret inflammatorisk hudsygdom, som rammer ca 2-3% af befolkningen. Den Goeckerman regime består af udsættelse for ultraviolet B (UVB) lys og anvendelse af rå stenkulstjære (FTT). Goeckerman terapi er yderst effektiv og relativt sikkert til behandling af psoriasis og til forbedring af en patients livskvalitet. I den følgende artikel præsenterer vi vores protokol for Goeckerman terapi, der er udnyttet specielt ved University of California, San Francisco. Denne protokol beskriver udarbejdelse af forsyningerne, administration af lysbehandling og anvendelse af aktuel tjære. Denne protokol beskriver også, hvordan man vurderer, at patienten dagligt, overvåge bivirkninger (herunder kløe og brændende) og justere behandling baseret på patientens respons. Selv om det er en af ​​de ældste behandlinger til rådighed for psoriasis, der er en mangel af offentliggjorte videoer viser processen i detail. Videoen er til gavn for leverandører af sundhedsydelser, der ønsker at administrere behandlingen, for praktikanter, der ønsker at lære mere om processen, og for potentielle patienter, der ønsker at gennemgå behandling for deres kutant sygdom.

I en undersøgelse udført på vores center på University of California San Francisco, blev PASI75 respons (en 75% forbedring i Psoriasis Assessment Severity Index) opnåede i 100% af patienter, der fik Goeckerman (n = 25) i løbet af en 3-måneders periode . 5 24/25 patienter havde brug for kun 2 måneder til at opnå PASI75, mens de resterende patient opnåede et PASI75 respons efter 3 måneder. I en anden undersøgelse administreret Menter et al. Den Goeckerman regime for 300 patienter og 100% af...

Watch this Scientific Journal Video about The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis at JoVE.com

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Psoriasis er en kronisk, immun-medieret inflammatorisk hudsygdom. Den Goeckerman regime, formuleret til behandling af psoriasis, består af udsættelse for ultraviolet B (UVB) lys og anvendelse af rå stenkulstjære (FTT). Følgende protokol er til administration af Goeckerman terapi til behandling af moderat til svær psoriasis.

Den Goeckerman regime til behandling af moderat til svær psoriasis

Psoriasis is a  chronic, immune-mediated inflammatory skin disease affecting approximately 2-3%  of the population. The Goeckerman regimen consists of ...

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