Carboxytherapy for Patients With Chronic Localized Plaque Psoriasis

The investigators recommend increasing the number of carboxytherapy sessions and adding maintenance sessions to patients' treatment regimens.

Carboxytherapy is a promising treatment for patients with chronic, localized plaque psoriasis, according to the results of a recent pilot study published in the Journal of Cosmetic Dermatology.

The current study enrolled a total of 30 patients with localized, stable plaque psoriasis. All patients received 8 sessions of intradermal carboxytherapy, with a 1-week interval between injections.

Each patient received treatment in only 1 lesion. Lesions were reported on the knee (14 patients), elbow (9 patients), forearm (3 patients), malleolus (2 patients), hand (1 patient), and leg (1 patient).

All patients were clinically and histopathologically assessed 2 weeks after their last treatment, with a follow-up visit scheduled 3 months after a patient’s final treatment to detect recurrence. Photographs were taken at baseline, at 2 weeks, and 3 months after a patient’s final treatment.

Clinical response was evaluated via a 6-point investigator’s global assessment (IGA) scale (clear, almost clear, mild, moderate, severe, and very severe), with treatment success defined as an IGA assessment of clear or almost clear. A 5-point scale was used to assess erythema, induration, and scales on psoriasis plaques (0, none; 1, mild; 2, moderate; 3, severe; and 4, very severe). The sum of the 3 individual scores, for erythema, induration, and scales, represented the total sign score (TSS). Perilesional erythema was also assessed with a 5-point scale.

On the basis of the IGA scale, 26.6% (8 of 30) of participants demonstrated treatment success, with 1 patient clear and 7 patients almost clear. Of the remaining patients, 13 were mild, 6 were moderate, and 3 were severe. A statistically significant correlation was shown between baseline IGA and IGA 2 weeks after treatment (P =.006). With respect to TSS, 26.6% (8 of 30) of patients demonstrated treatment success, with 1 patient having a TSS of 0 and 7 patients reporting a TSS of 1.

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A statistically significant association was observed between baseline TSS and TSS 2 weeks after treatment (P =.003). Regarding perilesional erythema 3 months after treatment, 70% (21 of 30) of patients reported a perilesional scale of 0 (ie, no erythema).

Patient satisfaction with carboxytherapy was evaluated 3 months after the final session, using a 10-point visual analog scale (0-10, with a level of 0 defined as “not satisfied at all” and a level of 10 defined as “completely satisfied”). Among those patients demonstrating treatment success according to IGA and TSS (26.6%), and the 70% of participants reporting no perilesional erythema, these scores were significantly correlated with patients’ visual analog scale ratings. In 83.3% of the improved patients, the recurrence area was within 1% to 10% of the baseline area.

On the basis of the study findings, the investigators recommend increasing the number of carboxytherapy sessions and adding maintenance sessions to patients’ treatment regimens.


Kamel AM, Abdelghani R. Carboxytherapy for treatment of localized chronic plaque psoriasis: clinical and histopathologic evaluation [published online January 17, 2018]. J Cosmet Dermatol. doi: 10.1111/jocd.12494