الفهرس 
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Abstract
Psoriasis is a common chronic inflammatory skin disease. Its high prevalence, chronicity, disfiguration, disability, and associated comorbidities make it a challenge for physicians.
Therapeutic options of psoriasis include topical treatments, systemic treatments, photo therapy and biological therapy.
Topical agents remain the main treatment option in mild to moderate psoriasis. However, patient satisfaction with available topical treatments remains modest.
Methotrexate (MTX) is an effective systemic cytotoxic, antiproliferative and anti-inflammatory chemotherapeutic agent that is still considered the first-line treatment of moderate to severe plaque psoriasis. However, high profile of systemic adverse effects limits its use in mild or localized psoriasis.
Topical MTX has become a more-interesting alternative. However, the topical action of MTX is challenging due to its limited percutaneous diffusivity.
In our study, we chose microemulsion based on jojoba oil as a topical nanocarrier for MTX to enhance its penetration and thus efficacy.
Also, photo therapy is a well-known line of treatment of psoriasis and the therapeutic efficacy of Excimer light and NB-UVB has been studied by various studies however, no studies showed their efficacy with topical MTX microemulsion.
So that, we performed this intra-individual comparative clinical trial to evaluate the efficacy and safety of topical methotrexate microemulsion when used as monotherapy or when combined with excimer light versus NB-UVB.
The MTX water in oil microemulsion based on jojoba oil was prepared according to the previously reported water dilution method after modification at Drug Research Center -Assiut University.
After ratio optimization, Successful single-phase clear (1 mg MTX/mL) microemulsion solution was formed with (40%) jojoba oil, (25%) tween 80, (25%) span 85 and (5%) MTX solution.
Morphology and particle size of the microemulsion were evaluated by transmission electron microscopy and revealed that spherical droplets of the internal phase were visible and the particle size of microemulsion droplets where the average of >60 droplets was 24.5 ± 6.9 nm.
Skin deposition test revealed that microemulsion successfully delivered MTX into the epidermis and also to the dermis.
After that, thirty patients with mild to moderate psoriasis vulgaris were recruited from the Dermatology out-patient clinic, Assiut university hospital, during the period from November 2021 to December 2022.