European Journal of Molecular & Clinical Medicine

Background: Topical corticosteroids (TCs) are one of dermatology’s most commonly used drugs. The clinical effects of TCs are maintained through their anti-inflammatory, vasoconstrictive, anti-proliferative, immunosuppressive and sex hormone-like effects.^2,3 There were fewer studieson the abuse of TC from developing countries like India, especially in Andhra Pradesh^4,5,6. So, this study was conducted to assess the magnitude of abuse of topical corticosteroids, their reasons, and various complications due to it.  Objectives: To know the prevalence of topical corticosteroid abuse, to know the reasons, pattern, adverse effects and formulation used among cases with TC abuse and to compare clinic-demographic profile among cases and controls. Methodology: The current study was done in the outpatient unit of the dermatology department.This is a type of cross-sectional, observational study done from September 2022 to November 2022. Patients aged above 18 years, males and females, presenting with some complaints to the dermatology unit, suspected of TC abuse and who are willing to participate and provided consent were included in the study. Results: TC abuse was seen among 26% of patients. Most of the patients were aged 21-30 years. 63% of patients were females, and 67% of patients reported the most common area of usage as the face. Most of the patients reported cosmetic reasons for topical corticosteroid abuse. 13.4% of patients reported intermittent usage. The most common adverse effect due to topical corticosteroid abuse seen was Tinea incognito. Conclusion: It is the need of the hour to increase public awareness and educate the prescribers on corticosteroids. One major step would be to regulate the manufacture and OTC sale of topical steroids. We highly recommend topical steroids and their combinations to be sold as “prescription-only” medications.

Aim: To determine the effect of various topical agents in chronic plaque type psoriasis.
Materials and Methods: The study was carried out on patients having chronic plaque type psoriasis vulgaris came to Department of Skin & VD, Medini Rai Medical College, Palamu, Jharkhand, India. Total 300 patients were enrolled and were divided into three groups comprising of 100 patients in each group. Group A patients were asked to apply ammonium lactate twice a day, Group B patients were asked to apply ammonium lactate in morning and clobetasol propionate in evening, Group C patients were asked to apply topical ammonium lactate in morning and calcipotriol in evening.
Results: Physician global assessment scale shows that in Group A, 39% patients had excellent response, 15% patients had good response, and 21% patients had fair response whereas 25% patients had poor response. In group B, 35% patients had excellent response, 29% patients had good response, and 17% patients had fair response whereas 19% patients had poor response. In group C, 31% patients had excellent response, 28% patients had good response, and 22% patients had fair response whereas 19% patients had poor response.
Conclusion: Combination therapy is effective, well tolerated with minimal side effects and better compliance was seen with patients. Ammonium lactate 12% can also be considered as one of the topical option as a monotherapy and also as a maintenance therapy.