What training is available for healthcare professionals to learn about Goeckerman therapy?

Goeckerman Therapy Training Options for Healthcare Professionals

Formal training opportunities for Goeckerman therapy are limited to specialized psoriasis centers, with most education occurring through hands-on experience at institutions that offer this treatment modality.

Background on Goeckerman Therapy

Goeckerman therapy is a well-established treatment for moderate to severe psoriasis that combines ultraviolet B (UVB) light exposure with application of crude coal tar. First described in 1925, this therapy has proven highly effective for treatment-resistant cases of psoriasis 1.

The treatment consists of:

• Application of crude coal tar (typically 1-5%)
• Exposure to UVB phototherapy (traditionally broadband, now often narrowband)
• Daily treatments over several weeks

Available Training Options

Specialized Psoriasis Centers

The primary training opportunities for Goeckerman therapy are found at specialized psoriasis treatment centers that actively perform this procedure:

• University of California, San Francisco (UCSF) Psoriasis and Skin Treatment Center - Offers hands-on training in their modified Goeckerman protocol 2, 3
• Major academic medical centers with dedicated psoriasis clinics that perform Goeckerman therapy

Educational Resources

1. Instructional Videos and Protocols:

   • UCSF has produced detailed instructional videos demonstrating their Goeckerman protocol 2
   • Patient-oriented guides that can also serve as training resources for providers 3

2. Published Protocols:

   • Journal articles detailing specific institutional protocols 2, 4, 5, 6
   • Modified protocols such as the "ultra" Goeckerman therapy described in the literature 6

3. Dermatology Residency Programs:

   • Some dermatology training programs include Goeckerman therapy in their curriculum, particularly those affiliated with institutions that offer this treatment

Limitations in Training Opportunities

Training for Goeckerman therapy faces several challenges:

• Limited Availability: Few centers regularly perform traditional Goeckerman therapy, as newer treatments have become more common 1
• Specialized Knowledge Required: The therapy requires expertise in both coal tar application and phototherapy administration
• No Standardized Certification: Unlike other medical procedures, there is no formal certification process specifically for Goeckerman therapy

Implementation Considerations

Healthcare professionals interested in implementing Goeckerman therapy should consider:

1. Protocol Development:

   • Determine optimal coal tar concentration (studies show 1% can be as effective as higher concentrations) 5
   • Establish appropriate UVB dosing schedules
   • Consider treatment duration (typically 2-3 months for full course) 4

2. Safety Monitoring:

   • Training should include recognition and management of side effects such as:
     • Phototoxicity
     • Folliculitis
     • Contact dermatitis
     • Theoretical long-term risk of carcinogenesis 1

3. Patient Selection:

   • Understanding appropriate candidates for therapy
   • Contraindications and precautions, particularly during pregnancy 1

Effectiveness and Outcomes

Goeckerman therapy has demonstrated impressive efficacy:

• 100% of patients reached PASI 75 by 12 weeks in one study 6
• 95% reached PASI 75 by 8 weeks in the same study
• Long remission periods are common after successful treatment

Conclusion

Healthcare professionals seeking training in Goeckerman therapy should:

1. Contact specialized psoriasis centers that actively perform the procedure
2. Review available instructional videos and published protocols
3. Consider visiting centers with established programs for hands-on experience

While formal training programs are limited, the combination of available educational resources and mentored experience can provide adequate preparation for implementing this effective therapy for treatment-resistant psoriasis.