Evaluation of safety and efficacy of topical 4% nicotinamide in treatment of psoriasis; among a representative sample of Egyptians (an analytical observational study)

To assess and evaluate the efficacy and safety of nicotinamide 4% topical formulation for the treatment of mild to moderate psoriasis. This study was conducted on 60 patients aged 18-65 years, with mild to moderate psoriasis vulgaris. Nicotinamide 4% in a cold cream base was used twice daily for 12 weeks. Nicotinamide 4% topical treatment shows satisfactory results, more in males than in females. Some patients report disturbing irritation (burning, itching, and redness) upon the usage of topical nicotinamide treatment and were advised to wash out the treated area after 1 h of cream application, which solved the issue. No other adverse effects of treatment were reported by patients during the study period. Unicentral base, a limited amount of sample size, and 12 weeks duration of therapy and follow-up period, which may not be sufficient to demonstrate the complete therapeutic properties and side effects of using nicotinamide as a long-term treatment for psoriasis. This study reveals statistically reliable evidence of the positive impact of topical 4% nicotinamide preparation used alone on the treatment of psoriasis with minimal side effects. Thus, we can conclude that topical nicotinamide preparation may be a good adjuvant to the current treatment regimens used alone or alternate currently used topical therapeutical regimens if used in combination.