Research

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10 pages, 2027 KiB

Open AccessArticle

Ultrasound Evaluation of the Effectiveness of the Use of Acitretin in the Treatment of Nail Psoriasis

by Magdalena Krajewska-Włodarczyk, Zbigniew Żuber and Agnieszka Owczarczyk-Saczonek

J. Clin. Med. 2021, 10(10), 2122; https://doi.org/10.3390/jcm10102122 - 14 May 2021

Cited by 7 | Viewed by 2070

The study aimed to evaluate the effect of retinoid treatment on the morphological changes in the nail apparatus in patients with nail psoriasis. Material and methods: 41 patients aged 32 to 64 with nail psoriasis, without clinical signs of psoriatic arthritis, started on [...] Read more.

The study aimed to evaluate the effect of retinoid treatment on the morphological changes in the nail apparatus in patients with nail psoriasis. Material and methods: 41 patients aged 32 to 64 with nail psoriasis, without clinical signs of psoriatic arthritis, started on acitretin 0.6 to 0.8 mg kg b.w./d, for six months and 28 people in the control group were included in the study. Both groups had ultrasound examination of fingernails and digital extensor tendon in the distal interphalangeal joints. In psoriatic patients, US examination was conducted before starting the treatment and after six months. A total of 685 nails were examined. Results: After six months of treatment, there was a reduction in the thickness of the nail bed and nail matrix (p = 0.046 and p = 0.031, respectively). The thickness of the nail plates decreased, although it was statistically insignificant (p = 0.059) and it was higher than in the control group (p = 0.034). The reduced severity of clinical nail changes after six months of retinoid treatment did not correlate with the reduction in extensor tendon thickness in any group of patients. Conclusions: In patients with nail psoriasis, acitretin treatment resulted in a rapid decrease in the thickness of the nail bed and matrix, but it did not affect the thickness of the nail plate after six months. There was no effect of acitretin on the digital extensor tendon thickness or the increased blood supply to the tendon area. The results of the study may indicate the usefulness of ultrasound nail examinations in patients with nail psoriasis not only to assess the advancement of morphological changes and response to treatment, but also to choose the potential treatment. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

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7 pages, 227 KiB

Open AccessArticle

Ocular Manifestations in Psoriasis Screening (OcMaPS) Questionnaire: A Useful Tool to Reveal Misdiagnosed Ocular Involvement in Psoriasis

by Angelo Ruggiero, Gabriella Fabbrocini, Sara Cacciapuoti, Eleonora Cinelli, Lucia Gallo and Matteo Megna

J. Clin. Med. 2021, 10(5), 1031; https://doi.org/10.3390/jcm10051031 - 03 Mar 2021

Cited by 19 | Viewed by 2223

Abstract

Psoriasis is an immune-mediated, chronic inflammatory disease, which mainly affects the skin, although it has systemic pathological effects. Comorbidities of psoriasis include ocular disorders, which are often nonspecific or mildly symptomatic. The aim of this study was to show the importance of ocular-disease [...] Read more.

Psoriasis is an immune-mediated, chronic inflammatory disease, which mainly affects the skin, although it has systemic pathological effects. Comorbidities of psoriasis include ocular disorders, which are often nonspecific or mildly symptomatic. The aim of this study was to show the importance of ocular-disease screening in psoriatic patients using the Ocular Manifestations in Psoriasis Screening (OcMaPS) questionnaire. Patients suffering from moderate-to-severe psoriasis referring at our outpatient-clinic were consecutively enrolled. Each patient was asked to complete a screening questionnaire (OcMaPS). Patients reporting ocular symptoms were referred for an ophthalmological examination. A total of 372 patients were enrolled in the study. Ocular symptoms were detected in 39 patients (10.5%), and 37 patients were referred to ophthalmological examination which confirmed the presence of ocular manifestation in 30 patients. There were three cases (10%) of uveitis, 14 (46.6%) of dry eye and 13 (43.3%) of cataract, in progress or already treated with surgery. In the remaining seven patients, no ocular manifestations were found. Ocular manifestations in psoriatic patients are not rare. It is important to be aware of ocular symptoms in psoriatic patients, screening patients (with a consultation or OcMaPS questionnaire), which leads to earlier diagnosis and treatment. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

8 pages, 278 KiB

Open AccessArticle

Prevalence of Chronic Inducible Urticaria in Elderly Patients

by Maddalena Napolitano, Gabriella Fabbrocini, Luca Stingeni and Cataldo Patruno

J. Clin. Med. 2021, 10(2), 247; https://doi.org/10.3390/jcm10020247 - 12 Jan 2021

Cited by 8 | Viewed by 2094

Abstract

Background: No data currently exist regarding the epidemiology of chronic inducible urticarias (CIndUs) in the ≥65-year-old population. Objective: The study aimed to determine the prevalence of CIndUs among elderly patients affected by chronic urticaria (CU). Methods: The medical records of all patients referred [...] Read more.

