Psoriasis CTS ( Coal Tar Solution 5% / Triamcinolone Acetonide 0.16% / Salicylic Acid 5% / Urea 10%) Cream

Coal Tar Solution
Coal tar is indicated for the symptomatic management of pruritus and irritation caused by dandruff, seborrheic dermatitis, atopic dermatitis, eczema, and psoriasis. Treatment with coal tar and UV light or sunlight can be beneficial because of its photosensitizing action. Official USP coal tar preparations include crude coal tar, coal tar topical solution, and coal tar ointment. Crude coal tar is produced as a byproduct secondary to the destructive distillation of coal, and it can be further refined into coal tar topical solution or ointment. Commercially available preparations that are not officially recognized by USP and do not have specifications for composition include coal tar extract and distillate. The application of crude coal tar preparations may be aesthetically displeasing to the patient; however, further refined products are believed by many clinicians to be therapeutically inferior. It has been suggested that the variability in refining processes may be responsible for differences in therapeutic response to coal tar preparations. Coal tar was in use prior to 1938 and was approved by the FDA at its inception.

Triamcinolone Acetonide
Triamcinolone is a synthetic glucocorticoid that is considered slightly more potent than prednisone when given orally. Triamcinolone has little mineralocorticoid activity and is therefore not used systemically to manage adrenal insufficiency unless a more potent mineralocorticoid is administered concomitantly. Triamcinolone is commercially available in nasal, parenteral, topical, and intravitreal injection formulations. Oral and respiratory formulations of triamcinolone were previously available but are no longer marketed in the U.S. Triamcinolone injections are commonly used for intra-articular use when such therapy is indicated. The nasal spray is used to manage symptoms of seasonal and perennial allergies. Topical preparations for corticosteroid-responsive dermatoses are considered to be of medium or high potency.

Salicylic Acid
Salicylic acid is a topical keratolytic agent. It is used to remove excess keratin in hyperkeratotic skin disorders such as common and plantar warts, psoriasis, seborrheic dermatitis, calluses, and corns. Salicylic acid also is used to treat acne. Salicylic acid works by causing desquamation of the horny layer of skin. Prolonged or repeated daily use over large areas of skin may result in salicylism, especially in children and patients with renal or hepatic impairment. This drug was approved by the FDA in 1939.

Urea
Urea (also known as carbamide) is available as topical formulations and as a powder for oral solutions. It is used topically to treat dry skin (xerosis) and for the destruction and dissolution of dystrophic nails due to onychomycosis. As an oral agent, urea is an osmotic diuretic and is used for the treatment of hyponatremia, particularly due to SIADH.