Indoor salt water baths followed by artificial ultraviolet B light for chronic plaque psoriasis

Peinemann, Frank; Harari, Marco; Peternel, Sandra; Chan, Thalia; Chan, David Yiu Leung; Labeit, Alexander; Gambichler, Thilo

doi:10.1002/14651858.cd011941.pub2

Cited by 6 publications

(4 citation statements)

References 83 publications

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“…6 Ultraviolet (UV) irradiation with either artificial UVA or UVB light or with natural sunlight is another treatment option. 7 This can be combined with salt water 8,9 or alternatively as a combination with more favourable climate conditions termed climatotherapy. 10 Despite the current myriad of treatment options, some patients decline all systemic therapies because of personal concerns 11 or due to contraindications or side effects.…”

Section: Introductionmentioning

confidence: 99%

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

Emmanuel

Petersen

Houborg

et al. 2022

Experimental Dermatology

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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.

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Section: Introductionmentioning

confidence: 99%

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

Emmanuel

Petersen

Houborg

et al. 2022

Experimental Dermatology

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“…A Cochrane review suggested infliximab, ixekizumab, secukinumab, brodalumab, risankizumab, and guselkumab to be significantly more effective in reaching PASI 90 than ustekinumab and three anti-TNF alpha agents: adalimumab, certolizumab, and etanercept [37]. Salt baths with artificial ultraviolet B light may improve PASI by 75% in people with chronic plaque psoriasis compared with UVB light treatment alone [38]. One meta-analysis showed that pioglitazone was associated with a remarkable reduction in PASI scores in patients with psoriasis vulgaris [39].…”

Section: Discussionmentioning

confidence: 99%

Individualized Homeopathic Medicines in the Treatment of Psoriasis Vulgaris: Double-Blind, Randomized, Placebo-Controlled Trial

Balamurugan¹,

Nayak²,

Chattopadhyay³

et al. 2023

Complement Med Res

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Introduction: Psoriasis is a chronic inflammatory skin disorder, affecting the trunk and extensor surfaces of the limbs and scalp predominantly. Worldwide prevalence ranges between 0.1 and 11.4%, and in India between 0.4 and 2.8%; this creates a serious health burden. Psoriasis remains a frequently encountered condition in homeopathy practice, but there is a dearth of conclusive efficacy data supporting its use. Methods: This 6-month, double-blind, randomized trial was conducted on 51 patients suffering from psoriasis at the National Institute of Homoeopathy, India. Patients were randomized to receive either individualized homeopathic medicines (IHMs; n = 25) in LM potencies or identical-looking placebos (n = 26). Psoriasis area and severity index (PASI; primary), psoriasis disability index (PDI), and dermatological life quality index (DLQI; secondary) were measured at baseline and every 2 months, up to 6 months. The intention-to-treat sample was analyzed using a two-way repeated measure analysis of variance. Results: Although intragroup changes were significant in both groups in the outcome measures, improvements were significantly higher in the IHMs group than in placebos in PASI scores after 6 months of intervention (F1, 49 = 10.448, p = 0.002). DLQI daily activity subscale scores also yielded similar significant results favoring IHMs against placebos after 6 months (F1, 49 = 5.480, p = 0.023). Improvement in PDI total (F1, 49 = 0.063, p = 0.803), DLQI total (F1, 49 = 1.371, p = 0.247), and all remaining subscales were higher in the IHMs group than placebos after 6 months, but nonsignificant statistically. Calcarea carbonica, Mercurius solubilis, Arsenicum album, and Petroleum were the most frequently prescribed medicines. Conclusions: IHMs exhibited better results than placebos in the treatment of psoriasis. Further research is warranted.

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“…This article is an abridged version of a Cochrane Review published in The Cochrane Library 10 . While preparing this systematic review, we endorsed the PRISMA statement, adhered to its principles and conformed to its checklist 11 …”

Section: Methodsmentioning

confidence: 99%

“…We conducted an electronic literature database search on June 4, 2019 without applying any limits in the Skin Group Specialized Register (CRS), the Cochrane Central Register of Controlled Trials (CENTRAL) 2019, Issue 6 in the Cochrane Library, MEDLINE via Ovid (from 1946), Embase via Ovid (from 1974), and LILACS (Latin American and Caribbean Health Science Information database, from 1982). The strategies of the electronic searches including online trials registers and other sources are provided with the original Cochrane Review 10 …”

Section: Methodsmentioning

confidence: 99%

Indoor balneophototherapy for chronic plaque psoriasis: Abridged Cochrane Review

Peinemann

Harari

Peternel

et al. 2020

Dermatologic Therapy

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Artificial exposure to ultraviolet B light (UVB) while soaking in an indoor salt bath, also called balneophototherapy, could simulate the natural exposure to the sun while bathing in the Dead Sea. We aimed to assess the effects of this intervention on patients with chronic plaque psoriasis. We searched CENTRAL, MEDLINE, Embase, and LILACS up to June 2019. We included randomized controlled trials (RCTs). The primary efficacy outcome was psoriasis area and severity index (PASI)‐75 to detect people with a 75% or more reduction in the PASI score from baseline. The primary adverse outcome was treatment‐related adverse events requiring withdrawal. We included eight RCTs (2105 participants; 1976 analyzed). With respect to PASI‐75, two studies found that salt bath + UVB may improve psoriasis when compared to UVB alone (risk ratio 1.71, 95% confidence interval 1.24 to 2.35; 278 participants). With respect to treatment‐related adverse events requiring withdrawal, two other studies found little to no difference when compared to UVB alone (risk ratio 0.96, 95% confidence interval 0.35 to 2.64; 404 participants). Salt bath + UVB could improve psoriasis when compared to UVB alone, though, results are based on a limited number of studies and provide low‐certainty evidence.

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Indoor salt water baths followed by artificial ultraviolet B light for chronic plaque psoriasis

Cited by 6 publications

References 83 publications

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

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

Individualized Homeopathic Medicines in the Treatment of Psoriasis Vulgaris: Double-Blind, Randomized, Placebo-Controlled Trial

Indoor balneophototherapy for chronic plaque psoriasis: Abridged Cochrane Review

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