Background: No data currently exist regarding the epidemiology of chronic inducible urticarias (CIndUs) in the ≥65-year-old population. Objective: The study aimed to determine the prevalence of CIndUs among elderly patients affected by chronic urticaria (CU). Methods: The medical records of all patients referred to us with a diagnosis of CU from January 2008 to September 2020 were retrospectively reviewed, and the patients with CIndUs were identified. The subjects aged 65 years or above were included in the study. Results: The number of patients aged 65 years or above was 153 out of 1970 subjects affected by CU (7.77%; 92 females (60.13%); mean age 70.96 ± 4.22). Out of 153, 26 patients (16.99%; 20 females (76.9%); mean age 71.23 ± 2.6 years) were diagnosed with CIndUs. Most subjects (25/26; 96.15%) suffered from physical urticarias. Symptomatic dermographism was the most frequent, affecting 65.38% (17/26) of our patients, followed by cold urticaria (6/26 (23.08%) cases). Conclusion: Our data seem to indicate that CIndUs may also affect the elderly, although it occurs less frequently in aging patients than in lower age groups. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

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8 pages, 2742 KiB

Open AccessArticle

Identification of Skin Lesions by Using Single-Step Multiframe Detector

by Yu-Ping Hsiao, Chih-Wei Chiu, Chih-Wei Lu, Hong Thai Nguyen, Yu Sheng Tseng, Shang-Chin Hsieh and Hsiang-Chen Wang

J. Clin. Med. 2021, 10(1), 144; https://doi.org/10.3390/jcm10010144 - 04 Jan 2021

Cited by 11 | Viewed by 3097

Abstract

An artificial intelligence algorithm to detect mycosis fungoides (MF), psoriasis (PSO), and atopic dermatitis (AD) is demonstrated. Results showed that 10 s was consumed by the single shot multibox detector (SSD) model to analyze 292 test images, among which 273 images were correctly [...] Read more.

An artificial intelligence algorithm to detect mycosis fungoides (MF), psoriasis (PSO), and atopic dermatitis (AD) is demonstrated. Results showed that 10 s was consumed by the single shot multibox detector (SSD) model to analyze 292 test images, among which 273 images were correctly detected. Verification of ground truth samples of this research come from pathological tissue slices and OCT analysis. The SSD diagnosis accuracy rate was 93%. The sensitivity values of the SSD model in diagnosing the skin lesions according to the symptoms of PSO, AD, MF, and normal were 96%, 80%, 94%, and 95%, and the corresponding precision were 96%, 86%, 98%, and 90%. The highest sensitivity rate was found in MF probably because of the spread of cancer cells in the skin and relatively large lesions of MF. Many differences were found in the accuracy between AD and the other diseases. The collected AD images were all in the elbow or arm and other joints, the area with AD was small, and the features were not obvious. Hence, the proposed SSD could be used to identify the four diseases by using skin image detection, but the diagnosis of AD was relatively poor. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

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13 pages, 921 KiB

Open AccessArticle

Presence of Cutaneous Complement Deposition Distinguishes between Immunological and Histological Features of Bullous Pemphigoid—Insights from a Retrospective Cohort Study

by Sascha Ständer, Maike M. Holtsche, Enno Schmidt, Christoph M. Hammers, Detlef Zillikens, Ralf J. Ludwig and Khalaf Kridin

J. Clin. Med. 2020, 9(12), 3928; https://doi.org/10.3390/jcm9123928 - 03 Dec 2020

Cited by 7 | Viewed by 2075

Abstract

The practical implications of complement deposition in direct immunofluorescence (DIF) microscopy and its influence on the disease phenotype are poorly understood. We aimed to investigate whether the presence of complement deposition in DIF microscopy gives rise to differences in the morphological, immunological, and [...] Read more.

