Hydrogen helps with psoriasis and parapsoriasisScientific Research

псориазис

Positive effects of hydrogen-water bathing in patients of psoriasis and parapsoriasis en plaques

https://doi.org/10.1038/s41598-018-26388-3

Qinyuan Zhu, Yueshen Wu, Yongmei Li, Zihua Chen, Lanting Wang, Hao Xiong, Erhong Dai, Jianhua Wu, Bin Fan, Li Ping &  Xiaoqun Luo

Abstract

Psoriasis and plaque psoriasis are chronic inflammatory skin diseases, both of which represent treatment challenges and compromise quality of life in daily practice. Reactive oxygen species (ROS) have been shown to be involved in the pathogenesis of chronic inflammatory diseases. We now report that hydrogen water is an effective ROS scavenger that significantly and rapidly improves disease severity and quality of life in patients with psoriasis and plaque psoriasis. At week 8, our parallel-controlled study showed that 24.4% (10/41) of patients who received the hydrogen water bath had at least an improvement in the Psoriasis Area Severity Index (PASI) compared to 2.9% of patients 75% (1/34). Control group (Pc = 0.022, OR = 0.094, 95% CI = [0.011, 0.777]). In the bathing patients, 56.1% (23/41) had at least a 50% improvement in the PASI score compared to 17.7% (6/34) in the control group (P=0.001, OR = 0.168, 95%) CI = [ 0.057, 0.492]). Significant improvement in itching was also observed (P = 3.94 × 10-4). In addition, at week 8, 33.3% (2/6) of patients with plaque parapsoriasis had a complete response to these chronic inflammatory skin conditions and 66.7% (4/6) had a partial response.

Results

Improve psoriasis
A total of 41 patients with psoriasis were assigned to the hydrogen water bath treatment group and 34 patients were assigned to the control group. Treatment groups were well balanced with respect to demographics and baseline characteristics (Table 1). Only one patient in the control group was discontinued due to lack of improvement during the week 2 study period and was counted as a non-responder in the control group. After 8 weeks of bath treatment, the reaction was obvious. At week 8, the mean Psoriasis Area Severity Index (PASI) score and mean Visual Analogue Score (VAS) score in the hydrogen water bath group were 5.8 and 0, respectively, significantly lower than the baseline scores (P=7.08 × 10-6 ; P = 2.42 × 10−5).

Table 1 Characteristics of the psoriasis patients.

From: Positive effects of hydrogen-water bathing in patients of psoriasis and parapsoriasis en plaques

The Hydrogen-water bathing groupThe control group
BaselineWeek 8BaselineWeek 8
No41413433
Sex(male/female)24/1724/1718/1618/15
Age40 ± 15 (18–78)40 ± 15 (18–78)39 ± 12 (18–72)39 ± 13 (18–72)
BMI23.8 ± 3.8 (17.5–35.5)23.7 ± 3.9 (17.2–35.6)23.1 ± 4.2 (15.5–31.4)23.0 ± 4.6 (15.3–31.4)
Waistline (cm)82.7 ± 10.3 (63.3–103.3)82.8 ± 9.8 (63.3–103.3)76.8 ± 8.7 (58.2–95.4)76.8 ± 8.9 (58.2–95.4)
PASI score9.8 ± 5.9 (1.4–25.2)5.8 ± 5.5 (0.2–25.2)8.5 ± 4.1 (2.8–23.8)7.9 ± 6.8 (0.8–34.5)
VAS score (median, range)2 (0–8)0 (0–4)0 (0–7)0 (0–9)
  1. PASI: Psoriasis Area Severity Index; VAS: the visual analog scale; BMI: Body Mass Index.

After 8 weeks of treatment, patients treated with the hydrogen water bath showed significantly greater improvement than those in the control group, as assessed by PASI and VAS (Table 2 and Figure 1). Compared with 2.9% of control patients, 24.4% of patients who received the hydrogen water bath achieved the endpoint of at least a 75% improvement in PASI score (Pc=0.022, OR=0.094, 95% CI = [0.011, 0.777]). In PASI was improved by at least 50% in 56.1% of the patients who received the bath, compared with only 17.7% in the control group (P=0.001, OR=0.168, 95% CI=[0.057, 0.492]). Hydrogen water bath treatment also resulted in a significant improvement in itching as measured by VAS. The median change from baseline to week 8 in the bathing group was -2, while the median change in the control group was 0 (P = 3.94 × 10-4).

Table 2 Summary of the improvement of Psoriasis Area and Severity Index (PASI) and visual analog scale (VAS) at week 8.

