title: Patients with early-onset psoriasis achieve better results following Dead Sea climatotherapy.
abstract: BACKGROUND
  Plaque psoriasis has recently been divided in two types, which differ in severity and inheritance according to the age of the patient at the onset of the disease.
  
  
  OBJECTIVE
  To compare the effect of Dead Sea climatotherapy (DSC) on these two types of disease, with early vs. late onset, and to determine the impact of this treatment on the response rate.
  
  
  METHODS
  The files of 605 patients who were suffering from plaque psoriasis were retrieved from the database of the Research Institute at the Dead Sea (RIDS) and divided in two groups, types I and II, according to whether the age at the onset of the disease was under or over 40 years, respectively. The primary outcome for the assessment of DSC was Psoriasis Assessment of Severity Index of 95 (PASI 95), which indicates that the PASI improvement percentage reached 95%. Logistical regression was used to identify the factors that related to the observed outcome.
  
  
  RESULTS
  By the end of the study, 74% of the patients in group 1 reached PASI 95 in comparison to 62% in group 2. The 95% confidence interval for the odds ratio (OR) of the effect in group 2 in comparison to that of group 1 was [0.31, 0.99], which implies that group 1 responded better to treatment in comparison to group 2. Cut-off values for patients who were aged 30 and 20, respectively, exhibited similar trends; 75% vs. 65% and 78% vs. 68% for groups 1 and 2, respectively.
  
  
  CONCLUSIONS
  Efficacy rates following DSC were impressively high for plaque psoriasis patients. Contrary to our hypothesis, the treatment effect was found to inversely correlate with the age of the patient at disease onset.
authors.affiliation: RIDS The Joint Research Institute on Climatotherapy for Skin Diseases at the Dead Sea, The DMZ Medical Center and the Department of Dermatology, Hadassah University Hospital Jerusalem, Israel. marco.harari@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Harari
authors.forename: T
authors.initials: T
authors.lastname: Czarnowicki
authors.forename: R
authors.initials: R
authors.lastname: Fluss
authors.forename: T
authors.initials: T
authors.lastname: Ruzicka
authors.forename: A
authors.initials: A
authors.lastname: Ingber
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D013790:Climatotherapy; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000628:therapy*; D012720:Severity of Illness Index