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Abstract Psoriasis is a common genetically determined clinically well demarcated inflammatory, hyperproliferative skin disease. It results partly from chronic dysregulaticn of the immune system; the interaction between Tlymphocytes and keratinocytes via cytokines is likely to play an important role in the pathogenesis of psoriasis.Psoriatic epidermis demonstrates as aberrant expression of antigens associated with hyper proliferation, such as the heterodimer keratin 16, in addition, induced expression of ICAM-1 is observed. Several investigators have suggested that a proinflammatory THI cytokine profile predominates in the psoriatic T-cell response. Recent studies have revealed that the dominate role of IL-23 involves the stimulation of survival of proliferation of IL-17 T cells to produce IL-17 A which is a critical component in establishment and perpetuation of auto immune inflammation. This study was a trial to assess the effect of some of some therapeutic modalities on some histopathological parameters including epidermal thickness and ICAM-1, Kt6 immundnistochemistry and on one serological parameter IL-23 serum level in psorials and their correlation to the clinical severity of the disease. This study included 60 patients with chronic generalized psoriasis attending the outpatient clinic od the dermatology, venereology and Andrology department. The patients were divided into three groups each included 20 patients: the first group (group A) were treated with acitritin ,patients in group (B) were treated with methotrexate and patients in group (C) were treated with PUVA, the treatment duration was 3 months. PASI score was used to evaluate the severity of the disease and was measured monthly during the therapy duration . |