PATHOGENESIS OF СLIMATOTHERAPY OF PSORIASIS AND PSORIATIC ARTHRITIS AND OTHER DERMATOSIS

PATHOGENESIS OF СLIMATOTHERAPY OF PSORIASIS AND PSORIATIC ARTHRITIS AND OTHER DERMATOSIS

Hatem Ghaleb Maabreh

Graduate student, Peoples' Friendship University of Russia (RUDN University),

Russia, Moscow

Nadejda Vladimorovna Batkaeva

Candidate of Medical Sciences, Peoples' Friendship University of Russia (RUDN University),

Russia, Moscow

Edward alekcievech Batkaev

Professor, Peoples' Friendship University of Russia (RUDN University),

Russia, Moscow

Nashaat Sultan Al Khateeb

Graduate student, Peoples' Friendship University of Russia (RUDN University),

Russia, Moscow

Ziad Ahmad Alabdallah

Graduate student, Peoples' Friendship University of Russia (RUDN University),

Russia, Moscow

Background: Dead Sea climatotherapy (DSC) is a treatment option for psoriasis and psoriatic arthritis, as well atopic dermatitis and vitiligo Climatotherapy is a safe and effective alternative traditional treatment.

Aim: analyze and evaluate the effectiveness of climatotherapy in the treatment of psoriasis and psoriatic arthritis based on the pathogenesis of diseases.

Methods: 519 patients participated in a 3-week  treatment program in dead sea Jordan , Treatment were consisting of sun exposure , bathing in the dead sea and applying dead sea mud .

Results: DSC was associated with 11.0-point reduction (82%) in Psoriasis Area and Severity Index and a reduction of 1.7 (79.2%) on the 5-point Investigator's Global Assessment Scale, patients quality of life improved measured by the Dermatology Quality of Life Index.

Conclusions: The effectiveness of climatotherapy for the treatment of psoriasis and psoriatic arthritis was evaluated. Climatotherapy represents a safe and efficient alternative to the conventional therapeutic modalities, which are based on the healing ability of natural resources and improves quality of life, although long-term disease control is not observed

Introduction: Psoriasis is characterized by prolonged inflammation and hyperplasia of the epidermis, which ultimately leads to the formation the formation and long-term existence of rashes, which are usually located on the scalp, elbows, in the navel and in the lumbar region [8].

in most cases, psoriasis is a benign a qualitative skin disease, but at the same time it can have a serious impact on the quality of life of patients.

Psoriatic arthritis is a seronegative, chronic inflammatory arthropathy often associated with psoriasis. The estimated prevalence of fluctuations from 0.16% to 0.25%. Psoriatic arthritis can affect 20% to 30% of patients with psoriasis [8]. Psoriatic arthritis occurs in 5-30% of patients with giving skin manifestations of psoriasis. Psoriasis may first appear at any age, but most often the onset of the disease was noted in 20-30 years, and the second peak of the onset of the disease is 50–60 years. Approximately at 75% of patients onset of the disease occurs before the age of 45[13].

modern methods of treating psoriasis, including phototherapy, has a normalizing influence on the balance of cytokines, which makes it possible to assess indicators of the cytokine profile as a kind a marker of the severity of the course and, possibly, the effectiveness of the treatment of this dermatosis. Established pathogenetic interrelationships between the level of content of some cytokines (IL-1β; IFNγ; IL-17; IL-10), as well as severity and prevalence of the psoriatic process.

With an increase in the values of the PASI and DLQI indices in patients with psoriasis in the progressive stage of the disease is determined, an increase in the concentrations of a number of pro- and anti-inflammatory components of the cytokine profile (IL-1β; IL-17; IL-10). Most distinct increase in IFNγ content correlates with severity,the prevalence of psoriasis and has an adverse positive impact on the quality of life of patients. In persons with ex-convulsive and seborrheic forms of dermatosis marked a higher level of concentration of a number of cytokines in comparison with the vulgar and palmar-plantar form of disease [1, 4, 5].

Genetic factors are of great importance in the development of psoriasis.

tical factors: the risk of developing psoriasis in a child 41% if both parents have psoriasis, and 14% if one parent is ill, also the likelihood of illness is 6% if a brother or sister has psoriasis.

About 21% of the patients coming yearly to the Dead Sea for climatotherapy suffer from atopic dermatitis. This is a common, chronic, and relapsing disease which necessitates drug treatment (topical corticosteroids, antimicrobials, antihistamines, or immunomodulators), phototherapy, or climatotherapy. [15].

