Climatotherapy at the Dead Sea for psoriasis is a highly effective anti‐inflammatory treatment in the short term: An immunohistochemical study

Abstract

Climatotherapy is a well‐described treatment of psoriasis. Dead Sea climatotherapy (DSC) in Israel consists of intensive sun and Dead Sea bathing and is very effective in improving clinical and patient‐reported outcomes. However, the effect of DSC has not been widely studied. We aimed to investigate the effect of DSC on psoriasis skin using quantitative immunohistochemistry techniques and analysis of blood samples. Skin punch biopsies from 18 psoriasis patients from a previous cohort study were used. Biopsies were obtained from non‐lesional skin and from a psoriasis target lesion at baseline. A biopsy was acquired from the target lesion after DSC. Among patients who achieved complete visual clearance, a biopsy was also obtained at relapse. Blood samples were obtained at the same time points. We performed haematoxylin and eosin staining and quantitative immunohistochemical analysis of CD3, CD4, CD8, CD11c, CD103, CD163, CD207, forkhead box P3, Ki67 and myeloperoxidase. We performed blood tests of cholesterol, c‐reactive protein, glucose, haemoglobin A1c and triglycerides. All skin biomarkers except for CD207 were decreased after DSC. At relapse, none of the biomarkers were significantly different from the baseline lesional measurements. Total CD207 staining correlated with psoriasis area and severity index at baseline while CD163 staining correlated with psoriasis area and severity index at EOT. No changes were observed in selected blood tests during the study. Consistent with clinical results, DSC is highly effective in the short term almost normalising all investigated biomarkers. However, at relapse, biomarkers were upregulated to the baseline level.

Cutaneous Nrf2‐Keap1 pathway modulation by environmental factors: The Dead Sea area as a test case

“…These results align with the known DS phototherapic clinical results, 57–59 showing an improvement in skin condition after moderate exposure to the DS solar radiation and other environmental factors in the DS area.…”

“…These results align with the known DS phototherapic clinical results, [57][58][59] showing an improvement in skin condition after moderate exposure to the DS solar radiation and other environmental factors in the DS area. ORCID Dror Cohen https://orcid.org/0000-0003-2777-8958 Meital Portugal-Cohen https://orcid.org/0000-0002-2454-1376 Miriam Oron https://orcid.org/0000-0002-1316-558X Marina Frusic-Zlotkin https://orcid.org/0000-0001-7142-3359 Yoram Soroka https://orcid.org/0000-0002-1170-1801 Ze'evi Ma'or https://orcid.org/0000-0003-3757-9362 Ron Kohen https://orcid.org/0000-0001-7268-9845…”

Secukinumab and Dead Sea Climatotherapy Impact Resolved Psoriasis Skin Differently Potentially Affecting Disease Memory

“…In line with this, the epidermal thickness was still significantly increased in DSC-treated skin at EOT. Changes in immune cell infiltrates and the transcriptome precede morphological changes in epidermal thickness, so this observation might not only signify a delay in treatment response but also UVB-induced hyperproliferation of the epidermis [ 52 , 53 , 54 ]. Furthermore, immunohistochemistry showed more CD1a + cells in the dermis of resolved skin after SEC treatment.…”

Beneficial Effects of Geological Materials: With Africa Case Descriptions

“…The Dead Sea has a hot desert climate (Köppen climate classification BWh), with year-round sunny skies and dry air -just what the doctors treating psoriasis would order. Dead Sea climatotherapy (DSC) in Israel consists of intensive sun and Dead Sea bathing and has been found to be very effective in improving clinical and patient-reported outcomes (Emmanuel et al, 2022).…”