[Psoriasis and psoriatic arthritis--is climate therapy a treatment or a leisure activity?].
BACKGROUND
For many years, Norwegian patients with psoriasis or arthritic psoriasis have been offered climate therapy. In 2002, Rikshospitalet University Hospital's department for treatment abroad organised this treatment for the first time for a group of patients with combined psoriasis and arthritic psoriasis.


METHODS
In 50 patients, psoriasis severity (psoriasis area and severity index, PASI 0-72) was assessed at start and end of treatment in Turkey. Patients reported joint pain (VAS 0-100), skin (DLQI-N 0-29), arthritic psoriasis-related quality of life (ADI-N 0-33) and functional status of arthritis (MHAQ 1-4) at arrival, one week and two months after treatment. Standard response mean (difference/SD difference) was used to evaluate clinical relevance.


RESULTS
Disease activity was mild at start of treatment. The clinical relevance for the change in skin and arthritis related quality of life was considered high one week after treatment and moderate after two months. Change in psoriasis, pain and functional status of the joints had little clinic relevance. A statistical significant score improvement was found for PASI (6.0 vs. 2.0), DLQI-N (8.4 vs. 2.2 vs. 4.6), ADI-N (9.9 vs. 4.8 vs. 7.0) and MHAQ (1.6 vs. 1.3 vs. 1.4), all means. No significant change in pain score was demonstrated for those having arthritic psoriasis.


CONCLUSIONS
If climate therapy should be implemented as supplemental therapy, we recommend recruitment of patients with severe to moderate psoriasis and arthritic psoriasis and inclusion of an analysis of cost-effectiveness.
Mørk
Cato
C
Hudavdelingen, Rikshospitalet, 0027 Oslo. cato.mork@rikshospitalet.no
Ozek
Mehmet
M
Wahl
Astrid Klopstad
AK
D000328:Adult; D015535:Arthritis, Psoriatic / Q000191:economics / Q000523:psychology / Q000628:therapy*; D002980:Climate; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D018579:Patient Selection; D011565:Psoriasis / Q000191:economics / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D013472:Sunlight; D014195:Travel / Q000191:economics