Outcome evaluation

• Monitor the patient for clearance of skin lesions. Depending on the agent(s) used and site of lesions it may take 2 to 6 weeks or longer to see a response. Complete clearance may not be achieved for all patients.

• Monitor the patient for specific adverse effects, depending on agent(s) used. Some agents are discussed below, and others are discussed earlier in this chapter.

• Methotrexate: Monitor CBC and liver function tests at baseline and regularly, and consider liver biopsy prior to treatment and at a cumulative dose of 1.5 g. If available, monitor PIIINP at least three times yearly.

• Cyclosporine: Monitor SCr, blood urea nitrogen, and blood pressure at baseline and reassess biweekly for at least 12 weeks (or longer until values stabilize), then re9g,3u2-larly. Adjust doses when needed in response to SCr changes as discussed above. ,32

• Acitretin: Monitor serum lipids and liver function tests.

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