Fumaric acid and its derivatives in the treatment of psoriasis vulgaris: our experience in forty-one patients.

The use of fumaric acid esters in the treatment of psoriasis was first proposed in 1959. In the 1980s, more standardized oral preparations of fumaric acid esters were developed, containing dimethylfumarate and monoethylfumarate as the main compounds. In 1994, the drug was approved for the treatment of psoriasis in Germany, and since then it has become the most commonly used systemic therapy in this country. In the last few years, an oral integrator containing dimethylfumarate and monoethylfumarate (Psocaps, Dermatika s.r.l., Padua) has also been available in Italy for the treatment of psoriasis. In this paper we report on the history of treatment using fumaric acid esters and we describe our own experience during and following the treatment with such drugs in 41 patients affected by mild vulgar psoriasis. In our trial, an improvement in cutaneous psoriasis was observed in 46% of treated patients, while side effects were noticed in 52% of patients; only three patients dropped out due to gastrointestinal problems. Our results are comparable to literature data in terms of efficacy, safety and side effects.