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: 1. Pruritus severity scale. 2. Scaling, erythema, lichenification excoriation scores 3. Visual analogue scale. 4. Investigator's Global Assessment. 5. Itching mediators (Interleukin-31, Nerve Growth Factor and Substance P assays (itching mediators) 6. Depression improve more in which group of patients after treatment.
Age range
18 Years
Sex
ALL
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Comparison between 2 groups regarding change in Pruritus severity scale
Timeframe: through study completion, an average of 5months
Comparison between 2 groups regarding change in Visual analogue scale
Timeframe: through study completion, an average of 5months
Comparison between 2 groups regarding change in Investigator's Global Assessment.
Timeframe: through study completion, an average of 5months
Comparison between 2 groups regarding change in Scaling score
Timeframe: through study completion, an average of 5months
Comparison between 2 groups regarding change in Erythema score
Timeframe: through study completion, an average of 5months
Comparison between 2 groups regarding change in Lichenification score
Timeframe: through study completion, an average of 5months
Comparison between 2 groups regarding change in Excoriation score
Timeframe: through study completion, an average of 5months