Background: Turmeric demonstrated anti-inflammatory properties in laboratory and clinical studies that suggest its usefulness in psoriasis. This is the first randomized controlled trial comparing the efficacy and safety of turmeric 1% cream to clobetasol propionate 0.05% cream in the treatment of plaque-type psoriasis. Objectives: To determine the efficacy and safety of turmeric 1% cream versus that of clobetasol propionate 0.05% cream in the treatment of plaque-type psoriasis. Methods: This was a randomized, double-blind clinical trial to determine the proportion of patients with clinical remission. Secondary outcomes namely mean PASI and pruritus scores per visit, time to remission and incidence of adverse effects were also determined. Results: Fifty-nine patients were randomized into two groups: a turmeric (n=30) and a clobetasol (n=29) group. After four weeks of treatment, there was no significant difference (p=0.36) in the proportions of patients with clinical remission in the turmeric group (5/20, 25%) and the clobetasol group (8/23, 35%) (RR 1.15, 95% CI 0.78-1.70). The average time to achieve clinical remission was 4 weeks in the turmeric group and 3.38 ± 1.06 weeks in the clobetasol group (p=0.07). There was no significant difference in post-treatment mean PASI scores in turmeric (8.77 ± 5.71) and clobetasol (7.26 ± 6.04) groups (p=0.40). Post-treatment mean pruritus scores in turmeric (6.9 ± 2.83) and clobetasol (5.83 ± 3.87) groups (p=0.30) were also statistically comparable. Two patients in the clobetasol group developed folliculitis. Conclusion Turmeric 1% cream demonstrated comparable efficacy and safety with clobetasol 0.05% cream in the treatment of mild to moderate plaque-type psoriasis.
Curcuma ; Clinical Trial

Introduction: Cushing syndrome caused by application of topical corticosteroids is rarely reported. Systemic side effects like suppression of hypothalamic-pituitary-adrenal axis, growth retardation in children and iatrogenic Cushing syndrome can occur even in small doses of potent topical steroids.1 Case Summary: This is a case of a 3-month old female who was referred to our department due to generalized erythema with desquamation. History revealed that the patient had recurrent eczema and the mother applied an over-the-counter medication containing Ketoconazole+Clobetasol 10mg/500mcg per 7-gram cream thrice daily for ten weeks. The estimated topical steroid applied weekly was around 8.5 grams and at time of admission, the patient had been exposed to approximately 50 grams of a potent topical corticosteroid. The patient presented with fever, irritability, and had positive Nikolsky sign thus managed as a case of staphylococcal scalded skin syndrome associated with topical steroid – induced iatrogenic Cushing syndrome. Unfortunately, patient’s condition worsened and with progressive pneumonia, she expired on the 23rd hospital day. The fatal outcome was due to SSSS which was complicated by progressive pneumonia and topical steroid – induced iatrogenic Cushing syndrome. The complex interplay of these features eventually led to sepsis and death. Conclusion This case highlights the risks related to abuse of potent steroid-containing preparations and the importance of education to prevent severe and catastrophic outcomes of injudicious steroid use.
Staphylococcal Scalded Skin Syndrome