الفهرس 
Comparison between the efficacy of fractional Co2 laser monotherapy versus combined fractional Co2 laser and (topical steroids - vitamin D preparation) in treatment of nail psoriasis
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Abstract
Background:Nail psoriasis has a considerable psychosocial impact that affects quality of life and alters the patient{u2019}s body image; in addition, associated pain can lead to a reduction in activities of daily living. Nail psoriasis is notoriously refractory to treatment, with conventional therapies often having little effect.Treatment options include patient education, external topical treatments,intralesional steroids, systemic treatments, and non-pharmacological treatment options. Laser have gained much attention in the treatment of nail psoriasis due to the possibility of improved penetrability of the nail and/or nail matrix The mechanism of action of fractional Co2 laser therapy in nail psoriasis is not known, but we hypothesized that tissue ablation and the remodeling process stimulate rejuvenation of the abnormal nail bed and enhance the penetration of topical agents.Aim of work:The current study aimed to compare between the efficacy of fractional Co2 laser monotherapy versus combined fractional Co2 laser and (topical steroids - vitamin D preparation) in treatment of nail psoriasis.Patients and methodsThe study included 30 nail psoriasis patients with at least two affected finger nails, all patients were subjected to history and clinical examination.Target NAPSI score was calculated at the start of the study and 3 months after the last laser session.One affected fingernail of each patient received 6 sessions of fractional Co2 laser with 4 week intervals. Another affected fingernail of each patient received topical Calcipotriol Betamethasone ointment once daily in addition to the 6 fractional Co2 laser sessions with 4 week intervals.Improvement in onycholysis and subungual hyperkeratosis was assessed at the end of the study.All adverse events were monitored and recorded.Patient satisfaction and blinded physician scores were done at the end of the study