Saline Spa Water or Combined Water and UV-B for Psoriasis vs Conventional UV-B Lessons From the Salies de Bearn Randomized Study

Objective To study the effects of UV-B therapy and saline spa water given alone or in combination for the treatment of psoriasis. Design Randomized, controlled, comparative study with blinded observers. Setting Salies de Bearn, saline spa water center located in the southwest of France. Participants Seventy-one adult patients with psoriasis with a Psoriasis Area and Severity Index (PASI) score greater than 10. Intervention Patients were randomly assigned to 1 of 3 treatments: spa water alone (group A); UV-B 311-nm phototherapy alone (group B); and a combination of the 2 therapies (group C). The 3 groups were treated on a daily basis 5 days a week for a total of 21 days. Main Outcome Measures Change in PASI score from baseline as determined by an investigator blinded to randomization; variation in quality of life, adverse effects, and long-term effects (1 year after treatment). Results Four patients dropped out because of secondary effects. Efficacy was similar in groups B and C, with changes in PASI of −64% and −55%, respectively at 3 weeks. For group A, change in PASI was −29%, thus showing a minor therapeutic effect of saline spa water alone and poor efficacy compared with groups B and C ( P Conclusions Saline spa water alone had a minor therapeutic effect in psoriasis, and the beneficial effect of bathing to enhance phototherapy was not demonstrated.