Meta-analysis of traditional Chinese medicine dampness-removing therapy in the treatment of psoriasis vulgaris

Objective:To systematically evaluate the clinical effect and safety of dampness-removing therapy in the treatment of psoriasis vulgaris by Meta analysis.Methods:The clinical studies on the treatment of psoriasis with removing dampness therapy in CNKI,Wanfang,VIP,SinoMed,Medline,Embase and Cochrane Library were searched from the establishment of the database to June 2021.After screening,data extraction and bias risk assessment,the retrieved literature was statistically analyzed by Revman5.3 software.Results:A total of 2063 subjects were included in 24 clinical studies.The results of Meta analysis showed that the experimental group was superior to the control group in terms of total effective rate of treatment(OR=3.31,95%CI[2.55,4.31]),reducing PASI score(MD=-2.57,95%CI[-3.08,-2.06])and improving quality of life(MD=-3.23,95%CI[-3.70,-2.76]).The adverse reactions in the experimental group were slighter than those in the control group(OR=0.42,95%CI[0.29,0.61]).Conclusion:The method of removing dampness in traditional Chinese medicine is safe and effective in the treatment of psoriasis vulgaris,but in view of the low overall quality of the included research,larger samples and higher quality clinical trials are still needed to obtain more sufficient evidence.

Meta-analysis of traditional Chinese medicine Jiedu therapy in the treatment of psoriasis vulgaris

Objective:To evaluate the clinical efficacy of traditional Chinese medicine Jiedu therapy in treatment of psoriasis.Methods: CNKI, Wanfang knowledge service platform, VIP journal database, Chinese biomedical literature database ( CBM), PubMed, the Cochrane Library and EMbase database from the establishment of the database to March 2020 were searched for the randomized controlled trials (Rcts) on traditional Chinese medicine Jiedu therapy in treatment of psoriasis. Literature selection and information extraction was completed and screened by two independent reviewers, and then the Cochrane recommended bias risk assessment method was used to evaluate the bias risk, and Review Manager5.3 was used for the data analysis. Totally 17clinical Rcts were included in this study, involving 1376 patients.Results:Analysis results showed that traditional Chinese medicine Jiedu therapy had higher clinical effective rate, with statistically significant difference ( OR= 4.53, 95% CI[3.17,6.46], Z =8.32, P<0. 00001);the improvement of score was more evident, PASI score (WMD =-2.21, 95%CI[-2.77, -1.64], Z = 7.60, P<0. 00001);and trial-related adverse events were reported in 6RCTs. Conclusion: Studies have shown that traditional Chinese medicine Jiedu therapy had higher clinical efficacy.

<i>In vivo</i>study of biomechanical properties in psoriasis vulgaris: Effectiveness of sulfur spa therapy

Psoriasis is a prolonged inflammation of the skin. The causes of psoriasis are still unclear. The treatment options depend on the severity of the disease and may include topical agents (such as topically-applied drugs, sulfur spa therapy, phototherapy) and systemic agents (orally or percutaneously administered). The aim of this study was to investigate the mechanical properties of the skin in psoriatic plaques before and after treatment with sulfur therapy (Thermae Luigiane, Guardia Piemontese—Acquappesa, Italy), in comparison with the skin of healthy subjects. The study has been performed on 20 psoriatic plaques (10 on upper arm, 10 on upper back) and 10 control subjects (healthy males aged 47 ± 15). The efficacy of sulfur therapy was observed through the evaluation of the biomechanical properties of the skin. Investigation was performed with a Skin meter, an instrument useful to determine the physiological parameters by the means of a suction method, a non-invasive in vivo suction. The apparatus was equipped with 2-mm measuring probe. Unlike the optical method, in our test the color and/or distribution of the skin micro-circulation didn’t interfere with the measurement. The evaluation of mechanical properties of the psoriatic plaques after treatment showed a significative recovery of the parameters analysed, with an increase of the elasticity parameters (Ur, Ua, Ua/Uf, Ur/Uf) and a decrease of the viscoelasticity module (Uv/Ue).

