Hello. Thanks for writing to us
Psoriasis is a chronic immune mediated disease characterized by scaly plaques on various body sites, characteristically extensors like scalp, elbows, knee, ankles etc.
There is a variant of psoriasis which can affect the flexures like groins and perineal area, called as Sebopsoriasis. However, it can be easily confused with a
fungal infection, which is fairly common in these areas (body folds). Therefore, I would suggest that you seek an appointment with a
dermatologist, to establish as to what is the exact nature of the involvement in body folds, whether psoriasis or fungal infection?
As far as the topical cream that you have been using, it contains a potent
topical steroid (
clobetasol propionate). It is effective in psoriasis because psoriasis is a steroid responsive
dermatosis but psoriasis can relapse again after seemingly complete cure.
Topical steroids have a down side to them. They cannot be used over a long term because they can induce skin atrophy. Therefore it is always advisable to use topical steroids under the supervision of a dermatologist. A dermatologist would be able to look for any early signs of atrophy and therefore can substitute or change the medicine.
Apart from topical steroids various treatment option available for psoriasis are: topical coal tar and salicyclic acid, topical vitamin D analogues, topical psoralens. Systemic treatment options are: oral psoralens and UV A therapy (PUVA), NB- UVB phototehrapy. oral
Methotrexate, oral cyclosporin etc.
Choice of treatment depends on the severity, extent of involvement and the feasibility of treatment options. This can only be discussed in person with a dermatologist
Therefore I would reiterate that any treatment, whether topical or oral, should always be taken under the careful supervision of a dermatologist.
Regards