Radiation therapy in the adjuvant treatment of hyperkeratotic palmoplantar psoriasis: a case study

Psoriasis is an inflammatory autoimmune disease of the skin and nails, causing debilitating pain and having an adverse effect on the patients’ life. Typical treatment regimens involve topical and systemic therapies in combination with phototherapy. However, patients with extensive, chronic disease m...

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Bibliographic Details
Published in:Journal of medical radiation sciences 2021-09, Vol.68 (3), p.326-331
Main Authors: Shirley, Bronwyn, Andrae, Madeline, Le Lay, Tegan, Collins, Michael
Format: Article
Language:English
Subjects:
Adjuvants
Case reports
Case Study
Chronic Disease
Dosimetry
Drug dosages
Fractionation
Fractions
Humans
Light therapy
Pain
Patients
Phototherapy
Psoriasis
Psoriasis - radiotherapy
Radiation therapy
Skin diseases
Treatment Outcome
Treatment resistance
Wheelchairs
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Summary:Psoriasis is an inflammatory autoimmune disease of the skin and nails, causing debilitating pain and having an adverse effect on the patients’ life. Typical treatment regimens involve topical and systemic therapies in combination with phototherapy. However, patients with extensive, chronic disease may encounter treatment resistance, with limited or no success of these therapies. Radiation therapy (RT) has been shown to be an effective treatment for benign skin lesions; however, recommended dose, fractionation and long‐term follow‐up is not well established within the literature making clinical implementation challenging. Furthermore, RT may induce the Koebner Phenomenon, exacerbating the disease. This case study presents a patient with chronic hyperkeratotic palmoplantar psoriasis who was offered RT as a last resort. A total dose of 6Gy was delivered using photons and superficial energies. Significant reduction in extent of disease was seen as a result, with the patient no longer wheelchair‐bound and able to mobilise with minimal discomfort. This case is a single example of RT as a successful treatment for chronic palmoplantar psoriasis; however, a larger sample size and clinical trial is needed to ascertain dose and fractionation for optimal long‐term control. Implementation of such treatments within departments invites clinicians to further develop RT practices and provide much needed relief to a new cohort of patients with non‐malignant conditions. Dosimetry for feet positioned in custom‐made water bath.
ISSN:2051-3895
2051-3909
DOI:10.1002/jmrs.467