title: Effects of Rusanda Spa balneotherapy combined with calcipotriol on plaque psoriasis.
abstract: OBJECTIVE
  Treatment of psoriasis is very complex and there are no still universal, nor unique treatment modalities. Apart from conventional treatment, which includes topical calcipotriol (vitamin D3 analogue), balneotherapy is drawing increased attention worldwide. Being part of climatotherapy, balneotherapy is defined as the use of natural environmental factors in the treatment of health conditions, whereas in the treatment of psoriasis it means the use of mineral baths and peloids. The aim of this study was to examine the therapeutic efficacy of mineral waters and peloids of the Rusanda Spa on plaque psoriasis in patients also treated with calcipotriol.
  
  
  METHODS
  The study included 60 patients divided into two groups. The first group included patients treated with mineral waters, peloids and calcipotriol in the Rusanda Spa, while the second one included those treated only with calcipotriol. The study took 21 days, and each patient was followed up for at least one month after ending the treatment. The treatment efficacy was measured by psoriasis area severity index (PASI) scores on the days 0, 7, 14 and 21 during the treatment and 30 after the end of the therapy.
  
  
  RESULTS
  After a 3-week treatment in the Rusanda Spa, the first group showed a decrease in PASI score by 59.45%, whereas in the group of outpatients treated by calcipotriol it was 39.34%. On the day 30 following the treatment, the first group presented with the PASI score reduction of 58.44%, and the second group of 34.78%. The therapeutic efficacy of mineral waters and peloids combined with calcipotriol showed to be significantly higher in regard to monotherapy with calcipotriol (p < 0.05). In regard to clinical symptoms, the best results were obtained in the reduction of desquamation (p < 0.001).
  
  
  CONCLUSIONS
  The results of our study show that in the treatment of plaque-type psoriasis, topical calcipotriol combined with Spa Rusanda balineotherapy is more effective than topical calcipotriol alone. Randomized controlled trials are needed to confirm the effects of balneotherapy as monotherapy in treatment of this type of psoriasis.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Golusin
authors.forename: Marina
authors.initials: M
authors.lastname: Jovanović
authors.forename: Natasa
authors.initials: N
authors.lastname: Magda
authors.forename: Slobodan
authors.initials: S
authors.lastname: Stojanović
authors.forename: Milan
authors.initials: M
authors.lastname: Matić
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Petrović
mesh_terms: D000328:Adult; D000368:Aged; D001452:Balneology / Q000379:methods*; D002117:Calcitriol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; C055085:calcipotriene; D002117:Calcitriol