Adapting the Goeckerman Regimen for Psoriasis Treatment in Kenya: A Case Study of Successful Management in a Resource-Limited Setting.

IF 5.2 Q1 DERMATOLOGY Psoriasis (Auckland, N.Z.) Pub Date : 2024-08-29 eCollection Date: 2024-01-01 DOI:10.2147/PTT.S481148
Payton Smith, Allison Kranyak, Chandler E Johnson, Kathryn Haran, Isabel Muraguri Snr, Toby Maurer, Tina Bhutani, Wilson Liao, Samson Kiprono
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Abstract

Introduction:  Goeckerman therapy, which combines ultraviolet B (UVB) light with crude coal tar (CCT), remains highly effective for moderate-to-severe psoriasis. While it is rarely still used in the USA as effective biotherapeutics have become more readily available, it offers an alternative therapy in developing countries with limited access to newer medications. Moi Teaching & Referral Hospital (MTRH) in Eldoret, Kenya, in collaboration with UCSF, developed a modified Goeckerman regimen suitable for local healthcare needs, condensing the treatment into an intensive two-week program.

Case report:  A 55-year-old female with erythrodermic psoriasis traveled 350 kilometers to MTRH. After the diagnosis was confirmed, she underwent a nine-day inpatient treatment with narrow-band UVB phototherapy and topical medications under occlusion as a modified Goeckerman regimen.

Response to treatment:  Significant improvement was observed within three days, with full recovery in ten days. Follow-up one month later showed no active lesions, and her psoriasis remained controlled for four months with topical treatments.

Conclusion:  The modified Goeckerman regimen at MTRH, in collaboration with UCSF, effectively treated severe psoriasis in a challenging healthcare context. This case highlights the potential for adapting established treatments to improve patient outcomes in developing countries with limited access to systemic therapies.

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在肯尼亚采用 Goeckerman 方案治疗银屑病:资源有限环境中的成功管理案例研究》。
简介: 戈克曼疗法结合了紫外线 B (UVB) 和粗煤焦油 (CCT),对中重度银屑病仍然非常有效。由于有效的生物治疗药物越来越容易获得,这种疗法在美国已很少使用。肯尼亚埃尔多雷特的莫伊教学与转诊医院(Moi Teaching & Referral Hospital,MTRH)与加州大学旧金山分校合作,开发了适合当地医疗需求的改良戈克曼疗法,将治疗浓缩为为期两周的强化疗程: 病例报告:一名 55 岁的女性红皮病型银屑病患者不远 350 公里来到 MTRH。确诊后,她接受了为期九天的住院治疗,采用改良戈克曼疗法,在闭塞状态下进行窄波段紫外线光疗和外用药物治疗: 治疗反应:三天内病情明显好转,十天后完全康复。一个月后的随访显示没有活动性皮损,通过外用药物治疗,她的银屑病在四个月后仍得到控制: 结论:港铁医院与加州大学旧金山分校合作采用改良的戈克曼疗法,在极具挑战性的医疗环境中有效治疗了严重的银屑病。该病例突出表明,在系统性治疗手段有限的发展中国家,调整既有治疗方法以改善患者疗效的潜力巨大。
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