The use of salicylic acid and glucocorticosteroids in vulgar psoriasis

Abstract

Among all forms of psoriasis, vulgar psoriasis (VP) occupies a leading place. The pathogenesis of VP is complex and involves significant participation of various components of the immune system, which manifests itself in the development of not only local, but also systemic inflammation. Also, the course of psoriasis is characterized by disturbances at the level of cellular metabolism, which is reflected in the activation of free radical oxidation and a change in the redox potential. As a consequence, the course of VP is often accompanied by many chronic diseases. The treatment of patients with uncomplicated VP and without articular manifestations is based on the use of local therapy – topical glucocorticosteroids (tGCS), vitamin D analogues, calcineurin inhibitors, keratolytics, as well as targeted phototherapy. At the same time, tGCS monotherapy requires long-term supportive treatment, which is associated with the presence of specific side effects of tGCS. This, in turn, makes it rational to use a combination of local drugs. Considering the variety of approaches to the treatment of VP, it is relevant to study the effectiveness of the use of a combination of various local and systemic drugs of psoriasis therapy. The addition of keratolytics can potentiate the positive effects of tGCS and is especially effective with pronounced peeling. In addition, the use of systemic cytoprotective therapy in the treatment strategy of VP can improve the clinical effect due to the acceleration of degradation of free radical oxydation products and normalization of the redox potential of blood and tissues, which is disrupted in psoriasis. The article shows the clinical effectiveness of the use of combined local therapy based on salicylic acid and tGCS in medicinal forms of ointment and lotion for VP based on clinical examples.