Efficacy of the apitherapy in the treatment of recalcitrant localized plaque psoriasis and evaluation of tumor necrosis factor-alpha (TNF-α serum level: A double-blind randomized clinical trial

Background: No universal consensus about optimal modality for treating the recalcitrant localized plaque psoriasis (RLPP) is available. Objective: To evaluate the immunological and clinical therapeutic effect of using apitherapy in the treatment of RLPP. Methods: Randomized 50 patients with RLPP received apitherapy (n = 25) and placebo (n = 25) every week. Both treatments were injected into lesions at weekly intervals for a maximum of 12 treatments. Following up was 6 months later. Tumor necrosis factor-alpha (TNF-alpha) level was measured at pre-study and at 12th week. Results: A significant difference was found between the therapeutic responses of RLPP to the apitherapy and placebo groups (p<0.001). In the apitherapy group, complete response was achieved in 92% of patients. There was statistically significant decrease in TNF-alpha in the apitherapy group compared to the placebo group. No recurrence was observed in the apitherapy group. Conclusion: Apitherapy is effective and a safe treatment for recalcitrant localized plaque psoriasis, when other topical or physical therapies have failed.