Assessing the Effectiveness of Potent Topical Steroids Alone and Combined with Salicylic Acid or 20% Urea in the Treatment of Mild to Moderate Chronic Plaque Psoriasis: A Randomized Controlled Trial
Keywords:
Betamethasone Chronic plaque psoriasis, PASI score, UreaAbstract
Background: Chronic plaque psoriasis is a prevalent immune mediated skin disorder marked by the development of thick plaques covered with silvery scales mostly on the extensor surfaces of body. A variety of therapeutic options exist to manage this condition such as corticosteroids, vitamin D analogs, and retinoids, keratolytics and phototherapy. Urea is a strong emollient and keratolytic agent, helpful in reduction of scales in psoriasis. Beneficial effects of topical urea preparations have been shown by various studies but none has assessed its efficacy with betamethasone ointment. This study aimed to fill this research gap. Objectives: To assess the effectiveness of 20% urea combined with betamethasone vs betamethasone ointment alone or in combination with salicylic acid in the treatment of mild to moderate chronic plaque psoriasis. Methods: It is Randomized Control Trial. About 180 patients were enrolled in this study and divided into three groups. Group A Patient applied betamethasone dipropionate 0.05% ointment on lesional skin twice a day, Group B applied betamethasone in combination with salicylic acid and patients in Group C applied 20% urea in combination with betamethasone for 6 months regularly. The main outcome was reduction of PASI score from the baseline. Final results were compiled after 6 months keeping p value of <0.05 as significant. Results: The mean age in Group A, B and C was 31.19 ± 6.87, 29.46 ± and 7.83, 28.83 ± 7.51 years respectively. Duration of disease and male to female ratio was comparable in both groups. The mean PASI score was10.55 ± 1.63± in Group A ,9.76 ± 2.77± in Group B and 9.916 ± 1.78 in Group C. After 6 months it reduced to 10.02 ± 1.79, 8.54 ± 1.92 and 7.66 ± 1.34 in Group A, B & C respectively (p value=.00034). Conclusion: It is concluded that 20% urea gives better results than salicylic acid when both were combined with betamethasone.References
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