To assess whether adding fractional laser to topical corticosteroid improves treatment outcomes in palmoplanter psoriasis compared to topical corticosteroid alone.
· To evaluate and compare the reduction in disease severity of palmoplantar psoriasis using the Palmoplantar Psoriasis Area and Severity Index (PPPASI) in both treatment groups
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
32
Sessions of fractional CO2 every 4 weeks with application of topical steroids
Daily application of topical corticosteroids on palmoplantar psoriasis
Cairo University
Cairo, Cairo Governorate, Egypt
Improvement in Palmoplantar Psoriasis Severity Index (ppPASI) by topical corticosteroids only vs fractional CO₂ laser-assisted delivery of topical corticosteroids
The primary outcome will be the change in the Palmoplantar Psoriasis Severity Index (ppPASI) score from baseline to the end of treatment (at Week 12). The ppPASI assesses disease severity based on erythema, scaling, and induration/infiltration of the palms and soles, in addition to the affected surface area. Scores range from 0 to 72, with higher scores indicating more severe disease. Treatment success: Achievement of ppPASI-50, ppPASI-75, and ppPASI-90 (≥50%, ≥75%, and ≥90% reduction from baseline).
Time frame: 3 month
Physician Global Assessment (PGA)
Clinical improvement will be assessed using the Physician Global Assessment for palmoplantar psoriasis. The PGA is a 5- or 6-point scale: 0 = Clear 1. = Almost clear 2. = Mild 3. = Moderate 4. = Severe 5. = Very severe (if using the 6-point scale)
Time frame: 3 months
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