Reproducible effects of intravenously administered fish oil in acute relapsing psoriasis

Abstract
In several studies, dietary fish oil has been found to be beneficial in psoriasis, although the results have been controversial. To overcome the slow kinetics and limited availability of oral supplementation, a patient with acute relapsing psoriasis received an ω-3 fatty acid-based lipid emulsion (100 ml/day containing 2.1 g eicosapentaenoic acid (EPA) and 2.1 g docosahexaenoic acid) for 10 days. Clinical symptoms were assessed using the PASI. The PASI score dropped from 18.4 to 4.2. In addition leukotriene generation of ionophore-stimulated neutrophils showed a more than tenfold increase in EPA-derived lipoxygenase product formation. Because of a renewed exacerbation 1 year later, a second trial was started with double the previous dose over a period of 15 days. Probably because of a worse clinical condition, the patient responded more slowly than during the first trial, and the increase in EPA-derived metabolites was more retarded. Modulation of eicosanoid metabolism by intravenous ω-3 fatty acid supplementation appears to have a rapid and reproducible beneficial effect on inflammatory skin lesions in acute relapsing psoriasis.