Management of Guttate and Generalized Psoriasis Vulgaris: Prospective Randomized
Nina G. Caca-Biljanovska, Marija T. V’lckova-Laskoska
Department of Dermatology, Sts. Cyrilus and Methodius University School of Medicine, Skopje, Republic of
Aim. To assess the efficacy of betamethasone dipropionate 0.05% cream plus ultraviolet B (UVB) radiation with and
without additional penicillin therapy in the treatment of guttate psoriasis, and to compare the efficacies of oral psoralen
plus ultraviolet A (PUVA) therapy and systemic retinoids therapy for treatment of generalized psoriasis.
Methods. Sixty patients with guttate (n=20) and generalized psoriasis vulgaris (n=40) of various intensity and duration
treated at the Department of Dermatology, Medical School in Skopje, from February 2000 to January 2002, were in-
cluded in this prospective, open-label, randomized, parallel group study. The clinical features of the patients were
quantified according to the mean psoriasis area and severity index (PASI) values. Student’s t-test for paired samples and
two independent samples were used in statistical analysis.
Results. The final PASI values were not significantly different for the patients receiving different treatments of guttate
psoriasis or generalized psoriasis. The initial PASI values for guttate psoriasis patients treated with betamethasone
dipropionate plus UVB with and without penicillin treatment (5.7±2.1 and 5.9±2.5, respectively) declined to
0.5±0.8 and 1.0±0.9, respectively, after the therapy. The initial PASI values in generalized psoriasis patients receiving
PUVA dropped from 24.1±3.6 to 1.7±1.5 by the end of the therapy. Finally, pre-treatment PASI values in patients
with generalized psoriasis receiving retinoids decreased from 24.6±3.5 to 0.9±1.1 after treatment. However, patients
receiving systemic retinoids for generalized psoriasis had statistically higher incidence of side effects than patients re-
ceiving PUVA therapy (t=6.458, df=38, p<0.001).