The practical implications of complement deposition in direct immunofluorescence (DIF) microscopy and its influence on the disease phenotype are poorly understood. We aimed to investigate whether the presence of complement deposition in DIF microscopy gives rise to differences in the morphological, immunological, and histological characteristics of patients with BP (bullous pemphigoid). We performed a retrospective study encompassing patients with BP in a specialized tertiary referral center. Logistic regression model was utilized to identify variables independently associated with complement deposition. The study included 233 patients with BP, of whom 196 (84.1%) demonstrated linear C3 deposition along the dermal-epidermal junction (DEJ) in DIF analysis. BP patients with C3 deposition had higher mean (SD) levels (645.2 (1418.5) vs. 172.5 (243.9) U/mL; p < 0.001) and seropositivity rate (86.3% vs.64.9%; p = 0.002) of anti-BP180 NC16A and less prevalent neutrophilic infiltrate in lesional skin specimens (29.8% vs. 52.4%; p = 0.041). C3 deposition was found positively associated with the detection of anti-BP180 NC16A autoantibodies (OR, 4.25; 95% CI, 1.38–13.05) and inversely associated with the presence of neutrophils in lesional skin (OR, 3.03; 95% CI, 1.09–8.33). To conclude, complement deposition influences the immunological and histological features of BP. These findings are in line with experimental data describing the pathogenic role of complement in BP. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

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11 pages, 249 KiB

Open AccessArticle

Systemic Comorbidities in Korean Patients with Rosacea: Results from a Multi-Institutional Case-Control Study

by Yu Ri Woo, Hei Sung Kim, Se Hoon Lee, Hyun Jeong Ju, Jung Min Bae, Sang Hyun Cho and Jeong Deuk Lee

J. Clin. Med. 2020, 9(10), 3336; https://doi.org/10.3390/jcm9103336 - 17 Oct 2020

Cited by 11 | Viewed by 2858

Abstract

Recent evidence links rosacea to systemic disease, but there are not enough methodologic studies addressing this association in Asians. Our aim was to identify rosacea comorbidities in Koreans and establish a reference database. A multi-center, case-control study was performed where a total of [...] Read more.

Recent evidence links rosacea to systemic disease, but there are not enough methodologic studies addressing this association in Asians. Our aim was to identify rosacea comorbidities in Koreans and establish a reference database. A multi-center, case-control study was performed where a total of 12,936 rosacea patients and 12,936 age- and sex-matched control subjects were identified from 2007 to 2018. Logistic regression was performed to find significant association between rosacea and Sjögren syndrome (odds ratio [OR] 2.05; 95% confidence interval, 1.40–3.00), systemic sclerosis (OR 6.56; 95% CI, 1.50–28.7), rheumatoid arthritis (OR 1.72; 95% CI, 1.50–1.98), ankylosing spondylitis (OR 2.32; 95% CI, 1.42–3.84), autoimmune thyroiditis (OR 1.96; 95% CI, 1.40–2.73), alopecia areata (OR 1.77; 95% CI, 1.27–2.45), vitiligo (OR 1.90; 95% CI, 1.30–2.77), lung cancer (OR 1.54; 95% CI, 1.06–2.21), hepatobiliary cancer (OR 1.38; 95% CI, 1.06–1.77), alcohol abuse (OR 1.59; 95% CI, 1.05–2.39), diabetes mellitus (OR 1.11; 95% 1.02–1.19), obesity (OR 1.72; 95% CI, 1.22–2.41), allergic rhinitis (OR 1.65; 95% CI, 1.54–1.76), allergic conjunctivitis (OR 1.57; 95% CI, 1.27–1.94), chronic rhinosinusitis (OR 1.28; 95% CI, 1.14–1.42), herpes infection (OR 1.69; 95% CI, 1.53–1.86), and human papillomavirus infection (OR 2.50; 95% CI, 2.06–3.02). Higher odds for Sjogren syndrome, systemic sclerosis, ankylosing spondylitis, thyroiditis, vitiligo, hepatobiliary cancer, and obesity was exclusive in female subjects with rosacea, whereas increased prevalence of alopecia areata and alcohol abuse was confined to men. Only those who were 50 years and older exhibited higher odds for vitiligo, lung cancer, and gastroesophageal reflux disease while individuals younger than 50 were exclusively associated with hepatobiliary cancer, allergic conjunctivitis, and irritable bowel syndrome. Our study suggests that Koreans with rosacea are more likely to experience systemic comorbidity. Clinicians should acknowledge these interrelations and employ comprehensive care with an individual-based approach. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

