Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Painsi, C.
PASI reduction and patient satisfaction after classical inpatient dithranol treatment
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Graz Medical University; 2018. pp.
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- Autor*innen der Med Uni Graz:
- Painsi Clemens
- Betreuer*innen:
- Inzinger Martin
- Wolf Peter
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- Abstract:
- Dithranol, invented by Eugen Galevsky in 1916, is designated as one of the oldest, safest and most effective topical antipsoriatic treatments. Though, the well-known dithranol irritation in lesional and perilesional skin, which is tightly linked to its efficiency, represents a substantial cut-back. However, studies on dithranol’s therapeutic efficacy according to a modern standard for scoring the extension of the disease such as the Psoriasis Area and Severity Index (PASI) reduction rates and patient perspectives on it have been scarce. Therefore, the recommendations with regard to topical dithranol treatment differ among various national guidelines. The aims of this thesis were thus as follows: The first aim of the thesis was to show the PASI reduction after a classical inpatient dithranol therapy (CID) by a retrospective analysis of data reported to the Psoriasis Registry Austria (PsoRA) (http://www.psoriasisregistry.at). The second aim was to provide information on the patient perspectives in terms of satisfaction, efficacy, adverse effects and recurrence-free interval after CID by using a telephone interview survey in a subset of these patients. In total, data from 110 patients [75 men (68.2%) and 35 women (31.8%)] treated with CID had been reported to the PsoRA and were analyzed retrospectively for this thesis. The results of this thesis showed that CID is a highly effective and safe antipsoriatic treatment option which led in over 82.7% of the patients to a =75% reduction in PASI (PASI75) after treatment initiation within a median time of 14 days. The responses in the interview revealed that 77.2 % (44 out of 57) of the patients assessed CID as an effective antipsoriatic treatment option tied to an overall satisfaction in 61.7%, i.e. 37 out of 60 interviewed patients. Conversely, 56.9% (33 out of 58) of patients assessed CID as time consuming and 19.7% (12 out of 61) assessed its irritation as substantial or maximal. The median recurrence free interval after CID was stated with 4 (95% confidence intervaI, i.e., 3-9) months. In summary, classical inpatient dithranol provides in many cases a faster remission of psoriasis than any other topical and/or systemic treatment option currently available. Beside the well-known CID therapy limitations (e.g. time consuming and CID irritation) patients assess CID as an effective antipsoriatic treatment option which provides satisfaction to a high portion of patients.