Foamed microemulsion nanodroplets loaded with chlorin e6 for epidermal-targeted treatment against psoriasis

Psoriasis is a chronic skin disease characterized by the hyperproliferation of keratinocytes and an overactive autoimmune response. Photodynamic therapy (PDT) has been established as a promising intervention for alleviating psoriasis. However, the current transdermal delivery of photosensitizers is inefficient and imprecise. In this study, we developed a foamed microemulsion nanodroplets system containing chlorin e6 (Ce6 FM), exhibiting precise epidermal targeting and retention, which targeted the aberrantly proliferating epidermal cells at psoriatic skin lesions and avoided the damage to the normal cutaneous cells. Upon application in a psoriatic mouse model, Ce6 FM efficiently induced keratinocyte apoptosis by generating reactive oxygen species under laser. Furthermore, Ce6 FM-based PDT activated the cyclooxygenase-2-induced immunosuppressive pathway in keratinocytes, resulting in the amelioration of the autoimmune microenvironment in psoriatic skin. Additionally, Ce6 FM-based PDT did not induce skin damage or atrophy associated with non-targeted halometasone treatment. Overall, Ce6 FM-based PDT holds promise as an effective, safe and compliant strategy for psoriasis treatment.

Mechanism of traditional Chinese medicine in the treatment of psoriasis with depression:A review

Psoriasis is a kind of immune-mediated, chronic, inflammatory skin disease, which is often associated with different degrees of psychological disorders. Specifically, there is a significant correlation between psoriasis and depression, and they show the relationships of reciprocal causation and mutual promotion. Psoriasis with depression is more harmful than simple psoriasis, and its prognosis is worse, which brings a huge burden to the family and society and is worthy of clinical attention. Based on the pathogenic factors of western medicine and pathogenesis of traditional Chinese medicine in psoriasis with depression, the paper summarized and elaborated the research progress on the mechanism of traditional Chinese medicine in the treatment of psoriasis with depression, in order to provide new ideas for clinical treatment.

Systemic Amyloidosis Secondary to Psoriasis: A Rare, Autoimmune and Genetically-Determined Disorder That Is Amenable to Treatment with Cyclosporin A—Cyclosporin A for Psoriasis-Induced Amyloidosis

Background: Systemic secondary amyloidosis (SSA) is associated with chronic inflammatory disorders and/or chronic infections. Patients and Methods: Over the past 10 years;a total of 21 patients, with long-term (17 months) and extensive psoriasis (P) with psoriasis area severity index (PASI) >29, were evaluated. Results: Two patients had nephrotic syndrome (proteinuria 3.9 and 3.6 g/day) and decrease creatinine clearance (46 and 62 ml/minute). Their renal biopsy revealed Congo-red (+) nodular glomerulosclerosis that lacked immune-deposits and resisted wash with K-permanganate wash indicating SSA. Three months subsequent to Cyclosporin A (CyA) therapy with 100 mg twice daily;psoriasis improved in all patients with decrease in (PASI) from 29.5 to 3.5 1. In the 2 patients with SSA;proteinuria decreased to 2.1 and 1.8 g/day and creatinine clearance improved to 51 and 69 ml/minute. Such improvement persisted up to 2 years of follow up and up to 78 months in patients with SSA. Conclusion: psoriasis-induced SSA is an autoimmune disease, with genetic predisposition that is amenable to CyA therapy.

