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[The treatment of psoriasis. Critical study of the use of ACNU (nimustine hydrochloride)].

The present study deals with the results of topical treatment of psoriasis with ACNU (nimustine hydrochloride), a water-soluble derivative of nitrosourea developed in Japan. Solutions at concentrations of 0.1 p. 100, 0.2 p. 100 and 0.4 p. 100 were obtained by dissolving ACNU in water and alcohol. An 0.4 p. 100 ointment was prepared by mixing ACNU with polyethylene glycol. Seventeen patients (12 male and 5 female), ranging in age from 19 to 68 years, were treated. Improvement of the skin lesions was observed in all 10 patients treated with the solution and in 6 of the 7 patients treated with the ointment. Clinical and histological pictures of the 4 main cases are shown with photographs. Compared with other treatments, the ACNU solution and ointment have the same effect as corticosteroid ointments of moderate strength or Goeckerman therapy. Side-effects included papules, redness, pigmentation and irritation. ACNU has been used for the treatment of mycosis fungoides, but we were the first to use this drug in psoriasis. This treatment has some side-effects, but they are less severe than those of other anti-cancer drugs. ACNU is relatively expensive and unsuitable for long term use. Thus, topical applications of ACNU may be of some value in cases where conventional treatments have failed.