Psoriasis vulgaris is a chronic, multifactorial, inflammatory skin disease. Either cyclosporine (CsA) or methotrexate (MTX) is regarded as most commonly used systemic drugs for the treatment of moderate to severe psoriasis. However, there is no sufficient information related with clinical and laboratory characteristics of psoriatic patients which might have an influence on the therapeutic efficacy. 
The goal of this study was to compare clinical and laboratory manifestations among the psoriatic patients treated with either CsA or MTX. Patients with psoriasis vulgaris, who had been treated with either CsA or MTX at the dermatologic clinic of Ajou University Hospital from January 2012 to December 2016, were enrolled. The patients were divided into four subgroups including CsA responders, MTX responders, CsA non-responders, whose CsA were switch to MTX, and MTX non-responders, whose MTX were switched to CsA. The clinical and laboratory information was retrospectively reviewed. 
Total 488 patients with psoriasis vulgaris were enrolled, including 199 CsA responders, 199 MTX responders, 53 CsA non-responders, 37 MTX non-responders. Disease durations before initial visit were significantly longer in MTX responders, compared to in CsA responders (80.83±7.38 vs. 45.11±5.80 [months], p<0.05). Also, either CsA or MTX non-responders had significantly longer disease duration than either CsA or MTX responders (102.07±12.76 vs. 87.33±4.83 [months], p=0.04). Body mass index was significantly higher in CsA non-responders, compared to in CsA responders (22.15±0.71 vs. 23.65±0.50 [kg/m2], p=0.04). Erythrocyte sedimentation rate was significantly elevated in MTX non-responders, compared to in MTX responders (17.70±3.04 vs. 11.35±0.88 [mm/hour], p=0.02). In addition, either CsA or MTX non-responders showed significantly elevated ESR than either CsA or MTX responders (15.46±2.21 vs. 10.75±0.68 [mm/hour], p=0.03). 
This data showed CsA or MTX non-responders showed longer disease duration, higher BMI and elevated ESR/CRP.

Clinical characteristics according to therapeutic efficacy of cyclosporine or methotrexate in patients with psoriasis vulgaris