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Lessons From the Salies de Béarn Randomized Study

Christine Léauté-Labrèze, MD; Florence Saillour, MD; Geneviève Chêne, MD; Colette Cazenave, MD; Marie-Laure Luxey-Bellocq, MD; Catherine Sanciaume, MD; Jean François Toussaint, MD; Alain Taïeb, MD

Arch Dermatol. 2001;137:1035-1039.

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 Béarn, 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<.001). More adverse effects were reported in groups A and C but did not reach significance. Combined saline spa water and UV-B therapy had no sparing effect on UV-B dosages. One year after treatment, no long-term benefit could be attributed specifically to a given regimen, but the patients had overall significantly better PASI scores than at baseline.

Conclusions  Saline spa water alone had a minor therapeutic effect in psoriasis, and the beneficial effect of bathing to enhance phototherapy was not demonstrated.

From the Department of Dermatology and Institut National de la Santé et de la Recherche Médicale U330, Pellegrin University Hospitals, Bordeaux, France.

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