Fractional Carbon Dioxide Laser: A Novel Therapeutic Option for Lichen Simplex Chronicus
The goal of this randomized control trial is to compare the use of fractional carbon dioxide (Co2) laser to topical corticosteroids to treat lichen simplex chronicus (LSC) patients presenting to Dermatology outpatient clinic, Faculty of Medicine, Cairo University.

Participants will:

Be assessed clinically by doctor
Biopsies will be taken from them by doctor
Receive treatment as laser or topical steroids or both
Fill in depression questionnaire.

Researchers will divide and compare groups as follows:

Sixty patients will be divided randomly through closed envelop technique into 2 groups (Group A and B) each of 30 patients. Group A will be subdivided into 2 groups (1 and 2). All LSC lesions will be treated in any patient having multiple lesions.

Group 1 - A: Patients will receive 3 monthly laser sessions, in addition to the use of topical emollients only once daily in between the sessions.
Group 2 - A: Patients will receive 3 monthly laser sessions, in addition to topical steroids twice daily and topical emollient once daily in between the sessions.
Group B: Patients will be prescribed topical steroids twice daily and topical emollient once daily for 3 months.

to see if:

Pruritus severity scale.
Scaling, erythema, lichenification excoriation scores
Visual analogue scale.
Investigator's Global Assessment.
Itching mediators (Interleukin-31, Nerve Growth Factor and Substance P assays (itching mediators)
Depression

improve more in which group of patients after treatment.
- EligibilityCriteria: Inclusion Criteria:  Patients with LSC with no underlying dermatological disease, not on topical or systemic treatment for at least 4 weeks prior to study.  Exclusion Criteria:  Pregnant and lactating females. Patients who are diagnosed with any systemic disease that can result in generalized pruritus (e.g. hepatic, renal, uncontrolled diabetes mellitus, thyroid,….etc ) from history. Patients with contraindications to laser e.g., keloidal tendency, post inflammatory hyperpigmentation (PIH). Patients with dermatological disease (e.g. psoriasis, atopic dermatitis, ….etc) - HealthyVolunteers: Accepts Healthy Volunteers - Gender: All - MinimumAge: 18 Years - StdAgeList: Adult, Older Adult