Role of oral colchicine in plaque type psoriasis. A randomized clinical trial comparing with oral methotrexate

Patients with moderate to severe psoriasis generally require phototherapy, photochemotherapy or systemic agents to control their disease adequately. The potential toxic effects of long term use of the classic antipsoriatics, prolonged continuous therapy, higher cost and low socio-economic conditions of patients obligate us to consider some cheaper older alternatives like colchicine. A prospective, randomized controlled clinical trial was carried out on two groups of patient of psoriasis, group A [Case, n=30] was treated with 2.1 mg per day oral colchicine, in two divided doses and group B [Control, n= 30] was treated with 7.5 mg of oral methotrexate once weekly for 8 weeks. No topical agent except bland emollients was applied during the trial period. Psoriasis area severity index [PASI] was calculated as main outcome measure at entry level and follow up after one month and two months. The mean percentage reduction of PASI was statistically significant [p=0.001] at both first and second follow up with oral colchicine. PASI-50 was achieved in 23.3% of respondent in colchicine group and 53.3% in methotrexate group [p<0.05]. Oral colchicine is an effective therapy for chronic plaque psoriasis but it is less effective than methotrexate, the gold standard antipsoriatic therapy [p<0.05]

Cutaneous morphological patterns of adverse drug reactions: a study of 50 cases

Adverse drug reactions are common complications in drug therapy. About 3-8% of all hospital admissions are the results of adverse drug reactions, and these can cause significant disability to patients. To evaluate the clinical spectrum of all cutaneous adverse drug reactions and to establish the causal link between suspected drug and the reaction. This observational cross-sectional study was done among the patients having cutaneous drug eruptions. 50 consecutive patients were enrolled. Purposive sampling was done. In every patient a detailed history was taken. Examination was carried out to find out the type of cutaneous reactions. Data were collected in a predesigned structured questionnaire. Statistical analysis was done with the help of SPSS. Out of 50 respondents, 20% had a history of indigenous drug intake followed by 18% sulphonamides, 14% NSAIDs, 14% quinolones, 8% anticonvulsants, 8% cephalosporins, 6% penicillins, 4% antituberculous drugs, 4% metronidazole and 4% tetracyclines. 34% had maculopapular rash, 24% Stevens-Johnson syndrome, 12% exfoliative dermatitis, 10% urticaria, 8% fixed drug eruption, 8% erythema multiforme, 8% bullae, 6% vesicles, 2% lichenoid eruption and 2% scaly eruptions. Frequency distribution of the offending drugs and the adverse reactions revealed that cephradine was responsible for maculopapular rash, sulphonamides for Stevens-Johnson syndrome, indigenous medicines for exfoliative dermatitis, NSAIDs for urticaria and paracetamol for fixed drug eruption