Evaluation of The Efficacy and Safety of Topical Cyclosporine 2% Gel versus Topical Liposomal Formulation of Cyclosporine 2% in Mild to Moderate Stable Plaque Psoriasis: Clinical, Dermoscopic and Histopathologic Study

Background: Psoriasis vulgaris (PV) is a chronic inflammatory skin disease with an immunological basis, characterized by alternating phases of flare-ups and remission. Oral cyclosporine is commonly used in the management of severe recalcitrant plaque psoriasis (Ps).  
Objectives: This study aimed to assess the efficacy and safety of topical cyclosporine 2% gel versus topical cyclosporine 2% in liposomal formulation in the management of chronic stable mild to moderate plaque Ps.
Patients and Methods: The study included 30 patients with chronic stable mild to moderate plaque Ps. Each participant applied topical cyclosporine 2% gel on lesions of the right side of the body and topical cyclosporine 2% liposomal formulation on lesions of the left side once daily for 12 weeks. Lesions were scored according to PASI index and the Erythema, Scaling & Infiltration Score System at baseline, after 1 month, 2 months, and 3 months of treatment.
Results: The present study revealed that Erythema, induration and scales decreased significantly in both groups at 1, 2, and 3 months compared to baseline with a statistically significant improvement in the clinical findings in both groups along the treatment course in both study groups. There was statically significant improvement in the dermoscopic findings including red dots, scales and Pink background in both groups during the treatment course in both study groups. The degree of improvement was higher in the cases treated with topical cyclosporine 2% liposomal formulation.  
Conclusion: Both preparations resulted in significant clinical and dermoscopic improvement; however, the liposomal formulation demonstrated superior efficacy.