From: Positive effects of hydrogen-water bathing in patients of psoriasis and parapsoriasis en plaques

The Hydrogen-water bathing groupThe control groupP value
Baseline PASI scoreBaseline PASI score
MildModerateSevereTotalMildModerateSevereTotal
(N = 26)(N = 11)(N = 4)(N = 41)(N = 24)(N = 9)(N = 1)(N = 34)
PASI (%)>PASI901 (2.4)1 (2.4)02 (4.8)0000>0.05
>PASI755 (12.2)3 (7.3)2 (4.9)10 (24.4)1 (2.9)001 (2.9)0.022*
>PASI5013 (31.7)8 (19.5)2 (4.9)23 (56.1)4 (11.8)2 (5.9)06 (17.6)0.001
VAS improvement (%)≤−53 (7.3)0 (0)0.31*
≤−39 (22.0)1 (2.9)0.04*
<021 (51.2)7 (20.6)0.006
≥020 (48.8)27 (79.4)0.006
  1. *The corrected P (Pc) values were adjusted by using Yate’s correction for continuity.

figure 1

Clinical improvement in psoriasis after 8 weeks of hydrogen water bath treatment. Case 1: A 64-year-old patient with psoriasis at baseline (PASI 16.4, a, b) and after bath therapy (PASI 1.8, c, d). Despite treatment with 30 mg Acitretin capsules daily for more than 4 months, psoriatic lesions did not improve except for partially reduced scaling on the plaques. Due to unbearable dryness and ruptured mucous membranes, he refused to increase the dose of the drug. Case 2: A 40-year-old patient with psoriasis at baseline (PASI 21.1, a, b) and after last bath treatment (PASI 4.1, c, d). He complained of severe itching and treatment-resistant lesions (acitretin capsules 40 mg daily for 6+ months) and was able to reduce the dose after bath therapy. Case 3: A 43-year-old patient with psoriasis at baseline (PASI 20.2, a, b) and after last hydrotherapy (PASI 4.8, c, d). The man had been receiving 5 mg of methotrexate weekly for more than 10 months and was able to successfully reduce the dose after balneotherapy. Note that patients experienced similar responses in areas not shown.

Improvement in parapsoriasis in plaques
Six patients were included: 1 male and 5 females, with a mean age of 32.8 ± 4.9 (range: 25-40) years and a mean treatment duration of 34.4 ± 31.1 (range: 12-96) months. Four patients were classified as LPP and two were classified as SPP. The characteristics of the patients are shown in Table 3. Lesion morphology or distribution improved in all patients (Figure 2). Complete responses were observed in 33.3% (2/6) of patients and partial responses were observed in 66.7% (4/6).

Table 3 Characteristics and the clinical outcomes of patients with parapsoriasis en plaques.

From: Positive effects of hydrogen-water bathing in patients of psoriasis and parapsoriasis en plaques

PatientsSex/AgeType of parasporiasisDistribution at initial presentationMorphology at initial presentationDuration of disease (month)Clinical response at week 8
1F/40LPPtrunk and extremitiespatch, plaque25PR
2F/31LPPtrunkpapule, patch12PR
3F/33SPPtrunk and extremitiespapule, patch, plaque28PR
4F/33SPPtrunkpapule, patch15PR
5M/35LPPtrunk and extremitiespatch, plaque30CR
6F/25LPPtrunk and extremitiespatch, plaque96CR
  1. SPP: small plaque parapsoriasis; LPP: large plaque parapsoriasis; PR: partial response; CR: complete response.

figure 2

Clinical evaluation of a patient with plaque parapsoriasis who rapidly achieved complete remission after 4 weeks of hydrogen water bathing. A 35-year-old man with large plaque parapsoriasis was followed for 30 months, during which two biopsies were performed, neither showing progression. He had flare-ups after 10 months of narrow-band UVB therapy, and despite an increase in power, there was no significant improvement in the subsequent 6 months of phototherapy. Even after only 4 weeks, his lesions rapidly improved significantly without concomitant therapy (a). Hematoxylin-eosin staining showed mildly hyperkeratotic and partially parakeratotic epidermis with moderate density of superficial perivascular infiltrates. Lymphoid cells are mostly cytologically normal small lymphocytes, and there is focal unicellular epidermotropism (b).side effect. Two psoriasis patients complained about the temperature of hydrogen water. After adjusting the actual temperature based on patient satisfaction, the discomfort was alleviated. No other side effects were found during the study.

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