Psoriasis treatment using minimally manipulated umbilical cordderived mesenchymal stem cells:A case report

BACKGROUND Psoriasis is a chronic autoimmune disease that usually manifests as a red scaly epidermis,induration,and hyperproliferation of basal keratinocytes.About 2%of the world’s population suffers from psoriasis but there are no clear therapeutics yet.Recently,mesenchymal stem cells(MSCs)have been regarded as a therapeutic alternative for autoimmune diseases,as they possess immunosuppressive effects without risks.Human umbilical cord-derived MSCs effectively regulate immune cells and are characterized by low immunogenicity,which has many advantages in treating immune diseases.CASE SUMMARY The patient was a 47-year-old male,diagnosed with psoriasis in 1995.He had received various treatments for 25 years,but the psoriatic condition was not significantly improved.He was given three rounds of minimally manipulated umbilical cord-derived MSCs over 2 wk.The erythema gradually disappeared.Three months after the 1st round,all erythema completely disappeared,and the psoriasis did not recur.CONCLUSION Minimally manipulated umbilical cord-derived MSC transplantation can potentially treat patients who suffer from psoriasis.

A New Immunosuppressive Therapy for Very Severe Aplastic Anemia in Children with Autoantibodies

Objective At present,a number of very severe aplastic anemia(VSAA)patients cannot receive hematopoietic stem cell transplantation(HSCT)or standard immunosuppressive therapy(IST)due to the high cost of therapy,shortage of sibling donors,and lack of resources to support the HSCT.In addition,some VSAA patients with autoantibodies have no life-threatening infections or bleeding at the time of initial diagnosis.Considering the disease condition,economics and other factors,the present study designed a new and relatively mild treatment strategy:cyclosporine A plus pulsed high-dose prednisone(CsA+HDP).Methods The present study retrospectively analyzed 11 VSAA patients,who were treated with CsA+HDP in our hospital from August 2017 to August 2019.Results The median follow-up time for these patients was 24.9 months.The overall response rate was 54.5%(6/11)at six months after the initiation of IST and 81.8%(9/11)at deadline.Five patients achieved complete remission and four patients met the criteria for partial response at the last follow-up.The median time to response for responders was 110 days.Three patients underwent HSCT due to the poor effect of CsA+HDP or to find a suitable transplant donor.Recurrence and clonal evolution were not found in any of these patients.The estimated 3-year overall survival rate and 3-year failure-free survival rate were 100.0%and 72.7%,respectively.In addition,the results revealed that the cyclosporine-prednisone-associated toxicity was mild and well-tolerated by most patients.Conclusion The novel CsA+HDP regimen has good therapeutic effect and safety for VSAA patients with autoantibodies,who have no serious life-threatening infections or bleeding at the time of initial diagnosis.

Interrupted Etanercept Therapy: A New Case Report

Psoriasis is a chronic, immune-mediated, inflammatory disease with a high prevalence in the general population (2%). The anti-tumor necrosis factor receptor etanercept is Food and Drug Administration (FDA) approved for the treatment of moderate-to-severe plaque psoriasis. Both continuous and interrupted etanercept therapy is effective and well-tolerated. This report aims to document a new case presentation of psoriasis on intermittent etanercept injection throughout 36 weeks with long-lasting sustained efficacy and no risk factor. Case Report: A 39-year-old adult male patient with long-standing chronic plaque psoriasis for 15 years duration without joint involvement started loading dose treatment of etanercept injection in whom due to his work circumstances not taken maintenance therapy and showed-up at the clinic after 36 weeks from first induction therapy when partial relapse of psoriatic lesions appear in last week with continued improvement when reintroducing loading treatment on followed-up over the next 36 weeks. Conclusion: Intermittent etanercept therapy considers effective for 36 weeks with prolonging sustained efficacy and without adverse effect.

A Randomized Controlled Single-Blind Clinical Trial on 84 Outpatients with Psoriasis Vulgaris by Auricular Therapy Combined with Optimized Yinxieling Formula(银屑灵优化方)

