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Quality of Life of Psoriasis Patients before and after Balneo - or Balneophototherapy

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Purpose: An observational prospective study was conducted to study the effects of hypotonic spa-water baths and narrowband ultraviolet B therapy given alone or in combination for treatment of moderate-severe psoriasis. Materials and Methods: Two treatments were analysed: 2 weeks of balneotherapy followed by ultraviolet-B (UVB) 311-nm phototherapy (BPT) or 2 weeks of daily bath treatments of Comano water alone (BT). One hundred and eleven adult patients with moderate to severe chronic plaque psoriasis were enrolled. Quality of life (QoL) questionnaires {36-item Short Form of the Medical Outcomes Study questionnaire (SF-36) and Skindex-29} were administered at baseline and 2 months from the end of therapy. The self-administered Psoriasis Area Severity Index (SAPASI), and the General Health Questionnaire (GHQ)-12 (to assess clinical severity and psychological distress, respectively) were also recorded at the same time-periods. Results: SAPASI was significantly reduced from 15.2 to 8.7 in BPT group and 11.6 to 7.8 in BT. A decrease of greater than 50% after therapy in SAPASI_50 score was reached by 42% and 37% of patients in the BPT and BT groups, respectively. At follow-up, both groups had better scores on all SF-36 scales (with statistically significant improvement in social functioning and mental health in the BPT group) and in all Skindex-29 scales. A statistically significant reduction of GHQ-12 positive cases was observed in the BPT group. Conclusion: Comano spa-water alone or in combination with phototherapy had beneficial therapeutic effects on patients with psoriasis. Although our observational study design prevents us from making meaningful comparisons between the 2 interventions, the combination of balneo and phototherapy seems to improve QoL and lessen clinical severity, and reduced the proportion of GHQ-12 positive cases.

Abstract

Purpose: An observational prospective study was conducted to study the effects of hypotonic spa-water baths and narrowband ultraviolet B therapy given alone or in combination for treatment of moderate-severe psoriasis. Materials and Methods: Two treatments were analysed: 2 weeks of balneotherapy followed by ultraviolet-B (UVB) 311-nm phototherapy (BPT) or 2 weeks of daily bath treatments of Comano water alone (BT). One hundred and eleven adult patients with moderate to severe chronic plaque psoriasis were enrolled. Quality of life (QoL) questionnaires {36-item Short Form of the Medical Outcomes Study questionnaire (SF-36) and Skindex-29} were administered at baseline and 2 months from the end of therapy. The self-administered Psoriasis Area Severity Index (SAPASI), and the General Health Questionnaire (GHQ)-12 (to assess clinical severity and psychological distress, respectively) were also recorded at the same time-periods. Results: SAPASI was significantly reduced from 15.2 to 8.7 in BPT group and 11.6 to 7.8 in BT. A decrease of greater than 50% after therapy in SAPASI_50 score was reached by 42% and 37% of patients in the BPT and BT groups, respectively. At follow-up, both groups had better scores on all SF-36 scales (with statistically significant improvement in social functioning and mental health in the BPT group) and in all Skindex-29 scales. A statistically significant reduction of GHQ-12 positive cases was observed in the BPT group. Conclusion: Comano spa-water alone or in combination with phototherapy had beneficial therapeutic effects on patients with psoriasis. Although our observational study design prevents us from making meaningful comparisons between the 2 interventions, the combination of balneo and phototherapy seems to improve QoL and lessen clinical severity, and reduced the proportion of GHQ-12 positive cases.

참고문헌 (27)

