title: Dead Sea ultraviolet climatotherapy for children with atopic dermatitis.
abstract: BACKGROUND
  Atopic dermatitis (AD) is a common, chronic, and relapsing inflammatory skin disorder. Moderate to severe cases represent an extremely disabling disease, for both children and their parents. Dead Sea climatotherapy (DSC), recognized as a natural treatment for patients with skin diseases, takes advantage of the selectively scattered ultraviolet irradiation (UV) present at the lowest terrestrial site on the earth.
  
  
  OBJECTIVE
  To investigate the impact on short-term results of DSC in moderate to severe AD children from the Czech Republic treated 4 weeks at the Deutsches Medizinisches Zentrum (DMZ), Israel, and to correlate their results to the cumulative UVA and UVB irradiation doses received during treatment.
  
  
  METHODS
  Seventy-two patients aged <19 years were divided into three groups and treated in March 2014, October 2014, and March 2015 with gradually increasing sun exposure during 28 consecutive days. Daily and cumulative exposure doses of UVB and UVA were calculated through patients' recorded sun exposure logs. The SCORing Atopic Dermatitis (SCORAD) index was recorded immediately after DSC and 3 months later by the same dermatologist.
  
  
  RESULTS
  Good clinical results were observed in all groups, with overall improvement in SCORAD reaching 87.5 ± 13.4% and 71.3 ± 21.3% immediately after DSC and 3 months later, respectively. No side effects were observed during the treatments. Higher cumulative exposure times correlated with better results and enhanced remission.
  
  
  CONCLUSIONS
  Dead Sea climatotherapy represents a valuable option for the treatment of AD in children. Medically controlled and prescribed sun exposure seems to directly and positively influence the results obtained.
authors.affiliation: Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Beer Sheva, Israel.|Arava & Dead Sea Science Center, Neve Zohar, Israel.
authors.forename: Avraham
authors.initials: A
authors.lastname: Kudish
authors.affiliation: Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Anna
authors.initials: A
authors.lastname: Marsakova
authors.affiliation: DMZ Medical Center, Lot Spa Hotel, Dead Sea, Ein Bokek, Israel.
authors.forename: Irmgard
authors.initials: I
authors.lastname: Jahn
authors.affiliation: Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Gkalpakiotis
authors.affiliation: Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Peter
authors.initials: P
authors.lastname: Arenberger
authors.affiliation: Arava & Dead Sea Science Center, Neve Zohar, Israel.|DMZ Medical Center, Lot Spa Hotel, Dead Sea, Ein Bokek, Israel.
authors.forename: Marco
authors.initials: M
authors.lastname: Harari
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D013790:Climatotherapy; D003876:Dermatitis, Atopic / Q000628:therapy*; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D013997:Time Factors; D014467:Ultraviolet Therapy
keywords: Dead Sea climatotherapy; SCORing Atopic Dermatitis index; atopic dermatitis; ultraviolet irradiation