Butler Glenn, Michaels Julio Chávarri, Al-Waili Noori, Finkelstein Michael, Allen Michael, Petrillo Richard, Carrey Zev, Kolanuvada Bangaruraju, Lee Bok Y, Riera Alfonso Gonzales, Michaels Cesar Chávarri, Urteaga Gary
J Med Case Rep. 2009 Aug 10;3:7023. doi: 10.1186/1752-1947-0003-0000007023.
Psoriasis is an inflammatory and immunological cutaneous disease. The high morbidity in patients with psoriasis results from severe clinical manifestations and/or adverse effects of treatment. The Undersea and Hyperbaric Medical Society and Federal Medicare and Medicaid Services have approved the use of hyperbaric oxygen (HBO(2)) for more than 15 indications, including wound healing, infections and late effects of radiation, which are largely unresponsive to conventional treatments. Accumulated data show that HBO(2) has anti-inflammatory effects and other positive influences on the immune system, making it a rational treatment in the management of psoriasis plaques and arthritis.
We present the cases of two patients with long histories of psoriasis vulgarus who exhibited marked improvement with use of HBO(2.) The first patient was 40 years old and had pustular psoriasis and psoriatic arthritis. He was treated with six sessions of HBO(2) (at 2.8 atmospheres of pressure for 60 minutes), which successfully controlled his symptoms. At the 18-month post-treatment follow up, the patient exhibited complete remission of psoriasis and marked improvement in psoriatic arthritis without medication. The second patient was 55 years old with extensive psoriatic lesions, and exhibited marked improvement within 15 sessions of HBO(2). No adverse effects of HBO(2) were identified.
HBO(2) may possess potential therapeutic efficacy in the management of psoriasis. We outline the pathogenesis of psoriasis and the selective anti-inflammatory and immunosuppressive effects of HBO(2). We hope that this will provide a basis for elucidating the mechanisms of action and consequently pave the way for further controlled studies.
银屑病是一种炎症性和免疫性皮肤病。银屑病患者的高发病率源于严重的临床表现和/或治疗的不良反应。水下和高压医学协会以及联邦医疗保险和医疗补助服务中心已批准将高压氧（HBO₂）用于15种以上的适应症，包括伤口愈合、感染和辐射后遗症，这些病症对传统治疗大多无反应。积累的数据表明，HBO₂具有抗炎作用以及对免疫系统的其他积极影响，使其成为治疗银屑病斑块和关节炎的合理选择。
我们报告了两名寻常型银屑病病史较长的患者，他们使用HBO₂后病情有显著改善。第一名患者40岁，患有脓疱型银屑病和银屑病关节炎。他接受了6次HBO₂治疗（在2.8个大气压下持续60分钟），成功控制了症状。在治疗后18个月的随访中，患者银屑病完全缓解，银屑病关节炎在未用药的情况下有显著改善。第二名患者55岁，有广泛的银屑病皮损，在接受15次HBO₂治疗后有显著改善。未发现HBO₂的不良反应。
HBO₂在银屑病治疗中可能具有潜在的治疗效果。我们概述了银屑病的发病机制以及HBO₂的选择性抗炎和免疫抑制作用。我们希望这将为阐明其作用机制提供依据，并因此为进一步的对照研究铺平道路。
