The application of photodynamic therapy in the case of insufficient effect of the inhibitors of tumour necrosis factor in the patients with psoriasis

Psoriasis is a systemic chronic inflammatory disease that affects in the first place the skin and occurs in 1-5% of the general population. The treatment of the patients presenting with this condition implies the application of the topical agent and biological preparations as well as phototherapy and systemic therapy. The patients suffering severe forms of psoriasis in whom systemic immunosuppressive therapy does not yield the desired effect are in need of the treatment with biological preparations. The use of the inhibitors of tumour necrosis factor-alpha produces the insufficient effect even in the case of the positive response, i.e. the psoriasis area and severity index (PASI) of approximately 50 scores (PASI 50). This article presents the results of the application of photodynamic therapy (PDT) for the treatment of 8 patients treated with the inhibitors of tumour necrosis factor-alpha in whom the PASI value of 50 was achieved within the first week after the onset of the treatment. In all these patients, a course of photodynamic therapy consisting of 2-3 procedures made it possible to increase the PASI values to 75 and even 100 scores. It is concluded that the patients showing positive but insufficient effect of biological therapy (PASI 50) need to be prescribed a course of photodynamic treatment in order to enhance the effectiveness of the biological therapeutic factors.