Assessing the Efficacy of Topical Treatments for Psoriasis in Urban Adult Populations

Thesis Abstract

This study investigates the efficacy of topical treatments for psoriasis among adult populations residing in urban environments, addressing the ongoing challenge of optimizing management strategies for a chronic, inflammatory skin condition that significantly affects quality of life. Psoriasis, characterized by hyperproliferation of keratinocytes and immune dysregulation, remains a therapeutic challenge owing to variations in treatment responses, adherence issues, and the diverse presentation of the disease. Despite widespread use of topical therapies such as corticosteroids, vitamin D analogs, and coal tar preparations, there is limited comprehensive data on their comparative effectiveness within urban settings where environmental factors and lifestyle variations may influence treatment outcomes. The primary aim of this research is to evaluate the clinical efficacy of prevalent topical treatments and identify factors associated with improved patient outcomes. Specific objectives include determining the extent of lesion clearance, evaluating patient adherence levels, analyzing side effect profiles, and exploring socio-demographic factors influencing treatment response. A quantitative research design employing a longitudinal cohort approach was adopted to facilitate the assessment of treatment efficacy over a 12-week period. The study population comprised 300 adult individuals diagnosed with stable plaque psoriasis, recruited from dermatology outpatient clinics in a metropolitan city through stratified random sampling to ensure representation across age, gender, and socioeconomic status. Data collection instruments consisted of standardized clinical assessment tools such as the Psoriasis Area and Severity Index (PASI), patient adherence questionnaires, side effect reporting forms, and structured interviews capturing socio-demographic variables. To ensure validity and reliability, instruments were pilot-tested with 30 participants (excluded from the main study), and Cronbach's alpha coefficients exceeded 0.80 for adherence and side effect scales. Data analysis involved descriptive statistics to profile the sample, inferential techniques including repeated-measures ANOVA to compare PASI scores pre- and post-treatment, multiple regression analysis to identify predictors of treatment success, and chi-square tests to explore associations between socio-demographic variables and clinical outcomes. The study was framed within the Health Belief Model and the Transtheoretical Model to interpret adherence behaviors and patient engagement with treatments. Ethical approval was obtained from the institutional review board, and informed consent was secured from all participants, ensuring confidentiality and voluntary participation. Expected findings suggest significant reductions in PASI scores following topical therapy, with corticosteroids demonstrating higher immediate efficacy but increased side effects, whereas vitamin D analogs show sustained response with better tolerability. Treatment adherence is anticipated to be positively correlated with socio-economic status, patient education, and perceived disease severity. The study aims to fill existing gaps in empirical evidence regarding the comparative effectiveness of topical treatments in urban adult populations, particularly considering environmental and lifestyle factors unique to metropolitan settings. The research's contribution to academic knowledge includes providing evidence-based insights into optimal topical management strategies, identifying adherence barriers, and informing clinical decision-making tailored to urban populations. The findings are expected to guide dermatologists in personalized treatment planning and foster the development of patient-centered interventions to improve therapeutic outcomes. In conclusion, the study underscores the importance of integrating clinical efficacy data with behavioral insights to enhance psoriasis management, advocating for continuous patient education, adherence support, and context-specific treatment guidelines. Recommendations include further research on long-term outcomes, evaluating combination therapies, and exploring the impact of environmental factors on treatment response in urban settings.