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

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.