The effect of aloevera phonophoresis on skin thickness in patients with psoriasis: a randomized controlled trail


Aim: The current study was conducted to evaluate the efficacy of aloe vera phonophoresis in the treatment of psoriasis. Methods: Thirty patients had psoriasis of the chronic plaque type, their ages ranged from 20-40 years. Patients were divided randomly into two equal groups. Group (A) received topical aloe vera that transmitted through the ultrasound, the ultrasound was delivered for 5 minutes with a frequency of 1 MHz, intensity of 1.5w/cm2 with continuous mode, 3 sessions/week for two months as a total period of treatment. Group (B) received topical aloe vera once/day, massaged for 5 minutes, 3 times per week for two months as a total period of treatment. Method of evaluation was ultrasonography. Results: There was greater improvement in patients treated with aloe vera phonophoresis than those treated with topical aloe vera as evidenced by ultrasonography. Conclusions: The combination of ultrasound and aloe vera gel can be considered as an effective method to enhance the drug efficacy and penetration thus enhancing the treatment of psoriasis.


  • Akinbo S, Owoeye O, Adesegun S (2011) Comparison of the therapeutic efficacy of diclofenac sodium and methyl salicylate phonophoresis in the management of knee osteoarthritis. Turk. J. Rheumatol 26(2): 111-119.
  • Alshami MA (2010) Clinical profile of psoriasis in Yemen, a 4-year retrospective study of 241 patients. J Eur Acad Dermatol Venereol 24(4): 14.
  • Antonio L, Antonio B, Egberto M, Fla´vio A Regiane A (2010) Comparative study of the topical application of aloe vera gel, therapeutic ultrasound and phonophoresis on the tissue repair in collagenase-induced rat tendinitis. Ultrasound in Med. and Biol 36 (10): 1682-1690.
  • Augustin M, Krüger K, Radtke MA, Schwippl I, Reich K (2008) Disease severity, quality of life and health care in plaquetype psoriasis: a multicenter cross-sectional study in Germany. Dermatology 216(4): 366–72.
  • Augustin M, Radtke MA, Glaeske G, Reich K, Christophers E, Schaefer I et al. (2015) Epidemiology and Comorbidity in Children with Psoriasis and Atopic Eczema. Dermatology 231(1): 35–40.
  • Barbara C (2003) Phonophoresis versus topical application of ketoprofen: comparison between tissue and plasma level. Phys. Ther 7: 349-356.
  • Bedi TR (1995) Clinical profile of psoriasis in North India. Indian J Dermatol Venereol Leprol 61(4): 202–5.
  • Boehncke W-H, Schön MP (2015) Psoriasis. Lancet 386(9997): 983–94.
  • Cagnie B, Elke V, Steven R Guy Vanderstraeten (2003) Phonophoresis versus topical application of ketoprofen: comparison between tissue and plasma levels. Phys. Ther 83: 707-712.
  • Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn PA (2010) prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis. J. Eur. Acad. Dermatol 24: 168-172.
  • Danielsen K, Olsen AO, Wilsgaard T, Furberg AS (2013) Is the prevalence of psoriasis increasing? A 30–year follow-up of a population–based cohort. Br J Dermatol 168: 1303–10.
  • De Korte J, Sprangers MA, Mombers FM, Bos JD (2004) Quality of life in patients with psoriasis: a systematic literature review. J Investig Dermatol Symp Proc 9(2): 140–7.
  • Duansak D, Somboonwong J, Patumraj S (2003) Effects of aloe vera on leukocyte adhesion and TNF-a and IL-6 levels in burn wounded rats. Clin. Hemorheol. Microcirc 29: 239-246.
  • Fuji R, Mould JF J, Tang B, Brandt H, Pomerantz D, Chapnick J et al. (2012) Burden of disease in patients with diagnosed psoriasis in Brazil: results from 2011 national health and wellness survey (NHWS). Value Health 15(4): A107.
  • Gibbs S (1996) Skin disease and socioeconomic conditions in rural Africa: Tanzania. Int J Dermatol 35(9): 633–9.
  • Gomaa EGA, Berghout MA, Moustafa MR, El Taweel FM, Farid HM (2018) Thermodynamic and Theoretical solvation parameters for 2-amino-4, 5-dimethylthiophene-3-carboxamide (ADTC) in Ethanol and Mixed EtOH-H2O solvents. Progress in Chemical and Biochemical Research 1(1, pp. 1-80): 19-28.
  • Goraj-Szczypiorowska B, Zajac L, Skalska-Izdebska R (2007) Evaluation of factors influencing the quality and efficacy of ultrasound and phonophoresis treatment. Ortop. Traumatol. Rehabil 9 (5): 449-458.
