Psoriasis is a chronic disease that often requires lifelong treatment. While topical steroids remain as first-line therapy, there is a need for alternative treatments due to steroid-induced long-term side effects. Azelaic acid is a natural, plant-sourced, saturated dicarboxylic acid that can potentially be beneficial for the treatment of psoriasis plaques. Objectives The study was conducted to determine whether azelaic acid 15% cream is non-inferior to betamethasone valerate 0.1% cream in efficacy and safety for the treatment of plaque-type psoriasis.

Twenty-nine patients with mild to moderate plaque psoriasis applied azelaic acid 15% cream and betamethasone valerate 0.1% cream on symmetric and contralateral lesions for 6 weeks.

There was no statistically significant difference between the azelaic acid and betamethasone valerate groups in terms of pruritus, erythema, induration, scaling, and DLQI scores at baseline, 2 weeks, 4 weeks, and 6 week (p>0.05). Azelaic acid was also non-inferior to betamethasone valerate in terms of safety, and the study showed a much lower frequency of mild adverse events with azelaic acid than a previous study.

Azelaic acid 15% cream was noninferior to betamethasone valerate 0.1% cream in terms of efficacy and safety in the treatment of plaque-type psoriasis and may be a promising alternative to topical steroids