Abstract
Background
Dead Sea climatotherapy is a proven and useful option for the treatment of plaque psoriasis. However, combination with methotrexate treatment has not been studied.
Objective
We sought to evaluate the added benefit of Dead Sea climatotherapy in patients with psoriasis vulgaris receiving methotrexate treatment and compare their results with those of patients not receiving this therapy.
Methods
In this retrospective comparative study, 40 patients with psoriatic vulgaris were recruited at the Deutsches Medizinisches Zentrum Medical Center in Ein Bokek, Israel, between 2003 and 2005. Twenty (50%) patients were also treated with methotrexate (group 1), and 20 (50%) patients were not (group 2). A five-item scale, equivalent to Psoriasis Area and Severity Index (PASI) scores, was used to evaluate clinical response. Logistic regression using an exact method was performed on demographic and clinical parameters.
Results
Ten (50%) patients in group 1 and 13 (65%) patients in group 2 were totally plaque free on leaving the Dead Sea. Five (25%) patients in group 1 and four (20%) patients in group 2 were almost cleared (<5% involvement, 95%–99% PASI improvement), and five patients (25%) in group 1 and three patients (15%) in group 2 were markedly improved (>50% clearance, 50%–94% PASI improvement) at the end of Dead Sea climatotherapy (adjusted OR 1.43; 95% CI 0.2–16.6).
Conclusion
Dead Sea climatotherapy did not show better results in patients treated simultaneously with methotrexate. No side effects were observed from this combination therapy. However, the study design and the small sample size do not allow conclusions about methotrexate withdrawal before natural phototherapy.
Get full access to this article
View all access options for this article.