Psoriasis is a multifactorial disease and angiogenesis is arecognized event in psoriasis. Vascular endothelial growth factor (VEGF)is a key factor in promoting angiogenesis in the psoriatic plaques. In thisstudy 12 patients with psoriasis were treated by methotrexate and another12 patients received PUVA with measuring of the level of lesional VEGFby PCR and estimation of the blood flow by laser Doppler perfusionimager in the hand lesions before and after treatment. We found that both methotrexate and PUVA showed significantreduction in the amount of VEGF expression, yet the percentage ofreduction in the amount of VEGF expression was higher in themethotrexate group (P <0.001). Regarding the perfusion of the psoriatic skin, the perfusion oflesional psoriatic skin was approximately 2.5 times higher than theperfusion of the normal skin of the control. The perfusion of psoriaticlesions was lower after treatment in both groups, yet the percentage ofreduction in the perfusion of lesions was higher in the methotrexate group(P= 0.001) than the PUVA group.