Objective：To explore the therapeutic effect of auricular therapy combined with optimized Yinxieling Formula（银屑灵优化方） on psoriasis vulgaris.Methods：A randomized controlled single-blind clinical trial on 84 outpatients with psoriasis vulgaris was conducted.The patients were randomized to a treatment group（43 cases treated by auricular therapy combined with optimized Yinxieling Formula） and a control group （41 cases treated by optimized Yinxieling Formula alone） according to a random number generated by SPSS 17.0 software.The treatment duration for both groups was 8 weeks.The therapeutic effect was comprehensively measured by the primary outcome measure[Psoriasis Area and Severity Index（PASI） reduction rate]and the secondary outcome measure[PASI,Visual Analogue Scale（VAS）,Dermatology Life Quality Index（DLQI）, Self-rating Depression Scale（SDS）,and Self-rating Anxiety Scale（SAS）].The outcomes of both groups were obtained and compared before and after the intervention.Results：The PASI reduction rate in the treatment group was 74.4%（32/43）,which was higher than that in the control group（36.6%,15/41,P0.01）.The PASI scores decreased in both groups after treatment and was lower in the treatment group compared with the control group （P0.01）.With stratified analysis,there were significant differences between the PASI scores in the following subgroups：age 18-30,baseline PASI10 and stable stage（P0.05）.DLQI decreased in both groups on some categories after treatment,but there were no significant differences between the two groups in SDS,SAS and VAS（P0.05）.No obvious adverse reactions were found in either group.Conclusion：The therapeutic effect of auricular therapy combined with Optimized Yinxieling Formula was superior to Optimized Yinxieling Formula alone with no obvious adverse reaction.

Progressive Symmetrical Erythrokeratoderma-Like Psoriasis: A New Case Report

Background: Psoriasis, a chronic, systemic, inflammatory disease with prominent skin involvement, affects approximately 2% - 4% of the world population. Common variants of psoriasis are plaque psoriasis, inverse psoriasis, guttate psoriasis, erythrodermic psoriasis, pustular form either palmoplantar pustular psoriasis or generalized pustular psoriasis, nail psoriasis, and psoriatic arthritis. Progressive Symmetrical Erythrokeratoderma (PSEK) is a rare genetic disorder, characterized by fixed, well-defined erythematous and hyperkeratotic plaques distributed predominantly on the elbows, knees, trunk, and dorsal surfaces of hands and feet. Clinically has the same presentation to psoriasis especially at early onset and could be confused with psoriasis but histopathological findings and progression of the psoriatic disease can differentiate between both conditions. Aim: To document a new variant of a severe, recalcitrant type of psoriasis with a history of recurrent attacks of exacerbations and partial remissions especially in lesions involving lower extremities that are clinically PSEK-like in presentation, but histopathologically consistent with psoriasis. Case report: A 12-year-old childhood male, known case of Down’s syndrome, presented to our clinic with a history of severely pruritic skin rashes involving the perioral area, corners of the mouth, bilateral elbows, dorsal hands, scrotum, and both lower extremities for 6 years duration. The rashes gradually progressed with time to form fixed lesions in the last 2 years. He was received multiple treatment modalities, including topical steroids, topical vitamin D derivatives, and narrowband UVB phototherapy without significant improvement and the lesions became more worsened over time. Conclusion: psoriasis can be presenting with a new variant of a severe, recalcitrant, and difficult to treat type in Down syndrome cases with a history of recurrent attacks of exacerbations and partial remissions especially in lesions involving lower extremities which are clinically PSEK-like in presentation, but histopathologically consistent with psoriasis. However, early diagnosis and strict management are important in controlling the severity of the condition.

Amelioration of imiquimod-induced psoriasis-like dermatitis in mice by DSW therapy inspired hydrogel

Psoriasis is a long-lasting and recurrent autoimmune disease which is incurable so far.Dead Sea water(DSW)therapy is an effective approach to help control the symptoms of psoriasis due to the abundant mineral ions in DSW,which inspired the material formulation in this study.Rubidium–Sodium alginate/Polyacrylamide hydrogels(Rb-SA/PAAm gels)composed of sodium alginate and polyacrylamide interpenetrating network structure with different concentrations of rubidium and certain magnesium and zinc content were prepared for the treatment of psoriasis.The obtained results suggest the good mechanical properties of the Rb-SA/PAAm gels including toughness and swelling performance.In terms of in vitro tests,the Rb-SA/PAAm gels not only show nontoxicity to human keratinocyte cell line(Hacats)but also inhibits the activity against inflammatory NF-κβ signaling pathway.Meanwhile,they can release Rb+which enable the Rb-SA/PAAm gels have better antibacterial ability to Streptococcus and Escherichia coli.The results obtained from in vivo tests indicate that these hydrogels could alleviate the symptoms of psoriasis caused by Imiquimod(IMQ)in mice by reducing the inflammatory factor in STAT3 pathway and therefore reduce the immune stimulation of the spleen.In conclusion,the 100Rb-SA/PAAm gel has demonstrated great potential to be a topical wettable dressing for psoriasis treatment.

