Psoriasis is a chronic inflammatory skin disease. It is associated with changes in
skin microbiome. The aim of this study was to evaluate how Lake Hévíz sulfur thermal
water influences the composition of microbial communities that colonizes skin in patients
with psoriasis. Our secondary objective was to investigate the effects of balneotherapy
on disease activity. In this open label study, participants with plaque psoriasis
underwent 30-min therapy sessions in Lake Hévíz, at a temperature of 36 °C, five times
a week for 3 weeks. The skin microbiome samples were collected by swabbing method
from two different areas (lesional skin-psoriatic plaque and non-lesional skin). From
16 patients, 64 samples were processed for a 16S rRNA sequence-based microbiome analysis.
Outcome measures were alpha-diversity (Shannon, Simpson, and Chao1 indexes), beta-diversity
(Bray–Curtis metric), differences in genus level abundances, and Psoriasis Area and
Severity Index (PASI). Skin microbiome samples were collected at baseline, and immediately
after treatment. Based on the visual examination of the employed alpha- and beta-diversity
measures, no systematic difference based on sampling timepoint or sample location
could be revealed in these regards. Balneotherapy in the unaffected area significantly
increased the level of Leptolyngbya genus, and significantly decreased the level of
Flavobacterium genus. A similar trend was revealed by the results of the psoriasis
samples, but the differences were not statistically significant. In patients with
mild psoriasis, a significant improvement was observed in PASI scores.
