الفهرس 
Title : Fractional Carbon Dioxide Laser Assisted Delivery of Topical Cyclosporine Cream for the Treatment of Plaque Psoriasis
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Abstract
Background: In mild psoriasis, topical agents remain the mainstay of
treatment. However, the available treatments are not satisfactory for a
significant proportion of patients in many terms such as efficacy and safety.
Because of these deficits, augmentation of therapeutic effect seems desirable.
This study aims: to evaluate new areas in the treatment of mild to
moderate chronic plaque psoriasis by using topical cyclosporine cream for the
treatment of plaque psoriasis preceded by fractional carbon dioxide laser.
Also, to compare the efficacy of laser assisted drug delivery of topical
cyclosporine cream versus the efficacy of topical clobetasol cream.
Patients and methods: A total of 46 patients with bilateral symmetrical
chronic plaque psoriasis were enrolled and divided into two arms. The first
arm included 24 patients where psoriatic lesions in each patient were randomly
allocated into 2 sides (right & left). Each patient was instructed to apply topical
cyclosporine cream twice daily over one side psoriatic lesions (group A) for
five consecutive days per week immediately after fractional Co2 laser session.
While lesions in the other side (group B) a placebo cream was applied twice
daily for five days / week immediately after fractional Co2 laser session. In
the second arm: 22 patients were included and were randomly allocated into 2
groups A & B. 11 patients in each group. group A patients applied topical
cyclosporine cream twice daily over their psoriatic lesions for five consecutive
days per week immediately after fractional Co2 laser session. While in group
B patients, clobetasol cream was applied to psoriatic lesions twice daily for
five consecutive days per week without laser.
Results: There was a significant improvement of erythema, plaque
elevation, and scaling (p < 0.001) with the use of topical cyclosporine cream
delivered by the aid of fractional CO2 laser, compared to base line.
Conclusion: Laser-assisted delivery of topical cyclosporine can provide
clinical and pathological improvement in the psoriatic plaques. However,
topical steroid showed more improvement