7 pages, 234 KiB

Open AccessArticle

The HLA-Cw6 Dilemma: Is It Really an Outcome Predictor in Psoriasis Patients under Biologic Therapy? A Monocentric Retrospective Analysis

by Martina Burlando, Roberto Russo, Andrea Clapasson, Luca Carmisciano, Anna Stecca, Emanuele Cozzani and Aurora Parodi

J. Clin. Med. 2020, 9(10), 3140; https://doi.org/10.3390/jcm9103140 - 28 Sep 2020

Cited by 10 | Viewed by 1837

Abstract

HLA-Cw6 is one of the most strongly associated psoriasis susceptibility alleles. Data regarding correlation between HLA-Cw6 status and biologic treatment outcomes are divergent. The aim of our study in our cohort of psoriatic patients was to explore if the HLA-Cw6 status influences the [...] Read more.

HLA-Cw6 is one of the most strongly associated psoriasis susceptibility alleles. Data regarding correlation between HLA-Cw6 status and biologic treatment outcomes are divergent. The aim of our study in our cohort of psoriatic patients was to explore if the HLA-Cw6 status influences the response rate to biologic therapies at 16 and 48 weeks. One hundred and one psoriatic patients eligible for biologic therapies were enrolled. HLA-C*06 alleles were detected from their blood samples. The effectiveness of antipsoriatic treatments was reported as 90% Psoriasis Area and Severity Index reduction (PASI90). All biologics showed efficacy at week 16, without significant differences between one another. HLA-Cw6 status did not seem to affect baseline characteristics, or treatment response at week 16. At week 48, IL-12/23 and IL-17 targeting drugs were more effective on Cw6-positive patients than on Cw6-negative patients. Conversely, TNF-targeting drugs seemed to be more effective on Cw6- negative patients than on Cw6-positive patients. The HLA-Cw6 test could well deserve to be integrated into the clinical laboratory work-up supporting the choice of the correct biologic. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

16 pages, 6576 KiB

Open AccessArticle

Use of Guselkumab for the Treatment of Moderate-to-Severe Plaque Psoriasis: A 1 Year Real-Life Study

by Marco Galluzzo, Lorenzo Tofani, Paolo Lombardo, Alessandra Petruzzellis, Dionisio Silvaggio, Colin Gerard Egan, Luca Bianchi and Marina Talamonti

J. Clin. Med. 2020, 9(7), 2170; https://doi.org/10.3390/jcm9072170 - 09 Jul 2020

Cited by 60 | Viewed by 7178

Abstract

Little information is available from real-life studies evaluating the efficacy of guselkumab in moderate-to-severe psoriasis. In this real-life study, we retrospectively examined a database of 52 patients with moderate-to-severe psoriasis treated with guselkumab (100 mg, s.c.) and followed for 1 year. Disease severity [...] Read more.

Little information is available from real-life studies evaluating the efficacy of guselkumab in moderate-to-severe psoriasis. In this real-life study, we retrospectively examined a database of 52 patients with moderate-to-severe psoriasis treated with guselkumab (100 mg, s.c.) and followed for 1 year. Disease severity and treatment response was assessed by the Psoriasis Area and Severity Index (PASI) at baseline and after 4, 12, 20, 28, 36, 44, and 52 weeks. Predictors of a PASI response were evaluated by univariate and multivariate regression. After 12 months, 84.2% of patients (mean age 51.3 ± 14.1 years) treated with guselkumab achieved a PASI score of <3. Furthermore, PASI score decreased from 20 ± 13.3 at baseline to 4.4 ± 4.7 and 2.7 ± 3.9 at 12 and 20 weeks, and PASI 75, 90, and 100 response was achieved in 84.2%, 78.9%, and 63.2% of patients respectively at 12 months. Stepwise multivariate regression analysis revealed that previous biological treatment and the presence of comorbidities were associated with poorer response between 28–44 weeks, however the presence of obesity per se was not associated with poorer response. Difficult-to-treat areas were also improved as early as 12 weeks following guselkumab. Guselkumab was observed to be effective and safe in patients with moderate-severe chronic psoriasis in a real world-setting. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

