Comparative analysis of success of psoriasis treatment with standard therapeutic modalities and balneotherapy

Abstract

Introduction. Psoriasis is a chronic, inflammatory, immune-mediated skin disease. In addition to standard therapeutic modalities (antibiotics, cytostatics, phototherapy, photochemotherapy and retinoids), nonstandard methods can be used in the treatment of psoriasis. This includes balneotherapy which is most commonly used in combination with therapeutic resources. The aim of this research was to determine the length of remission of psoriasis in patients treated with standard therapeutic modalities, balneotherapy, and combined treatment (standard therapeutic modalities and balneotherapy). Material and Methods. The study analyzed 60 adult patients, of both sexes, with different clinical forms of psoriasis, who were divided into three groups according to the applied therapeutic modalities: the first group (treated with standard therapeutic modalities), the second group (treated with balneotherapy) and the third group (treated with combined therapystandard methods therapy and balneotherapy). The Psoriasis Area and Severity Index was determined in first, third and sixth week of treatment for all patients. The following laboratory analysis were performed and monitored: C reactive protein, iron with total iron binding capacity, unsaturated iron binding capacity and ferritin, uric acid, rheumatoid factors and antibodies to streptolysin O in the first and sixth week of treatment. Results. The average length of remission in patients treated with standard therapeutic modalities and in those treated with balneotherapy was 1.77 ± 0.951 months and 1.79 ± 0.918 months, respectively. There was a statistically significant difference in the duration of remission between the patients treated with combination therapy and patients treated with standard therapeutic modalities (p=0.019) and balneotherapy (p=0.032). Conclusion. The best results have been achieved when the combination therapy was administered. SažetakUvod. Psorijaza je hronična, inflamatorna, imunoposredovana kožna bolest. Pored standardnih terapijskih modaliteta (antibiotici, citostatici, fototerapija, fotohemoterapija i retinoidi), u terapiji se primenjuju i nestandardne terapijske metode kao balneoterapija, ali najčešće kombinacija više terapijskih sredstava. Cilj rada bio je da se utvrdi dužina remisije psorijaze kod pacijenata lečenih standardnim terapijskim modalitetima, balneoterapijom i kombinovanim lečenjem (standardnim terapijskim modalitetima i balneoterapijom). Materijal i metode. Analizirano je 60 odraslih pacijenata oba pola, obolelih od različitih kliničkih oblika psorijaze, podeljenih u tri grupe prema primenjenim terapijskim modalitetima: grupa I (lečena standardnim terapijskim modalitetima), grupa II (lečena balneoterapijom) i grupa III (lečena kombinovanim terapijskim modalitetima − standardnim metodama i balneoterapijom). Svim pacijentima smo određivali indeks procene težine psorijaze u 1, 3. i 6. nedelji lečenja. Pratili smo laboratorijske analize: C-reaktivni protein, gvožđe, ukupni kapacitet vezanog gvožđa, kapacitet vezivanja nezasićenog gvožđa, fe...

Efficacy of hydrotherapy, spa therapy, and balneotherapy for psoriasis and atopic dermatitis: a systematic review

“…Mineral waters contain substances such as sulfur and salt that may be very effective in treating skin diseases. 46 Sulfate sources can be used in many chronic inflammatory diseases due to the properties of keratolytic, antifungal, antioxidant, and anti-inflammatory and antiproliferative effects. 38,65,66 Hydrogen sulfide is a small permeable gas that can enter the skin's intracellular molecules and have many effects.…”

“…Hydrogen sulfide can inhibit the proliferation of T lymphocytes and interleukin-8, as well as decrease cellular adhesion. 33,46,66 Lee et al 67 showed that balneotherapy by immunomodulatory leads to a decrease in the production of Th1 and Th2-dependent cytokines such as intercellular adhesion molecule 1 expression, and E-selectin can be in human endothelial cells and thus reduce the complications of this disease. Also, some studies have shown that in in vitro conditions, balneotherapy is able to modulate the immune system due to the high amount of sulfur in its composition.…”

Mind-Body Interventions as Alternative and Complementary Therapies for Psoriasis: A Systematic Review of the English Literature

“…Although no data was obtained regarding length of the disease, they varied from one to 60 years, the most common values being centered around 20-30 years. Treatment length was most commonly 3-4 weeks, although some balneotherapy interventions took 6 or 8 weeks [22][23][24], whereas some patients under climatotherapy followed this treatment for as little as 6 days [25]. It is worth mentioning that the study of Langeland and that by Wahl employed the same patient population based on their characteristics [26,27].…”

“…Other locations that have climatotherapeutic or balneotherapeutic (bathing in hot springs) effects are in the Black Sea, Nord Sea, Baltic Sea, Canary Islands, Kangal Hot Springs in Turkey, or the Blue Lagoon in Iceland, but the evidence regarding each of these sites is lacking when compared to the Dead Sea [11,18,70,110,111]. Balneotherapy alone or in combination with standard treatment or phototherapy has repeatedly proven to be more effective than standard treatment alone [23,[85][86][87][88][89]. Geothermal sea water balneotherapy and narrowband UVB (NB-UVB) light therapy is apparently more effective in attaining clinical and histological amelioration, results in longer remission time and allows for lower UV doses than NB-UVB therapy alone [21].…”

Fish Pedicure: Review of Its Current Dermatology Applications

“…Today the Kangal Spring is designated as a certified thermal health center by the Turkish Ministry of Health and offers a 21-day treatment for psoriasis for visitors from around the world. This therapy provides an alternative to other forms of biotherapies which have been shown to improve psoriasis such as balneotherapy and thalassotherapy or treatment with seawater and mineral water, respectively [2,3]. Anecdotally, ichthyotherapy can also be used to treat skin diseases other than psoriasis, such as acne and eczema [1].…”