title: Synchronous balneophototherapy is effective for the different clinical types of psoriasis.
abstract: BACKGROUND
  The efficacy of synchronous balneophototherapy in clearing psoriasis is based on the multiple-targeted effects of UVB light and Dead Sea salt. Their synchronous application produces a synergic effect.
  
  
  OBJECTIVE
  The purpose of this retrospective study is: 1) to evaluate the efficacy of synchronous balneophototherapy for treating different clinical types of psoriasis; 2) to determine whether there is any difference between response to treatment, and 3) to gain more data in order to predict the effect of treatment in different clinical types, and thus to support the selection of patients for treatment.
  
  
  METHODS
  Patients received a basic course of synchronous balneophototherapy according to the Regensburg scheme, consisting of 35 treatment sessions, followed by a maintenance course of a further 25 treatments. The patients' skin status was monitored by weekly assessment using the PASI score throughout the course. The efficacy of the treatment was evaluated through the results of 373 patients treated according to protocol during the basic course, and the results of 78 of these patients during the maintenance course. One hundred and eighty-six patients were enrolled into the study comparing the efficacy of the basic course for the different clinical types of psoriasis: data of patients with large plaques, small plaques, guttate and confluating type of skin signs were summarized and compared.
  
  
  RESULTS
  During the basic course of treatment 70.7% improvement of the average PASI index was observed; the average PASI index decreased from 16.14 to 4.73. A further improvement from 4.58 to 4.27 of the average PASI was found during the maintenance therapy. Small plaque-type skin signs showed the best response with a PASI decrease of 76.1%; Guttate type had a PASI decrease of 73.7%, large plaque type, 67.1% and confluating type, 62%. Comparing data with the average PASI decrease, a statistically significant lower decrease was found in confluating type cases.
  
  
  CONCLUSIONS
  These results confirm that synchronous balneophototherapy is an effective treatment modality for different clinical types of psoriasis. Patients with small plaques have the greatest chance of the most marked clinical clearing; guttate and large plaque types of psoriasis also respond well to the treatment.
authors.affiliation: Department of Dermatovenereology and Dermatooncology Semmelweis Medical School, Budapest, Hungary. holpet@bor.sote.hu
authors.forename: P
authors.initials: P
authors.lastname: Holló
authors.forename: R
authors.initials: R
authors.lastname: Gonzalez
authors.forename: M
authors.initials: M
authors.lastname: Kása
authors.forename: A
authors.initials: A
authors.lastname: Horváth
mesh_terms: D000328:Adult; D000368:Aged; D001452:Balneology / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010789:Phototherapy / Q000379:methods*; D011336:Probability; D011565:Psoriasis / Q000175:diagnosis* / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome