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Abstract N ail psoriasis affects 10-55% of psoriasis patients, and the lifetime incidence of nail involvement in psoriatic patients is estimated to be 80–90 %. Psoriasis may involve the nails only without any other signs of skin affection in 1 to 5% of patients. Nail psoriasis leads to impairment in the quality of life due to aesthetic concerns as well as limitations in daily activities resulting from the associated pain. The Nail Psoriasis Severity Index (NAPSI) is a numeric, reproducible, objective, simple tool for clinical evaluation of nail psoriasis. Dermoscopy is a noninvasive and quick technique that allows optimal visualization of morphological features of skin and nails. Dermoscopy of the hyponychium is useful in follow-up with a positive correlation between reduction in the number of twisted capillaries and response to therapy. The aim of this work was to compare the effect of Pulsed Dye Laser and Long Pulsed Nd:YAG 1064 nm Laser in treatment of nail psoriasis by objective clinical and dermoscopic evaluation. There were two groups, twenty patients with 180 nails affected (left hand with 90 nails affected) were treated by ND-YAG and other group treated by PDL (right hand with also 90 nails affected). Each patient was subjected to a detailed history taking and full examination, also each patient had a once monthly session of PDL, for 6 months, applied to the affected nails of right hand while the other affected nails of left hand was treated by ND: YAG laser (8 sessions with 1 week interval on the nail plate and proximal nail fold then one session monthly). Dermoscopic and clinical evalauation before and after laser sessions was performed and photos were taken at baseline, month 3, and one month after the last session (month 7). Clinical evaluation showed decrease in total NAPSI and divided NAPSI score and dermoscopially showed decrease in capiilary number after treatment. The results of the present study showed that both were effective in treatment of nail psoriasis but PDL was more effective. Also, patient satisfaction was higher with PDL. The results of the study were discussed with a final conclusion of the effectiveness of PDL and Nd: YAG 1064 nm laser in treatment of nail psoriasis. |