Yonsei Med J.  2009 Apr;50(2):215-221.

Quality of Life of Psoriasis Patients before and after Balneo - or Balneophototherapy

• Tabolli S
• Calza A
• Di Pietro
• Sampogna F
• Abeni D

Abstract

PURPOSE
An observational prospective study was conducted to study the effects of hypotonic spa-water baths and narrowband ultraviolet B therapy given alone or in combination for treatment of moderate-severe psoriasis. MATERIALS AND METHODS: Two treatments were analysed: 2 weeks of balneotherapy followed by ultraviolet-B (UVB) 311-nm phototherapy (BPT) or 2 weeks of daily bath treatments of Comano water alone (BT). One hundred and eleven adult patients with moderate to severe chronic plaque psoriasis were enrolled. Quality of life (QoL) questionnaires {36-item Short Form of the Medical Outcomes Study questionnaire (SF-36) and Skindex-29} were administered at baseline and 2 months from the end of therapy. The self-administered Psoriasis Area Severity Index (SAPASI), and the General Health Questionnaire (GHQ)-12 (to assess clinical severity and psychological distress, respectively) were also recorded at the same time-periods. RESULTS: SAPASI was significantly reduced from 15.2 to 8.7 in BPT group and 11.6 to 7.8 in BT. A decrease of greater than 50% after therapy in SAPASI_50 score was reached by 42% and 37% of patients in the BPT and BT groups, respectively. At follow-up, both groups had better scores on all SF-36 scales (with statistically significant improvement in social functioning and mental health in the BPT group) and in all Skindex-29 scales. A statistically significant reduction of GHQ-12 positive cases was observed in the BPT group. CONCLUSION: Comano spa-water alone or in combination with phototherapy had beneficial therapeutic effects on patients with psoriasis. Although our observational study design prevents us from making meaningful comparisons between the 2 interventions, the combination of balneo and phototherapy seems to improve QoL and lessen clinical severity, and reduced the proportion of GHQ-12 positive cases.

Keyword

Psoriasis; balneotherapy; phototherapy; Skindex-29; General Health Questionnaire-12; 36-item Short Form of the Medical Outcomes Study questionnaire

MeSH Terms

Adult
Balneology/*methods
Female
Humans
Logistic Models
Male
Middle Aged
Phototherapy/*methods
Psoriasis/*therapy
*Quality of Life

Figure

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  Fig. 1 Skindex-29 test and SF-36 scales before and after BPT or BT therapies. SF-36, 36-item Short Form of the Medical Outcomes Study questionnaire; BTP, balneophototherapy; BT, balneotherapy, PF, physical functioning; RP, role-physical; BP, bodily pain; GH, general health; VT, vitality; SF, social functioning; RE, role-emotional; MH, mental health.

• 

  Fig. 2 SF-36 scales before and after BPT or BP therapies in patients with reduction of SAPASI > 50%. SF-36, 36-item Short Form of the Medical Outcomes Study questionnaire; BTP, balneophototherapy; BT, balneotherapy, SAPASI, self-administered Psoriasis Area Severity Index; PF, physical functioning; RP, role-physical; BP, bodily pain; GH, general health; VT, vitality; SF, social functioning; RE, role-emotional; MH, mental health.

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