To the Editor: Re: Goeckerman treatment for remission of psoriasis refractory to biologic therapy. The letter of Serrao and Davis1Serrao R. Davis M.D. Goeckerman treatment for remission of psoriasis refractory to biologic therapy.J Am Acad Dermatol. 2009; 60: 348-349Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar raises some interesting points and questions. In this study they showed that 20 of 23 patients had greater than 80% clearance over the 3-week duration of Goeckerman therapy. Yet, it is interesting to note that only 3 of these subjects, “refractory to biologic therapy”, had previously received infliximab2Menter A. Feldman S.R. Weinstein G.D. Papp K. Evans R. Guzzo C. et al.A randomized comparison of continuous vs. intermittent infliximab maintenance regimens over 1 year in the treatment of moderate-to-severe plaque psoriasis.J Am Acad Dermatol. 2007; 56 (e1-15. Epub 2006 Sep 6): 31Abstract Full Text Full Text PDF PubMed Scopus (466) Google Scholar or adalimumab,3Menter A. Tyring S.K. Gordon K. Kimball A.B. Leonardi C.L. Langley R.G. et al.Adalimumab therapy for moderate to severe psoriasis: a randomized, controlled phase III trial.J Am Acad Dermatol. 2008; 58 (Epub 2007 Oct 23): 106-115Abstract Full Text Full Text PDF PubMed Scopus (732) Google Scholar agents expected to give greater than 80% clearance in the majority of patients. Thus this comparison and statement concerning “resistance to biologics” is certainly not warranted.In addition, while the authors do mention and reference “excellent remissions” obtained with Goeckerman therapy, they do not, unfortunately, in their review of the 23 patients, give any specific data relating to their remission rates or duration, or indeed a cost comparison of the relative costs of 3 weeks of Goeckerman therapy (say, twice yearly) versus biologic therapies. Time away from work, cost of travel, and other factors would also need to be considered in this calculation. To the Editor: Re: Goeckerman treatment for remission of psoriasis refractory to biologic therapy. The letter of Serrao and Davis1Serrao R. Davis M.D. Goeckerman treatment for remission of psoriasis refractory to biologic therapy.J Am Acad Dermatol. 2009; 60: 348-349Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar raises some interesting points and questions. In this study they showed that 20 of 23 patients had greater than 80% clearance over the 3-week duration of Goeckerman therapy. Yet, it is interesting to note that only 3 of these subjects, “refractory to biologic therapy”, had previously received infliximab2Menter A. Feldman S.R. Weinstein G.D. Papp K. Evans R. Guzzo C. et al.A randomized comparison of continuous vs. intermittent infliximab maintenance regimens over 1 year in the treatment of moderate-to-severe plaque psoriasis.J Am Acad Dermatol. 2007; 56 (e1-15. Epub 2006 Sep 6): 31Abstract Full Text Full Text PDF PubMed Scopus (466) Google Scholar or adalimumab,3Menter A. Tyring S.K. Gordon K. Kimball A.B. Leonardi C.L. Langley R.G. et al.Adalimumab therapy for moderate to severe psoriasis: a randomized, controlled phase III trial.J Am Acad Dermatol. 2008; 58 (Epub 2007 Oct 23): 106-115Abstract Full Text Full Text PDF PubMed Scopus (732) Google Scholar agents expected to give greater than 80% clearance in the majority of patients. Thus this comparison and statement concerning “resistance to biologics” is certainly not warranted. In addition, while the authors do mention and reference “excellent remissions” obtained with Goeckerman therapy, they do not, unfortunately, in their review of the 23 patients, give any specific data relating to their remission rates or duration, or indeed a cost comparison of the relative costs of 3 weeks of Goeckerman therapy (say, twice yearly) versus biologic therapies. Time away from work, cost of travel, and other factors would also need to be considered in this calculation.