Patients with early-onset psoriasis achieve better results following Dead Sea climatotherapy.

Journal of the European Academy of Dermatology and Venereology : JEADV

PubMedID: 21575063

Harari M, Czarnowicki T, Fluss R, Ruzicka T, Ingber A. Patients with early-onset psoriasis achieve better results following Dead Sea climatotherapy. J Eur Acad Dermatol Venereol. 2012;26(5):554-9.
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.

AIM
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.