At the Dead Sea spas, which are 400 m below sea level, both the ultraviolet radiation from the sun and the mineral-rich waters of the lake have special features. The separate influence of these two factors was studied in 81 patients with psoriasis. The condition was assessed during 4 weeks of treatment using the psoriasis area and severity index (PASI). In subjects who only bathed in Dead Sea water the improvement was 28%, in those who only sunbathed it was 73%, and in those who did both it was 83%. The main therapeutic factor was thus shown to be sun exposure, possibly enhanced by bathing in Dead Sea water. Similar degrees of improvement in spring, summer and autumn led to speculation about the optimum dose of solar radiation needed. ( J Dermatol Treat (1996) 7: 83-86)

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The purpose of this study was to evaluate the immediate and delayed effects of balneotherapy at the Dead Sea on patients with psoriatic arthritis (PsA). A total of 42 patients with PsA were treated at the Dead Sea for 4 weeks. Patients were randomly allocated into two groups: group 1 (23 patients) and group 2 (19 patients). Both groups received daily exposure to sun ultraviolet rays and regular bathing at the Dead Sea. Group 1 was also treated with mud packs and sulfur baths. Patients were assessed by a dermatologist and a rheumatologist 3 days before arrival, at the end of treatment, and at weeks 8, 16, and 28 from the start of treatment. The clinical indices assessed were morning stiffness, right and left hand grip, number of tender joints, number of swollen joints, Schober test, distance from finger to floor when bending forward, patient's self-assessment of disease severity, inflammatory neck and back pain and psoriasis area and severity index (PASI) score. Comparison between groups disclosed a similar statistically significant improvement for variables such as PASI, morning stiffness, patient self-assessment, right and left grip, Schober test and distance from finger to floor when bending forward. For variables such as tender and swollen joints, and inflammatory neck and back pain, improvement over time was statistically significant in group 1. Addition of mud packs and sulfur baths to sun ultraviolet exposure and Dead Sea baths seems to prolong beneficial effects and improves inflammatory back pain.

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