  1. An appraisal of narrowband (TL-01) UVB phototherapy, "British Photodermatology Group workshop Report (April 1996)", Br J Dermatol, 137, pp.327~330 (1997)
  2. Halevy S, "Different modalities of spa therapy for skin diseases at the Dead Sea area", Arch Dermatol, 134, pp.1416~1420 (1998)
  3. Holló P, "Synchronous balneophototherapy is effective for the different clinical types of psoriasis", J Eur Acad Dermatol Venereol, 19, pp.578~581 (2005)
  4. Schiffner R, "Evaluation of a multicentre study of synchronous application of narrowband ultraviolet B phototherapy (TL-01) and bathing in Dead Sea salt solution for psoriasis vulgaris", Br J Dermatol, 142, pp.740~747 (2000)
  5. Tsoureli-Nikita E, "Alternative treatment of psoriasis with balneotherapy using Leopoldine spa water", J Eur Acad Dermatol Venereol, 16, pp.260~262 (2002)
  6. Léauté-Labrèze C, "Saline spa water or combined water and UVB for psoriasis vs conventional UV-B: lessons from the salies de Béarn randomized study", Arch Dermatol, 137, pp.1035~1039 (2001)
  7. Dawe RS, "A randomized controlled comparison of the efficacy of Dead Sea salt balneophototherapy vs. narrowband ultraviolet B monotherapy for chronic plaque psoriasis", Br J Dermatol, 153, pp.613~619 (2005)
  8. Zumiani G, "Evaluation of the efficacy of Comano thermal baths water versus tap water in the treatment of eczematous dermatitis", G Ital Dermatol Venereol, 135, pp.253~258 (2000)
  9. Feldman SR, "The self-administered psoriasis area and severity index is valid and reliable", J Invest Dermatol, 106, pp.183~186 (1996)
  10. Sampogna F, "IDI Multipurpose Psoriasis Research on Vital Experiences (IMPROVE) Study Group, in Performance of the self-administered psoriasis area and severity index in evaluating clinical and sociodemographic subgroups of patients with psoriasis", Arch Dermatol, 139, pp.353~358 (2003)
  11. Chren MM, "Improved discriminative and evaluative capability of a refined version of Skindex, a quality-of-life instrument for patients with skin diseases", Arch Dermatol, 133, pp.1433~1440 (1997)
  12. Abeni D, "Construction and validation of the Italian version of Skindex-29, a new instrument to measure quality of life in dermatology (in Italian, abstract in English)", G Ital Dermatol Venereol, 136, pp.73~76 (2001)
  13. Abeni D, "Further evidence of the validity and reliability of the Skindex-29: an Italian study on 2,242 dermatological outpatients", Dermatology, 204, pp.43~49 (2002)
  14. Ware JE Jr, "The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection", Med Care, 30, pp.473~483 (1992)
  15. Piccinelli M, "Validity and test-retest reliability of the Italian version of the 12-item General Health Questionnaire in general practice: a comparison between three scoring methods", Compr Psychiatry, 34, pp.198~205 (1993)
  16. Picardi A, "Assessing psychological distress in patients with skin diseases: reliability, validity and factor structure of the GHQ-12", J Eur Acad Dermatol Venereol, 15, pp.410~417 (2001)
  17. Picardi A, "Screening for psychiatric disorders in patients with skin diseases: a performance study of the 12-item General Health Questionnaire", J Psychosom Res, 57, pp.219~223 (2004)
  18. Sampogna F, "IDI Multipurpose Psoriasis Research on Vital Experiences (IMPROVE) investigators. The impact of changes in clinical severity on psychiatric morbidity in patients with psoriasis: a follow-up study", Br J Dermatol, 157, pp.508~513 (2007)
  19. Montgomery BJ, "Bathing for psoriasis in the Dead Sea", JAMA, 241, pp.227~231 (1979)
  20. Even-Paz Z, "The Dead Sea and psoriasis. Historical and geographic background", Int J Dermatol, 28, pp.1~9 (1989)
  21. Abels DJ, "Bioclimatology and balneology in dermatology: a Dead Sea perspective", Clin Dermatol, 16, pp.695~698 (1998)
  22. Boer J, "The influence of mineral water solutions in phototherapy", Clin Dermatol, 14, pp.665~673 (1996)
  23. Wiedow O, "Lesional elastase activity in psoriasis, contact dermatitis, and atopic dermatitis", J Invest Dermatol, 99, pp.306~309 (1992)
  24. Celerier P, "Modulatory effects of selenium and strontium salts on keratinocyte-derived inflammatory cytokines", Arch Dermatol Res, 287, pp.680~682 (1995)
  25. Olafsson JH, "Psoriasis treatment: bathing in a thermal lagoon combined with UVB, versus UVB treatment only", Acta Derm Venereol, 76, pp.228~230 (1996)
  26. Gambichler T, "Controlled clinical trials on balneophototherapy in psoriasis", Br J Dermatol, 154, pp.802~803
  27. Chiarini A, "Comano’s (Trentino) thermal water interferes with the expression and secretion of vascular endothelial growth factor-A protein isoforms by cultured human psoriatic keratinocytes: a potential mechanism of its anti-psoriatic action", Int J Mol Med, 18, pp.17~25 (2006)

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