Balneophototherapy of psoriasis: highly concentrated salt water <i>versus</i> tap water – a randomized, one‐blind, right/left comparative study

Gambichler, Thilo; Rapp, Solveig; Senger, Emil; Altmeyer, Peter; Hoffmann, Klaus A.

doi:10.1034/j.1600-0781.2001.017001022.x

Cited by 34 publications

(32 citation statements)

References 15 publications

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“…Gambichler et al 18 were not able to detect a significant difference in clearance of the psoriatic lesions between the sites soaked in SW and TW (PϾ.50). On the other hand, Dawe and coworkers 27 did observe a faster initial clearance and a slightly greater fall in psoriasis severity for patients treated with Dead Sea soaks and narrowband UV-B than for patients treated with narrowband UV-B alone.…”

Section: Commentmentioning

confidence: 93%

“…Nevertheless, long-term UV exposure due to repeated courses of UV treatment might be associated with an increased risk of photocarcinogenesis. 34,35 At baseline, our study participants had a median PASI of 17 (25th-75th percentile, [12][13][14][15][16][17][18][19][20][21][22][23]. Patients with this disease severity are also likely candidates for systemic antipsoriatics.…”

Section: -02mentioning

confidence: 99%

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Bath PUVA and Saltwater Baths Followed by UV-B Phototherapy as Treatments for Psoriasis

Schiener¹,

Brockow²,

Franke³

et al. 2007

Arch Dermatol

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To evaluate the efficacy of psoralens dissolved in a warm-water bath followed by exposure to UV-A irradiation (bath PUVA) or saltwater phototherapy (SW UV-B) compared with tap-water phototherapy (TW UV-B) or UV-B irradiation alone in psoriasis.Design: Multisite, prospective, randomized, controlled trial with 4 parallel groups.Setting: Total of 102 dermatologic outpatient clinics.Patients: Total of 1241 patients with stable psoriasis vulgaris and a Psoriasis Area and Severity Index score of 7 or greater.Interventions: Four-times-weekly UV-B, TW UV-B, SW UV-B, or bath-PUVA with baths preceding UV irradiation over a maximum of 8 weeks. The UV dose was adapted to erythemal response.Main Outcome Measures: Incidence of therapeutic success, defined as a reduction of the Psoriasis Area and Severity Index or affected body surface area of 50% or more.Results: Patients who received TW UV-B had a significantly higher incidence of therapeutic success than did patients treated with UV-B alone (60.7% vs 43.3%; PϽ.001; number needed to treat, 5.8; 95% confidence interval [CI], 3.9-10.9). Patients who received SW UV-B or bath PUVA had a significantly higher incidence of therapeutic success than did patients treated with TW UV-B (74.9% vs 60.7%; PϽ.001; number needed to treat, 7.0; 95% CI, 4.6-14.9; and 78.4% vs 60.7%; PϽ.001; number needed to treat, 5.7; 95% CI, 4.0-9.7, respectively). Bath PUVA was not superior to SW UV-B (78.4% vs 74.9%; P=.34). Conclusion:Bath PUVA and SW UV-B are comparably effective treatments in psoriasis and superior to UV-B and TW UV-B.

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Section: Commentmentioning

confidence: 93%

Section: -02mentioning

confidence: 99%

Bath PUVA and Saltwater Baths Followed by UV-B Phototherapy as Treatments for Psoriasis

Schiener¹,

Brockow²,

Franke³

et al. 2007

Arch Dermatol

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“…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 concentration and mineral composition of the salt solution were thought to play a major role in BPT for psoriasis. However, data obtained from small comparison studies suggest that any additional benefits from soaking in salt water and tap water before BPT are unlikely to be attributable to the salinity of the liquids [10,11,12]. …”

Section: Introductionmentioning

confidence: 99%

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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“…However, the actual type(s) and concentration(s) of HzS donors should be determined at each source, and the role played by temperature and additional mineral components of spring water should also be considered. In some studies the net effects of highly concentrated spring water vs tap water have been investigated, excluding that additional benefit of balneotherapy observed in patients with psoriasis and atopic dermatitis are due to the salinity (NaCl in primisi of the liquids (39).…”

Section: Fast Vs Slow H 2s Releasing Agentsmentioning

confidence: 99%

Skin, Inflammation and Sulfurous Waters: What is Known, What is Believed

et al. 2013

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One could argue that balneotherapy and mud therapy would have not lasted 2,000 years or so if they were not effective. No doubt a long history cannot be taken per se as scientific proof of efficacy. Some empiricism is still present in the field: the concept of spa itself is quite confounding, whereas spring waters are used for leisure purposes but also for non-acute patient therapy and late phases of clinical recovery. These confounding elements ultimately feed the opinion of those who aprioristically reject any potential beneficial effect of balneotherapy: instead, it should at least generate questions that deserve scientific answers. Clinical practices sequentially integrating pharmacological therapy with those natural principles for which a sufficient scientific demonstration is available, would probably cut the costs of public health, generating widespread advantages for the community. Recently, it has become evident that mineral waters may have intrinsic pharmacological properties. Of the numerous salts dissolved in thermal waters that might show pharmacological properties, for certain hydrogen sulfide (HzS)contained in sulfurous waters is the one that has obtained greater scientific attention, to which should be added the extensive scientific effort recently dedicated to HzS as a cellular gasotransmitter, independently from its natural sources. Dermatology and cosmetics are among the most studied applications of sulfurous waters, around which, however, some empiricism still confounds opinions: we therefore considered that a state-of-the-art focus on this topic might be timely and useful for future studies.

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Balneophototherapy of psoriasis: highly concentrated salt water versus tap water – a randomized, one‐blind, right/left comparative study

Abstract: Our results suggest that any additional benefit of soaking in salt water and tap water in BPT are unlikely to be due to the salinity of the liquids.

Cited by 34 publications

References 15 publications

Bath PUVA and Saltwater Baths Followed by UV-B Phototherapy as Treatments for Psoriasis

Bath PUVA and Saltwater Baths Followed by UV-B Phototherapy as Treatments for Psoriasis

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

Skin, Inflammation and Sulfurous Waters: What is Known, What is Believed

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