Non-alcoholic fatty liver disease and psoriasis: So far, so near

Psoriasis is a chronic inflammatory immune-mediated skin diseases which is frequently associated to comorbidities. Non-alcoholic fatty liver disease(NAFLD) is defined as an excessive accumulation of triglycerides in hepatocytes and includes a wide spectrum of liver conditions ranging from relatively benign steatosis to non-alcoholic steatohepatitis with fatty infiltration and lobular inflammation and to cirrhosis and endstage liver disease. Actually, psoriasis is considered a systemic diseases associated to comorbidities, as metabolic syndrome and NAFLD is seen the hepatic manifestation of the metabolic syndrome. The possible link between psoriasis, obesity and metabolic syndrome, which are known risk factors for NAFLD has beenrecently documented focusing in the crucial role of the adipose tissue in the development of the inflammatory background sharing by the above entities. According to recent data, patients with psoriasis show a greater prevalence of NAFLD and metabolic syndrome than the general population. Moreover, patients with NAFLD and psoriasis are at higher risk of severe liver fibrosis than those with NAFLD and without psoriasis. The link between these pathological conditions appears to be a chronic low-grade inflammatory status. The aim of this review is to focus on the multiple aspects linking NAFLD and psoriasis, only apparently far diseases.

Biological therapy for dermatological manifestations of inflammatory bowel disease

Ulcerative colitis and Crohn's disease are the two forms of inflammatory bowel disease(IBD). The advent of biological drugs has significantly changed the management of these conditions. Skin manifestations are not uncommon in IBD. Among the reactive lesions(immunemediated extraintestinal manifestations), erythema nodosum(EN) and pyoderma gangrenosum(PG) are the two major cutaneous ills associated with IBD, while psoriasis is the dermatological comorbidity disease observed more often. In particular, in the last few years, anti-tumor necrosis factor(TNF)-α agents have been successfully used to treat psoriasis, especially these kinds of lesions that may occur during the treatment with biological therapies. The entity of the paradoxical manifestations has been relatively under reported as most lesions are limited and a causal relationship with the treatment is often poorly understood. The reason for this apparent side-effect of the therapy still remains unclear. Although side effects may occur, their clinical benefits are undoubted. This article reviews the therapeutic effects of the two most widely used anti-TNF-α molecules, infliximab(a fusion protein dimer of the human TNF-α receptor) and adalimumab(a fully human monoclonal antibody to TNF-α), for the treatment of the major cutaneous manifestations associated with IBD(EN, PG and psoriasis).

