<p>Psoriasis is an immune-mediated systemic and chronic disease that can affect males and females equally. Treatments of psoriasis may and may not be effective and is based on the patients’ case and severity. There is currently no cure but treatments generally can help to control the symptoms. This work aims to compare the safety and efficacy of botulinum toxin as an intralesional injection versus topical steroid in treatment of plaque psoratic patients by evaluating the PASI score as well as the clinical improvement of the cases. Twenty patients with psoriasis vulgaris were included in the study where body was splitted into two bilaterally symmetrical psoriatic plaques and treated differently one side with single intradermal injecton of botulinum toxin and the other side with topical steroid. Both treatments showed significant decrease in PASI score in two and four weeks of treatment and follow-up. There was no significant difference between the two methods; however there were small changes in the results of the score and on skin generally. Improvement of psoriasis vulgaris lesions with botulinum toxin as single application with a high safety profile proposes a good target in psoriasis vulgaris treatment; however, more investigations showed be considered.</p>