Balneophototherapy for Psoriasis Using Saltwater Baths and UV-B Irradiation, Revisited

Gambichler, Thilo

doi:10.1001/archderm.143.5.647

Cited by 18 publications

(16 citation statements)

References 16 publications

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“…Other examples of unique and special places for climatotherapy and spa therapy are the Kangal hot spring in Turkey and the Blue Lagoon in Iceland, respectively [1,2,3]. Balneophototherapy (BPT) – combined phototherapy using artificial ultraviolet (UV) sources and salt water baths – has been widely used in Germany and other European countries for the management of psoriasis [4]. Previous controlled trials investigating combined therapy with salt water baths and UV exposures revealed controversial results [1,2,3,5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Enhanced UV transmission and a decrease in optical reflection and scattering due to salt water baths possibly include the biophysical mechanisms of action that may result, first, in an increase in erythema response after bathing and, second, in an increase in the therapeutically effective UV gain that may lead to improved treatment outcomes, in particular in psoriasis [4,10,12,13,14,15]. There is no standardized treatment regimen for BPT to date.…”

Section: Introductionmentioning

confidence: 99%

“…The main ionic component is sodium chloride. However, similar to the Dead Sea composition, some treatment modalities include a significant amount of magnesium, calcium and sulphate [1,2,4,11]. In the present trial, we aimed to investigate the impact of water and salt water soaks on psoriatic epidermis equivalents by focussing on the changes of UV transmission characteristics and the expression of antimicrobial peptides and proteins (AMPs) and the skin-derived antileukoproteinase (SKALP/elafin).…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Salt Water Soaks on Biophysical and Molecular Parameters in Psoriatic Epidermis Equivalents

et al. 2011

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Background/Aims: The exact mechanisms of action of balneophototherapy are incompletely understood. We aimed to investigate the effect of salt water soaks on ultraviolet (UV) transmission and the expression of molecular parameters of psoriasis. Methods: We studied UV transmission and the expression of antimicrobial peptides and skin-derived antileukoproteinase (SKALP/elafin) in psoriatic epidermis equivalents which were pretreated with tap water and differently concentrated salt water solutions. Moreover, we performed in vivo phototoxicity tests in healthy subjects. Results: Highly concentrated salt water soaks significantly increase UV transmission through psoriatic epidermis equivalents, in particular within the wavelength range of 305– 360 nm. In vivo tests revealed increased photosensitivity following highly concentrated salt water baths. A significant decrease in human β-defensin-2 (hBD-2) and SKALP/elafin is observed after highly concentrated NaCl soaks. Conclusion: An increase in UV transmission following highly concentrated salt water soaks likely causes enhanced UV gain within the viable epidermis. Moreover, our data indicate that salt water soaks seem to influence the protein profiles of hBD-2 and SKALP/elafin.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Impact of Salt Water Soaks on Biophysical and Molecular Parameters in Psoriatic Epidermis Equivalents

et al. 2011

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“…At least for some indications, studies have shown that health resort medicine is effective (Forestier 2000;StraussBlasche et al 2000a;Guillemin et al 2001;Leaute-Labreze et al 2001;Gutenbruner et al 2002;Codish et al 2005;Dönmez et al 2005;Ardic et al 2007;Cantarini et al 2007;Franke et al 2007b;Karagülle et al 2007b;Gaal et al 2008;Karagülle and Karagülle 2004;Devereux et al 2005;Pittler et al 2006;Bartels et al 2007;Verhagen et al 2007;Tomas-Carus et al 2007;Forestier and Francon 2008 Most of the latter studies deal with disorders of the locomotor system; however, there is evidence of beneficial effect in cardiovascular disorders (Gutenbrunner and Schuh 2002;Carpentier and Satger 2009;Ippolito et al 2008;Mancini et al 2003); skin disease (Coccheri et al 2002;Matz et al 2003;Kazandjieva et al 2008a;Brockow et al 2007c;Gambichler 2007); ear, nose and throat as well as lung disease (Tabolli et al 2009;Petraccia et al 2005;Vu and Mitsunobu 2004;Tanizaki et al 1997); and metabolic syndromes, gastrointestinal conditions and psychosomatic disorders (Vu and Mitsunobu 2005;Salamon et al 2008; see also Gutenbrunner and Hildebrandt 1998). A uniform and internationally used name for the medical field dealing with Health Resort Medicine, Balneotherapy, Hydrotherapy, and Climatotherapy does not exist.…”

