title: The role of trace elements in psoriatic patients undergoing balneotherapy with Dead Sea bath salt.
abstract: BACKGROUND
  A beneficial effect was observed in patients with psoriasis vulgaris following balneotherapy with Dead Sea bath salt.
  
  
  OBJECTIVE
  To evaluate the possible role of trace elements in the effectiveness of balneotherapy.
  
  
  METHODS
  Serum levels of 11 trace elements were analyzed in 23 patients with psoriasis vulgaris who participated in a double-blind controlled study of balneotherapy with either Dead Sea bath salt (12 patients) or common salt (11 patients). Thirteen healthy volunteers served as controls.
  
  
  RESULTS
  The mean pre-treatment serum levels of boron, cadmium, lithium and rubidium were significantly lower in patients compared to controls, whereas the mean pre-treatment serum level of manganese was significantly higher in patients compared to controls. Balneotherapy with Dead Sea bath salt resulted in a significant decrease (P = 0.0051) in the mean serum level of manganese from 0.10 +/- 0.05 mol/L to 0.05 +/- 0.02 mumol/L. The mean reduction in the serum level of manganese differed significantly (P = 0.002) between responders (% Psoriasis Area and Severity Index score reduction > or = 25) and non-responders (% PASI score reduction < 25). Following balneotherapy with Dead Sea bath salt the mean serum level of lithium decreased in responders by 0.01 +/- 0.02 mumol/L, whereas its level in non-responders increased by 0.03 +/- 0.03 mumol/L. (P = 0.015).
  
  
  CONCLUSIONS
  Manganese and lithium may play a role in the effectiveness of balneotherapy with Dead Sea bath salt for psoriasis.
authors.affiliation: Department of Dermatology, Soroka University Medical Center, Beer Sheva, Israel. halevy@bgumail.bgu.ac.il
authors.forename: S
authors.initials: S
authors.lastname: Halevy
authors.forename: H
authors.initials: H
authors.lastname: Giryes
authors.forename: M
authors.initials: M
authors.lastname: Friger
authors.forename: N
authors.initials: N
authors.lastname: Grossman
authors.forename: Z
authors.initials: Z
authors.lastname: Karpas
authors.forename: B
authors.initials: B
authors.lastname: Sarov
authors.forename: S
authors.initials: S
authors.lastname: Sukenik
mesh_terms: D000328:Adult; D000368:Aged; D001452:Balneology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009792:Oceans and Seas; D011565:Psoriasis / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology*; D012720:Severity of Illness Index; D012869:Skin Absorption / Q000502:physiology; D012965:Sodium Chloride / Q000097:blood / Q000627:therapeutic use; D014131:Trace Elements / Q000097:blood / Q000502:physiology* / Q000627:therapeutic use*
chemical_list: D014131:Trace Elements; D012965:Sodium Chloride