Preliminary report: modified Goeckerman therapy for hospitalized patients: ambulatory day care center and improved quantitative dosimetry.

The use of tar and ultraviolet light as an inpatient therapy for psoriasis was described by Goeckerman more than 50 yr ago. Since that time it has been shown . to be an effective treatment for psoriasis at numerous medical centers with the average period of hospitalization approximating 3 weeks. This study was designed to evaluate whether inpatient treatment would be comprised ifthe patients were permitted to spend each night of the final week of treatment at home. Of 267 patients hospitalized in 1979 for Goeckerman therapy, 84 patients were selected for study. These were divided into two groups, A and B. Group A consisted of patients receiving 3 weeks of inpatient care. Group B consisted of patients receiving 2 weeks hospitalization for inpatient Goeckerman therapy and 1 week of daily Goeckerman therapy in the ambulatory Psoriasis Treatment Center while spending the previous evening at home. Group ' A and group B were compared for rate a nd degree of improvement and for duration of remission following hospital discharge. For purposes of statistical comparisons, patients from groups A and B were matched by sex, age, and date of admission to the study. Both groups showed 80-90% c learing in the first 3 weeks. For patients in group A, the average total radiation received was 61.3 J/sq cm ofUVA and 9.85 J/sq cm of UVB. The average total radiation received by group B was 61.3 J/sq cm of UVA and 8.63 J/sq cm of UVB. Neither difference was statistically s ignificant (p < 0.50). Both Group A and group B had similar numbers of patients who exacerbations required readmission to the hospital for either repeat Goeckerman therapy or for other types of treatment during the 18 mo follow-up period. The length of time before rehospitalization was also similar for both groups. These findings are of a preliminary nature. However, it appears that the rate of clearing and period without exacerbation in psoriasis can be maintained by modifying the traditional inpatient Goeckerman regimen.