Section: Medicine In Health Resortsmentioning

confidence: 99%

A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology

et al. 2010

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Health Resort Medicine, Balneology, Medical Hydrology and Climatology are not fully recognised as independent medical specialties at a global international level. Analysing the reasons, we can identify both external (from outside the field) and internal (from inside the field) factors. External arguments include, e.g. the lack of scientific evidence, the fact that Balneotherapy and Climatotherapy is not used in all countries, and the fact that Health Resort Medicine, Balneology, Medical Hydrology and Climatology focus only on single methods and do not have a comprehensive concept. Implicit barriers are the lack of international accepted terms in the field, the restriction of being allowed to practice the activities only in specific settings, and the trend to use Balneotherapy mainly for wellness concepts. Especially the implicit barriers should be subject to intense discussions among scientists and specialists. This paper suggests one option to tackle the problem of implicit barriers by making a proposal for a structure and description of the medical field, and to provide some commonly acceptable descriptions of content and terminology. The medical area can be defined as "medicine in health resorts" (or "health resort medicine"). Health resort medicine includes "all medical activities originated and derived in health resorts based on scientific evidence aiming at health promotion, prevention, therapy and rehabilitation". Core elements of health resort interventions in health resorts are balneotherapy, hydrotherapy, and climatotherapy. Health resort medicine can be used for health promotion, prevention, treatment, and rehabilitation. The use of natural mineral waters, gases and peloids in many countries is called balneotherapy, but other (equivalent) terms exist. Substances used for balneotherapy are medical mineral waters, medical peloids, and natural gases (bathing, drinking, inhalation, etc.). The use of plain water (tap water) for therapy is called hydrotherapy, and the use of climatic factors for therapy is called climatotherapy. Reflecting the effects of health resort medicine, it is important to take other environmental factors into account. These can be classified within the framework of the ICF (International Classification of Functioning, Disability and Health). Examples include receiving health care by specialised doctors, being well educated (ICF-domain: e355), having an environment supporting social contacts (family, peer groups) (cf. ICF-domains: d740, d760), facilities for recreation, cultural activities, leisure and sports (cf. ICF-domain: d920), access to a health-promoting atmosphere and an environment close to nature (cf. ICF-domain: e210). The scientific field dealing with health resort medicine is called health resort sciences. It includes the medical sciences, psychology, social sciences, technical sciences, chemistry, physics, geography, jurisprudence, etc. Finally, this paper proposes a systematic international discussion of descriptions in the field of Health Resort Medicine, Balneology, M...

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“…[1][2][3][4] Previous randomized controlled trials demonstrated that balneophototherapy (BPT) -combined phototherapy using artificial ultraviolet (UV) sources and salt water baths -is superior to mono-phototherapy of psoriasis. [5][6][7] The concentration and/or mineral composition of the salt solution were thought to play a major role in BPT for psoriasis. [5][6][7][8][9][10] However, the exact molecular mechanisms of action of BPT are still unclear.…”

Section: Introductionmentioning

confidence: 99%

Expression of human β‐defensin‐2 in psoriatic epidermis models treated with balneophototherapy

Gambichler

Skrygan

2013

Acad Dermatol Venereol

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Both mono-treatment with salt water soaks and BPT of PEM result in altered expression of hBD2, whereas the effects observed are most prominent after BPT. hBD2 gene and protein expression is predominantly down-regulated following BPT indicating that this combined phototherapeutic regimen is superior to mono-UVB or salt water soaks alone with respect to normalization of hBD2 expression in psoriatic epidermis.

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Balneophototherapy for Psoriasis Using Saltwater Baths and UV-B Irradiation, Revisited

Cited by 18 publications

References 16 publications

The Impact of Salt Water Soaks on Biophysical and Molecular Parameters in Psoriatic Epidermis Equivalents

The Impact of Salt Water Soaks on Biophysical and Molecular Parameters in Psoriatic Epidermis Equivalents

A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology

Expression of human β‐defensin‐2 in psoriatic epidermis models treated with balneophototherapy

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