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Review

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15 pages, 858 KiB

Open AccessReview

Oxidative Stress in Cutaneous Lichen Planus—A Narrative Review

by Simona Roxana Georgescu, Cristina Iulia Mitran, Madalina Irina Mitran, Ilinca Nicolae, Clara Matei, Corina Daniela Ene, Gabriela Loredana Popa and Mircea Tampa

J. Clin. Med. 2021, 10(12), 2692; https://doi.org/10.3390/jcm10122692 - 18 Jun 2021

Cited by 19 | Viewed by 3378

Abstract

Lichen planus (LP) is a chronic, immune-mediated inflammatory skin condition that mainly affects the skin (cutaneous LP, CLP) and oral mucosa (oral LP, OLP). However, the mechanisms involved in the pathogenesis of the disease are not fully elucidated. Over time, several theories that [...] Read more.

Lichen planus (LP) is a chronic, immune-mediated inflammatory skin condition that mainly affects the skin (cutaneous LP, CLP) and oral mucosa (oral LP, OLP). However, the mechanisms involved in the pathogenesis of the disease are not fully elucidated. Over time, several theories that could explain the appearance of LP lesions have been postulated. The key players in LP pathogenesis are the inflammatory infiltrate consisting of T cells and the proinflammatory cytokines. The cytokines stimulate the production of reactive oxygen species that induce cell apoptosis, a defining element encountered in LP. The lead inquiry triggered by this revolves around the role of oxidative stress in LP development. There are currently numerous studies showing the involvement of oxidative stress in OLP, but in terms of CLP, data are scarce. In this review, we analyze for the first time the currently existing studies on oxidative stress in CLP and summarize the results in order to assess the role of oxidative stress in skin lesions offering a fresher updated perspective. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

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24 pages, 586 KiB

Open AccessReview

New Treatments for Atopic Dermatitis Targeting Skin Barrier Repair via the Regulation of FLG Expression

by Anna Dębińska

J. Clin. Med. 2021, 10(11), 2506; https://doi.org/10.3390/jcm10112506 - 05 Jun 2021

Cited by 20 | Viewed by 10048

Abstract

Atopic dermatitis (AD) is one of the most common chronic, inflammatory skin disorders with a complex etiology and a broad spectrum of clinical phenotypes. Despite its high prevalence and effect on the quality of life, safe and effective systemic therapies approved for long-term [...] Read more.

Atopic dermatitis (AD) is one of the most common chronic, inflammatory skin disorders with a complex etiology and a broad spectrum of clinical phenotypes. Despite its high prevalence and effect on the quality of life, safe and effective systemic therapies approved for long-term management of AD are limited. A better understanding of the pathogenesis of atopic dermatitis in recent years has contributed to the development of new therapeutic approaches that target specific pathophysiological pathways. Skin barrier dysfunction and immunological abnormalities are critical in the pathogenesis of AD. Recently, the importance of the downregulation of epidermal differentiation complex (EDC) molecules caused by external and internal stimuli has been extensively emphasized. The purpose of this review is to discuss the innovations in the therapy of atopic dermatitis, including biologics, small molecule therapies, and other drugs by highlighting regulatory mechanisms of skin barrier-related molecules, such as filaggrin (FLG) as a crucial pathway implicated in AD pathogenesis. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

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27 pages, 2610 KiB

Open AccessReview

Frontal Fibrosing Alopecia: A Review

by María Librada Porriño-Bustamante, María Antonia Fernández-Pugnaire and Salvador Arias-Santiago

J. Clin. Med. 2021, 10(9), 1805; https://doi.org/10.3390/jcm10091805 - 21 Apr 2021

Cited by 24 | Viewed by 8767

Abstract

Frontal fibrosing alopecia is a scarring alopecia, the prevalence of which is increasing worldwide since its first description in 1994. The reason for this emerging epidemic may be a higher exposure to an unknown trigger, although its aethiology and pathogenesis still remain enigmatic. [...] Read more.

