The following is a summary of “Efficacy and safety of epidural block with lidocaine for refractory severe plaque psoriasis: An open-label pilot study in real world setting,” published in the February 2024 issue of Dermatology by Xu, et al.

For a study, researchers sought to evaluate the effectiveness and safety of epidural lidocaine block, a non-selective blocker of voltage-gated sodium channels (Nav), in adult patients with severe, treatment-resistant plaque psoriasis.

The open-label pilot study enrolled patients with severe plaque-type psoriasis unresponsive to at least one systemic treatment. Participants underwent a 1-week epidural lidocaine block and were followed up for 48 weeks. About 36 patients were enrolled, with 32 completing the study.

At 12 weeks, there was a significant 59% improvement in the mean Psoriasis Area Severity Index (PASI) score (P < 0.001). By week 48, 28 out of 32 patients (87%) achieved PASI 75, and 18 out of 32 patients (56%) reached PASI 90. Additionally, within 7 days, 20 out of 21 patients (95%) reported a reduction in itch, with a mean itch reduction of 82% on day 1 and 94% on day 7. Importantly, no severe side effects were observed during the study.

The epidural lidocaine block has been demonstrated to be an effective and safe long-term treatment option for individuals with refractory severe plaque psoriasis. It has shown substantial improvement in PASI scores and itch reduction with no significant adverse effects.

Reference: onlinelibrary.wiley.com/doi/10.1111/1346-8138.17145