[Physical therapy of psoriasis. The modern methodological approaches].

This article describes the modern approaches to the application of physical factors for the treatment of various forms of psoriasis taking into consideration the severity of clinical manifestations and the phase of the disease, the extent of disturbances of the functional state of different organs. The principles of prescription of physiotherapeutictreatmnt are formulated taking account of the stages and forms of the disease. Special attention is paid to the high therapeutic effectiveness of ultraviolet irradiation of the skin including narrow-band UVВ (311 nm) as well as to photodynamic therapy (PUVA), intravenous laser irradiation of blood, and ozone therapy. Also considered is the spa and health resort-based treatment and peloid therapy at various stages of the pathological process. The application of the combined techniques is described with special reference to radon and hydrogen sulfide baths and microwave therapy in the patients presenting with psoriatic arthritis. Much attention is given to the effectiveness of the prescription of the spa and health resort-based treatment at the stationary and regressive stages of psoriasis. The pathogenetic mechanisms underlying the therapeutic action of the physical factors used for the treatment of patients suffering from psoriasis are discussed.

[The application of intravenous laser irradiation of the blood for the combined treatment of psoriasis].

The objective of the present comparative study was to estimate the efficacy of the treatment of 104 patients presenting with psoriasis with the use of PUVA therapy and intravenous laser irradiation of the blood or the combination of the two methods. It was shown that the latter treatment caused a faster reduction of the inflammatory processes than the former whereas their joint application was especially efficacious in inducing regression of concomitant infiltrative events. Erythrocytes from the patients undergoing intravenous laser irradiation of the blood were characterized by the enhanced activity of antioxidative enzymes that are known to play an important role in the cellular protection from oxidants. At the same time, PUVA therapy caused no appreciable changes in the antioxidtive status. Both treatments increased the levels of antiinflammatory cytokines and decreased those ofproinflammatory ones which suggests their immunomodulatory effect that was especially pronounced in the case of combined therapy. It is concluded that the introduction of intravenous laser irradiation of the blood in the combined treatment of psoriatic patients exerts positive effect on compromised immunoregulation, stimulates the antioxidative system, and improves microcirculation.