Indoor salt water baths followed by artificial ultraviolet B light for chronic plaque psoriasis

摘要: BACKGROUND Chronic plaque psoriasis is an immune-mediated, chronic, inflammatory skin disease, which can impair quality of life and social interaction. Disease severity be classified by the area index (PASI) score ranging from 0 to 72 points. Indoor artificial salt bath with or without ultraviolet B (UVB) light used treat psoriasis, simulating sea bathing sunlight exposure; however, evidence base needs clear evaluation. OBJECTIVES To assess effects indoor (artificial) water baths followed exposure UVB for treating chronic in adults. SEARCH METHODS We searched following databases up June 2019: Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, LILACS. also five trial registers, checked reference lists included studies, recent reviews, relevant papers further references trials. SELECTION CRITERIA Randomised controlled trials (RCTs) indoors adults who have been diagnosed type psoriasis. studies reporting between-participant data within-participant data. evaluated two different comparisons: 1) + versus other treatment UVB; eligible comparators were psoralen bath, A UVA) light, topical treatment, systemic placebo, 2) only; containing compositions concentrations only. DATA COLLECTION AND ANALYSIS standard methodological procedures expected Cochrane. GRADE certainty evidence. The primary efficacy outcome was PASI-75, detect people a 75% more reduction PASI baseline. adverse treatment-related events requiring withdrawal. For dichotomous variables PASI-75 withdrawal, we estimated proportion among assessed participants. secondary outcomes health-related using Dermatology Life Quality Index, (DLQI) pruritus measured visual analogue scale, time relapse, malignancies. MAIN RESULTS eight RCTs: six reported (2035 participants; 1908 analysed), (70 participants, 68 analysed; 140 limbs; 136 analysed). One study comparison Of these only any our pre-specified one that plus (psoralen did not report outcomes. mean age participants ranged 41 50 years studies. None on predefined this review. judged seven as at high risk bias least domain, most commonly performance bias. Total duration between months 13 months. In median participant baseline 15 18 balanced arms. Three score. Most conducted Germany; all set Europe. Half multi-centred (set spa centres outpatient clinics); half single centre either unspecified settings, daycare centre, centre. Commercial companies sponsored three health insurance funded another, association dermatologists funding. When comparing only, found may improve when 75 (achieving baseline) (risk ratio (RR) 1.71, 95% confidence interval (CI) 1.24 2.35; 278 low-certainty evidence). Assessment end equivalent weeks after start treatment. contributed same group, blind assessors. German Spas Association funding source stated trial. Two make little no difference withdrawal compared (RR 0.96, CI 0.35 2.64; 404 events, but specify events; irritation. similar results, severe itch immediately Dead Sea soak group instances inadequate response phototherapy conversion UVA (low-certainty AUTHORS' CONCLUSIONS Salt alone, there occurrence Both results are based limited number provided evidence, so cannot draw conclusions. non-existent limited, maximum given outcome. outcome, recommend RCTs detailed point, well events. Risk issue; future should ensure blinding assessors full reporting.