Management of psoriasis patients with hepatitis B or hepatitis C virus infection

The systemic therapies available for the management of Psoriasis (PsO) patients who cannot be treated with more conservative options, such as topical agents and/or phototherapy, with the exception of acitretin, can worsen or reactivate a chronic infection. Therefore, before administering immunosuppressive therapies with either conventional disease-modifying drugs (cDMARDs) or biological ones (bDMARDs) it is mandatory to screen patients for some infections, including hepatitis B virus (HBV) and hepatitis C virus (HCV). In particular, the patients eligible to receive an immunosuppressive drug must be screened for the following markers: antibody to hepatitis B core, antibody to hepatitis B surface antigen (anti-HBsAg), HBsAg, and antibody to HCV (anti-HCV). In case HBV or HCV infection is diagnosed, a close collaboration with a consultant hepatologist is needed before and during an immunosuppressive therapy. Concerning therapy with immunosuppressive drugs in PsO patients with HBV or HCV infection, data exist mainly for cyclosporine a (CyA) or bDMARDs (etanercept, adalimumab, infliximab, ustekinumab). The natural history of HBV and HCV infection differs significantly as well as the effect of immunosuppression on the aforementioned infectious diseases. As a rule, in the case of active HBV infection, systemic immunosuppressive antipsoriatic therapies must be deferred until the infection is controlled with an adequate antiviral treatment. Inactive carriers need to receive antiviral prophylaxis 2-4 wk before starting immunosuppressive therapy, to be continued after 6-12 mo from its suspension. Due to the risk of HBV reactivation, these patients should be monitored monthly for the first 3 mo and then every 3 mo for HBV DNA load together with transaminases levels. Concerning the patients who are occult HBV carriers, the risk of HBV reactivation is very low. Therefore, these patients generally do not need antiviral prophylaxis and the sera HBsAg and transaminases dosing can be monitored every 3 mo. Concerning PsO patients with chronic HCV infection their management with immunosuppressive drugs is less problematic as compared to those infected by HBV. In fact, HCV reactivation is an extremely rare event after administration of drugs such as CyA or tumor necrosis factor-&#x003b1; inhibitors. As a rule, these patients can be monitored measuring HCV RNA load, and ALT, aspartate transaminase, gamma-glutamyl-transferase, bilirubin, alkaline phosphatase, albumin and platelet every 3-6 mo. The present article provides an updated overview based on more recently reported data on monitoring and managing PsO patients who need systemic antipsoriatic treatment and have HBV or HCV infection as comorbidity.

Safety and efficacy of anti-tumor necrosis factors α in patients with psoriasis and chronic hepatitis C

Up to date,in literature,it is still debated the role of anti-tumor necrosis factors(TNF)-α treatments in hepatitis C virus(HCV) patients.TNF-α performs a lot of functions,it is an important pro-inflammatory cytokine and it is involved in the host's immunity.Since TNF-α is implicated in the apoptotic signaling pathway of hepatocytes infected by HCV,anti TNF-α therapy may increase the risk of viral replication or their reactivation.However the treatment of anti TNF-α could have a healthful role because TNF-α appears to be engaged in the pathogenesis of liver fibrosis,inducing apoptotic pathways.We describe the case of a patient with plaquetype psoriasis and concomitant chronic HCV,who was treated successfully with anti-TNF agents simultaneously to cyclosporine without sign of reactivation of HCV and increase of liver enzymes.Our personal experience shows that anti-TNF-α agents are not only effective but also safe.Furthermore the combination therapy of cyclosporine and anti-TNF-α appears to be well-tolerated and able to reduce the amount of liver enzymes as well as HCV-viral-load.However systematic,large-scale studies with long follow-ups will be needed to confirm our results,in association with close liver function monitoring.

Psoriasis treatment: Unconventional and non-standard modalities in the era of biologics

Psoriasis is a potentially debilitating inflammatory dermatosis affecting 0.2%-4.8% of the population worldwide causing a significant occupational, personal or psychosocial morbidity to these patients for life. The basic aim of psoriasis therapy is to control the disease to maximum possible extent and improve the patient's quality of life. Management of triggers for flareups, lifestyle modifications, and dietary supplements are often recommended. Intermittent or rotational therapy with frequent alterations in treatment options is usually needed to reduce toxicity of anti-psoriatic drugs in the absence of safer alternatives. Currently, several biological agents categorized as either T-cell targeted(e.g., Alefacept, Efalizumab) or cytokine modulating(e.g., Adalimumab, Infliximab, Etanercept) are available for treating severe psoriasis. However, their high cost is often precluding for most patients. The usefulness of systemic(methotrexate, cyclosporine, acitretin or several other therapeutic agents) or topical(tar, anthralin, corticosteroids or calcipotriol ointments, phototherapy with or without psoralens) therapies has been well established for the management of psoriasis. The literature is also replete with benefits of less used non-standard and unconventional treatment modalities(hydroxycarbamide, azathioprine, leflunomide, mycophenolate mofetil, isotretinoin, fumarates, topical calcineurin inhibitors, peroxisome proliferator-activated receptors agonists, statins, sulfasalazine, pentoxifylline, colchicine, grenz ray therapy, excimer laser, climatotherapy and balneophototherapy, peritoneal dialysis, tonsillectomy, ichthyotherapy, etc.). These can be used alternatively to treat psoriasis patients who have mild/minimal lesions, are intolerant to conventional drugs, have developed side effects or achieved recommended cumulative dose, where comorbidities pose unusual therapeutic challenges, or may be as intermittent, rotational or combination treatment alternatives.