Conclusions Climatotherapy of atopic dermatitis at the Dead Sea is a highly effective modality for treating this disease. It is also a highly cost-effective method, as the patients take no medications and experience no side-effects. Successful climatotherapy of atopic dermatitis requires strict medical supervision throughout the whole length of the patient’s stay on shore.[15]

Since the combination of solar radiation and sea water bathing at the Dead Sea is a successful treatment modality in various skin diseases, such as psoriasis and atopic eczema, as well as vitiligo, we wanted to investigate whether we could enhance the effect of the conventional pseudocatalase cream (PC-KUS) monotherapy in combination with the Balneo-climatotherapy at the Dead Sea.[17,19]

Materials and Methods

It is known that climatotherapy at the Dead Sea is changes to treat psoriasis and psoriatic arthritis for more than forty years, the first publications appeared in late 70s of the last century [10]. Using the system a mathematical approach, a search was carried out and the subsequent retrospective analysis of medical articles using the name of the search term is Dead Sea.

519 patients participated at the Dead Sea clinic and are divided into two groups, types I and II, depending on the beginning diseases by age were below or more than 40 years old, respectively.

The PASI improvement percentage has reached 95%. Logistic sky regression was used to identify the fact associated with the observed outcome.

By the end of the study, 74% of patients in group 1 underwent steagles PASI 95 versus 62% in group 2. Of this it follows that group 1 responded better to treatment compared with group 2. people aged 30 and 20, respectively, demonstrate similar tendencies; 75%, 65% and 78%, 68% for groups 1 and 2, respectively.

The performance indicators were impressive extremely high for patients with psoriasis.

it was found that the effect of treatment is inversely correlated with the growth of the patient at the onset of the disease [11].

Using computer visualization, examination of the skin of patients to determine if whether there will be a relapse of psoriasis after complete cleansing of the skin in patients who achieve complete remission after treatment of climatotherapy at the Dead Sea [9]. Sample was taken out of 5 men and 1 woman, PASI was 13.9 (standard deviation (sd) 5.5, range 8.08–19.6) and 4–53 (SD 2, range 1.34-7.71), respectively. Histopathological research showed typical psoriasis physical changes in the skin at the beginning and immediately after treatment climatotherapy at the Dead Sea. This research presents a method that allows learning plaque-specific recurrence of psoriasis and other re-circulating skin diseases [9].

Results and discussion

The study involved 519 patients in Jordan. In 29% of patients, the skin was completely cleared. 60% of patients had significant and moderate improvement. Observation of 215 patients showed that most of them were in a state of remission for a longer time than other therapies. Treatment consisted of increase in the time of exposure to the sun and bathing in the waters of the Dead Sea, moisturizers and olive oil, keratolytic ointments, used washed locally, as well as tar ointments used if necessary.

Thus, the climate of the Dead Sea, the lowest place on earth, has unique natural healing properties. These special properties are used to treat skin conditions such as psoriasis, psoriatic arthritis, atopic dermatitis and joint diseases. Climatotherapy is a natural and safe therapy with a high percentage of effectivity.

Climatotherapy at the Dead Sea has demonstrated high rates of effectiveness in the treatment of psoriasis for several decades. However more rigorous research is needed to evaluate duration of remission for different forms and stages of psoriasis.

In conclusion, the study confirms that (DSC) is beneficial in the short term for treatment of both psychological and dermatological aspects of psoriasis, however the effects are not long lasting.

that Dead Sea treatments are especially effective in psoriasis due to both the special characteristics of solar ultraviolet radiation in the Dead Sea and the Dead Sea water balneotherapy. Dead Sea mud and Dead Sea balneotherapy have been found to be beneficial in rheumatologic diseases, including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and knee osteoarthritis. In the safety analysis, we found no evidence for an increase in skin neoplasia, although skin actinic damage seems to be increased in patients treated in the Dead Sea. Dead Sea treatments do not lead to worsening of blood pressure. Substantial ingestion of Dead Sea water (generally in unusual near-drowning cases) is toxic and can result in cardiac rhythm disturbances because of electrolyte concentration abnormalities. Laboratory analysis of Dead Sea mud did not reveal mineral concentrations that could represent a health concern for their intended use.

Dead Sea treatments are beneficial in several rheumatologic diseases and psoriasis and have a good safety profile.

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