Topical 6-aminonicotinamide plus oral niacinamide therapy for psoriasis

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Abstract
Patients (99) with psoriasis were treated topically with 6-aminonicotinamide (6-AN) for 4 yr. In a double-blind study, 1% 6-AN gel was superior to 0.1% triamcinolone acetonide in 29 comparisons, equal in 3 and inferior in 1 when applied without occlusion for 4 wk. In an open study, 1% 6-AN was better than 4 potent steroid creams in 34 comparisons, equal in 4 and inferior in 1. Substantial improvement or complete clearing of plaques occurred in 85 of 99 patients. Tachyphylaxis occurred in 10 but was not permanent. Mucocutaneous toxicity appeared in 25% but was usually easily controlled. Tinnitus occurred in 4, but none had deterioration of audiogram readings. The combination of topical 6-AN and oral niacinamide therapy gives promise of an effective and safe treatment for psoriasis. Of 3 patients with pityriasis rubra pilaris improved considerably with 6-AN.

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