Frontal fibrosing alopecia is a scarring alopecia, the prevalence of which is increasing worldwide since its first description in 1994. The reason for this emerging epidemic may be a higher exposure to an unknown trigger, although its aethiology and pathogenesis still remain enigmatic. Clinical, trichoscopic, sonographic, and histopathologic findings are allowing clinicians to understand more aspects about this type of cicatricial alopecia. Several treatments have been used in frontal fibrosing alopecia, although the 5-alpha reductase inhibitors seem to be the most promising. The aim of this report is to provide a compilation about the published data regarding frontal fibrosing alopecia in a narrative review. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

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16 pages, 2573 KiB

Open AccessReview

Dermatological Manifestations in Inflammatory Bowel Diseases

by Elisabetta Antonelli, Gabrio Bassotti, Marta Tramontana, Katharina Hansel, Luca Stingeni, Sandro Ardizzone, Giovanni Genovese, Angelo Valerio Marzano and Giovanni Maconi

J. Clin. Med. 2021, 10(2), 364; https://doi.org/10.3390/jcm10020364 - 19 Jan 2021

Cited by 38 | Viewed by 16395

Abstract

Inflammatory bowel diseases (IBDs) may be associated with extra-intestinal manifestations. Among these, mucocutaneous manifestations are relatively frequent, often difficult to diagnose and treat, and may complicate the course of the underlying disease. In the present review, a summary of the most relevant literature [...] Read more.

Inflammatory bowel diseases (IBDs) may be associated with extra-intestinal manifestations. Among these, mucocutaneous manifestations are relatively frequent, often difficult to diagnose and treat, and may complicate the course of the underlying disease. In the present review, a summary of the most relevant literature on the dermatologic manifestations occurring in patients with inflammatory bowel diseases has been reviewed. The following dermatological manifestations associated with IBDs have been identified: (i) specific manifestations with the same histological features of the underlying IBD (occurring only in Crohn’s disease); (ii) cutaneous disorders associated with IBDs (such as aphthous stomatitis, erythema nodosum, psoriasis, epidermolysis bullosa acquisita); (iii) reactive mucocutaneous manifestations of IBDs (such as pyoderma gangrenosum, Sweet’s syndrome, bowel-associated dermatosis-arthritis syndrome, aseptic abscess ulcers, pyodermatitis–pyostomatitis vegetans, etc.); (iv) mucocutaneous conditions secondary to treatment (including injection site reactions, infusion reactions, paradoxical reactions, eczematous and psoriasis-like reactions, cutaneous infections, and cutaneous malignancies); (v) manifestations due to nutritional malabsorption (such as stomatitis, glossitis, angular cheilitis, pellagra, scurvy, purpura, acrodermatitis enteropathica, phrynoderma, seborrheic-type dermatitis, hair and nail abnormalities). An accurate dermatological examination is essential in all IBD patients, especially in candidates to biologic therapies, in whom drug-induced cutaneous reactions may assume marked clinical relevance. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

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19 pages, 294 KiB

Open AccessReview

The Role of Thermal Water in Chronic Skin Diseases Management: A Review of the Literature

by Sara Cacciapuoti, Maria A. Luciano, Matteo Megna, Maria C. Annunziata, Maddalena Napolitano, Cataldo Patruno, Emanuele Scala, Roberta Colicchio, Chiara Pagliuca, Paola Salvatore and Gabriella Fabbrocini

J. Clin. Med. 2020, 9(9), 3047; https://doi.org/10.3390/jcm9093047 - 22 Sep 2020

Cited by 35 | Viewed by 8618

Abstract

The benefits of thermal water in different diseases have been known since ancient times. Over the past decades, a re-assessment of the use of mineral water for the treatment of several pathologic conditions has taken place around the world. Today, water therapy is [...] Read more.

The benefits of thermal water in different diseases have been known since ancient times. Over the past decades, a re-assessment of the use of mineral water for the treatment of several pathologic conditions has taken place around the world. Today, water therapy is being practiced in many countries that have a variety of mineral springs considerably different in their hydrogeologic origin, temperature, and chemical composition. Thermal water and balneotherapy offer several advantages: this approach needs no chemicals or potentially harmful drugs; there are almost no side effects during and after treatment, and there is a low risk to the patient’s general health and well-being. However, it is difficult to evaluate the efficacy of this therapeutic approach in clinical practice due to the complexity of molecular mechanisms underlying its efficacy. Here we review the current knowledge of the chemical, immunological, and microbiological basis for therapeutic effects of thermal water with a specific focus on chronic inflammatory skin diseases. We also describe recent evidence of the major dermatologic diseases that are frequently treated by balneotherapy with a remarkable rate of success. Moreover, we discuss the potential role of balneotherapy either alone or as a complement to conventional medical treatments. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician)

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