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Abstract SUMMARY ail psoriasis affects up to 50% of psoriatic patients with an estimated lifetime incidence of 80% to 90%. Conversely, up to 5% of patients have isolated nail psoriasis without skin manifestations. The lesions in nail psoriasis can arise from the nail matrix (pitting, leukonychia, trachyonychia, Beau’s lines, red spots in lunula and nail plate crumbling) and/or nail bed (subungual hyperkeratosis, onycholysis, splinter hemorrhage, and salmon patches). Nail psoriasis leads to a significant cosmetic handicap and impairment in the quality of life. The Nail Psoriasis Severity Index (NAPSI) is a numeric, reproducible, objective, simple tool for clinical evaluation of nail psoriasis. Intense pulsed light (IPL) is a device that emits highintensity, polychromatic (between 400 and 1200 nm), noncoherent and non-collimated light. This allows to treat skin vascular disorders such as vascular tumors and telangiectasia. IPL has been used in the treatment of nail psoriasis due to the vascular nature of the disease. The energy is captured by the hemoglobin which leads to the destruction of the blood vessels. Methylene blue (MB) is a widely known histological dye that has been used to stain living organisms. It’s a hydrophilic PS, with low molecular weight and positive charge. It belongs N Summary 129 to the phenothiazinium class of compounds. The characteristic color of MB is caused by the strong absorption band in the 550–700 nm regions. It is well known to generate singlet oxygen, and the mitochondrial localization of this drug induce cell death by apoptosis during photodynamic therapy (PDT). Photodynamic therapy (PDT) is modern, safe, and noninvasive form of therapy that has been successfully used in dermatology. In our study, we aimed to evaluate and compare the efficacy of IPL and methylene blue assisted photodynamic therapy for the treatment of nail psoriasis. Twenty patients (15 males and 5 females) with different degrees of nail psoriasis, were randomly selected from the outpatient clinic of Dermatology, Venereology and Andrology, Ain Shams University. Their age ranged from 24 to 71 years. Each patient was subjected to a detailed history taking and full examination. An informed consent was obtained after explaining the aim of our study. Each patient had one session of MB-PDT every two weeks, for 3 months, applied to the affected nails of the right hand, and one session of IPL every two weeks, for 3 months, applied to the affected nails of the left hand. Two passes were performed. The hand piece was placed adjacent to the surface of the nail covering the proximal and lateral nail folds |