  • Harden JL, Krueger JG, Bowcock AM (2015) the immunogenetics of psoriasis: a comprehensive review. J Autoimmun 64: 66–73.
  • Henseler T, Christophers E (1985) Psoriasis of early and late onset: characterization of two types of psoriasis vulgaris. J Am Acad Dermatol 13(3): 450–6.
  • Horn E, Elizabeth J, Jennifer C (2007) Psoriasis affects daily activities. National Psoriasis Foundation 2:1-5.
  • Institute for Health Metrics and Evaluation (IHME) (2010) Global Burden of Disease Study Results by Cause 1990–2010. Seattle: IHME.
  • Kimball AB, Jacobson C, Weiss S, Vreeland MG, Wu Y (2005) The psychosocial burden of psoriasis. Am J Clin Dermatol 6(6):383–92.
  • Loyd V, Allen J (2005) Compounding for phonophoresis. Secundum Artem 1(11): 10- 17.
  • Meshali M, Abdel-Aleem H, Sakr F (2008) In vitro phonophoresis: effect of ultrasound intensity and mode at high frequency on NSAIDs transport across cellulose and rabbit skin membranes. Pharmazie 63 (1): 49-53.
  • Mohamed HSH, Ahmed SA (2019) Reviewing of Synthesis and Computational Studies of Pyrazolo Pyrimidine Derivatives. Journal of Chemical Reviews 1(3. pp. 154-251): 183-232.
  • Naik A, Kalia Y, Guy R (2000) Transdermal drug delivery: overcoming the skin‟s barrier function. PSTT 3 (9): 318-326.
  • Nestle F, Conrad C, Tun-Kyi A, Homey B, Gombert M, Boyman O, Burg G, Liu Y, Gilliet M (2005) Plasmacytoid predendritic cells initiate psoriasis through interferon-alpha production. J. Exp. Med 202(1): 135-143.
  • Nevitt GJ, Hutchinson PE (1996) Psoriasis in the community: prevalence, severity and patients’ beliefs and attitudes towards the disease. Br J Dermatol 135(4): 533–7.
  • Pariser D, Schenkel B, Carter C, Farahi K, Brown TM, Ellis CN and Psoriasis Patient Interview Study Group (2017) A multicenter, non-interventional study to evaluate patient-reported experiences of living with psoriasis. Indian Dermatol Online J (6): 454-459.
  • Reich K, Krüger K, Mössner R, Augustin M (2009) Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque-type psoriasis. Br J Dermatol 160(5):1040–7.
  • Russo PAJ, Ilchef R, Cooper AJ (2004) Psychiatric morbidity in psoriasis: a review. Australas J Dermatol 45(3): 155– 9.
  • Sampogna F, Tabolli S, Abeni D (2012) Multipurpose Psoriasis Research on Vital Experiences (IMPROVE) investigators. Living with psoriasis: prevalence of shame, anger, worry, and problems in daily activities and social life. Acta Derm Venereol 92(3): 299–303.
  • Srbely S (2008) Ultrasound in the management of osteoarthritis: part I: a review of the current literature. JCCA. J. Can. Chiropr. Assoc 52(1): 30-37.
  • Strigin MB (2019) World Conscience. Model of a Social Crystal. Journal of Environmental Treatment Techniques 7(4): 647-653.
  • Ter-Haar G (2007) Therapeutic applications of ultrasound. Progress in Biophysics and Molecular Biology 93: 111-129.
  • Vena GA, Altomare G, Ayala F, Berardesca E, Calzavara-Pinton P, Chimenti S et al. (2010) Incidence of psoriasis and association with comorbidities in Italy: a 5-year observational study from a national primary care database. Eur J Dermatol 20(5): 593–8.
  • Vranic E (2004) Sonophoresis-mechanisms and application. Bosn. J. Basic Med. Sci 4(2): 25-32.
  • Wolf N, Quaranta M, Prescott N, Allen M, Smith R, Burden A, Worthington J, Griffiths C, Mathew C, Barker J, Capon F. Trembath F (2008) Psoriasis is associated with pleiotropic susceptibility loci identified in type II diabetes and crohn disease. J. Med. Genet 45(2): 114-116.
  • World Health Organization (WHO) (2016) Global report on PSORIASIS, ISBN 978 92 4 156518 9. available on the WHO website (www.who. int)
  • Yamamah GA, Emam HM, Abdelhamid MF, Elsaie ML, Shehata H, Farid T et al. (2012) Epidemiologic study of dermatologic disorders among children in South Sinai, Egypt. Int J Dermatol 51(10):1180–5.
  • Yang J, Kim D, Yum M, Kim T, Shin S (2006) Trans-dermal delivery system of triamcinolone acetonide from a gel using phonophoresis. Arch. Pharm. Res 29 (5): 412-417.
  • Yueh-Ling H (2006) Effects of ultrasound and diclofenac phonophoresis on inflammatory pain relief: suppression of inducible nitric oxide synthase in arthritic rats. Phys. Ther 5: 110-121.


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