Clinical Efficacy of Whole-Body Aerocryotherapy in Combination with Phototherapy in Psoriasis

Background. Psoriasis is often resistant to standard treatment methods, and relapses frequently occur even after a full course of phototherapy. Whole-body cryotherapy may serve as an additional method that could enhance the effectiveness of psoriasis therapy. Of particular interest is its potential effect on reducing VEGF levels and vascularization in psoriatic plaques, which could strengthen the efficacy of PUVA therapy, result in a more pronounced therapeutic response, and provide longer remission after the main treatment course. The combined use of PUVA therapy and whole-body cryotherapy (WBC) may therefore represent a promising pathogenetic approach in psoriasis treatment.

Objective. To evaluate the comparative effectiveness of combined PUVA therapy and whole-body cryotherapy in patients with psoriasis.

Materials and Methods. The study included 40 patients with moderate plaque psoriasis. Group 1 (n=20) received standard therapy according to clinical guidelines in combination with PUVA therapy. Group 2 (n=20) received standard therapy in combination with PUVA therapy and WBC. The following parameters were assessed: changes in PASI and DLQI scores, vascular endothelial growth factor (VEGF) levels, and microcirculation within psoriatic plaques using non-invasive laser Doppler flowmetry (LDF) with a Lazma MC-1 analyzer (NPP “Lazma”, Russia).

Results. After treatment, the median PASI was lower in the combined therapy group (4.0 vs. 6.0; p=0.048), with a relative PASI reduction of 75.0% vs. 62.5% (p=0.003). PASI dynamics were also significantly greater (11.75 ± 3.26 vs. 9.60 ± 3.22; p=0.042). No intergroup differences in DLQI were found after therapy (p=0.558), although the degree of improvement was more pronounced with PUVA+WBC (8.80 ± 3.27 vs. 6.30 ± 2.70; p=0.012). VEGF reduction was significantly greater in the combined therapy group (39.0 [30.25–76.75] vs. 20.0 [7.25–23.65]; p<0.001). LDF data showed decreased perfusion in both groups, with significantly lower final values in PUVA+WBC patients (9.58 ± 2.27 vs. 11.41 ± 2.83; p=0.030). The dynamics of σ were also more pronounced in the combined treatment group (1.18 vs. 0.51; p=0.023), indicating stabilization of microcirculation. Kv values did not differ significantly (p>0.3).

Conclusion. This study presents comparative results of combined PUVA therapy and WBC in patients with mild to moderate psoriasis. The addition of WBC to standard PUVA therapy enhances therapeutic effectiveness, as evidenced by a greater reduction in PASI, significant improvement in quality of life, a marked decrease in VEGF levels, and normalization of microcirculation parameters compared with PUVA monotherapy.