A double-edged sword:ROS related therapies in the treatment of psoriasis

In the onset and progression of psoriasis,redox imbalance is a vital factor.It's widely accepted that too much reactive oxygen species(ROS)always make psoriasis worse.Recent research,however,has shown that the accumulation of ROS is not entirely detrimental,as it helps reduce psoriasis lesions by inhibiting epidermal proliferation and keratinocyte death.As a result,ROS appears to have two opposing effects on the treatment of psoriasis.In this review,the current ROS-related therapies for psoriasis,including basic and clinical research,are presented.Additionally,the design and therapeutic benefits of various drug delivery systems and therapeutic approaches are examined,and a potential balance between antioxidative stress and ROS accumulation is also trying to be investigated.

Podophyllin (10%) Ointment: A New Therapeutic Modality for Psoriasis

Background: There are many topical therapies for the treatment of plaque psoriasis like steroid, dithranol, tar and vitamin D analogues, but none of them is ideal. Most recently, in a pilot study, podophyllin 5% ointment on every other day regimen was as effective as clobetasole 0.05% ointment twice daily. Objective: To reassess the efficacy of a higher concentration of podophyllin (10%) in the treatment of mild psoriasis in comparison with clobetasole using a different regimen. Patients and Methods: This is therapeutic, comparative, placebo-controlled study conducted at the Department of Dermatology-Baghdad Teaching Hospital, during the period of January 2011 - October 2012. Eighty-seven patients with mild plaque-type psoriasis were divided into three groups: Group A (30) patients were treated with podophyllin 10% ointment;Group B (30) patients were treated with clobetasol propionate 0.05% ointment and Group C (27) patients were treated with Vaseline as a placebo control group. All patients were treated on every other day. The efficacy was evaluated every 2 weeks for 8 weeks using PASI score and the local and systemic side effects were recorded. The relapse was recorded after cessation of therapy in those patients who achieved good response during another 8 weeks follow-up period. Results: The patients were 60 (68.9%) males and 27 (31.1%) females (male: female ratio, 2.2:1). Their ages ranged from 18 - 62 (36.4 ± 10) years. Their disease duration ranged from 0.1 - 40 (7.8 ± 8.5) years. Their baseline PASI score ranged from 1.6 - 9.6 (4.4 ± 5.85). At the end of 8th week of therapy, Group A patients had achieved much higher reduction in PASI score (77.4 ± 14.1) than Group B patients (60.4 ± 27.8), P value = 0.004, and both of them were with statistically and significantly higher PASI reduction than patients in Group C (28 ± 23.4), P value = <0.001. The total relapse rate during 8 weeks follow-up was much lower among Group A treated patients, 20% versus 66.6% in Group B (P-value = 0.002), while the relapse rate was 100% in the Group C patients. Regarding side effects: 3 (10%) patients developed erythema, burning, pain, blistering and hypopigmentationin Group A. No side effects were reported in Groups B nor C patients with no statistically significant difference among the three groups (P = 0.052). Conclusion: Podophyllin 10% ointment was more effective than clobetasole 0.05% ointment on every other day treatment regimen at the end of 8 weeks treatment with no side effects and a much lower relapse rate in treatment of mild plaque-type psoriasis.