{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T20:18:38Z","timestamp":1788466718508,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Photoderm Photoimm Photomed"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Purpose<\/jats:title>\n                    <jats:p>Bath or oral PUVA is a key treatment modality for palmoplantar pustulosis (PPP), whereas topical PUVA and UVB have proven ineffective. Immersion in water prior to UVA may represent a therapeutic option.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      This study was a prospective, open label, three\u2010arm parallel\u2010group randomized controlled trial conducted from 2014 to 2017. The study was conducted in Ankara University Medical School Department of Dermatology and Venereology. The ethical committee approval was granted (07.10.2013\u2010 no 15\u2010585\u201013) and the trial registration number was NCT06458868. All participants had a biopsy with a confirmed diagnosis of PPP. The primary endpoint of the study was defined as having achieved a PPASI50 response at week 36. Out of 114 eligible patients, 68 patients were enrolled in the study. Randomization was performed using a computer program (clinstat). All arms received UVA irradiation for 36 sessions starting at 0.25\u2009J\/cm\n                      <jats:sup>2<\/jats:sup>\n                      with incremental increases. Bath PUVA arm: Local baths with water containing 0.5\u2009mg methoxypsoralen per litre at 37\u00b0C for 20\u2009min prior to phototherapy. Tap Water (TW) Group received local baths in tap water, Saltwater (SW) Group received local baths in 25% w\/v saline solution, both at 37\u00b0C for 20\u2009min prior to phototherapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 68 enrolled participants, 50 completed the study (F\/M: 43\/7, age: 47.8\u2009\u00b1\u200910.3\u2009years). In the intention to treat set, PPASI\u201050 response rates were 38.5%, 57.1%, and 71.4% in the TW, SW, and bath\u2010PUVA groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.085). In the per protocol set, corresponding rates were 52.6%, 85.7%, and 88.2% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immersion in water or saltwater prior to UVA without psoralens may provide a therapeutic effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/phpp.70081","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T18:44:08Z","timestamp":1771526648000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Randomized Clinical Trial: The Comparative Therapeutic Efficacy of Tap Water\u2010\n                    <scp>UVA<\/scp>\n                    , Saltwater\u2010\n                    <scp>UVA<\/scp>\n                    , and Conventional Bath\n                    <scp>PUVA<\/scp>\n                    in Palmoplantar Pustulosis"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4746-1675","authenticated-orcid":false,"given":"Hilayda Karak\u00f6k","family":"K\u0131\u015fla","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology Ankara University Medical School  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"G\u00fcndo\u011fdu","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Ankara University Medical School  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9431-2125","authenticated-orcid":false,"given":"Ay\u015fenur","family":"Botsal\u0131","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Ankara University Medical School  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130rem","family":"Kar","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Ankara University Medical School  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nihal","family":"Kundak\u00e7\u0131","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Ankara University Medical School  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cengizhan","family":"Erdem","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Ankara University Medical School  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.11.910"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/09546631003636817"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12223"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14386"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1067\/S0190-9622(03)01479-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-024-00849-0"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2147\/PTT.S400402"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12272"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12561"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.1990.tb03713.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1991.tb04955.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-3083.2000.00102-4.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2023.11.053"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.143.5.586"},{"issue":"2","key":"e_1_2_8_16_1","first-page":"202","article-title":"Dermatology Quality of Life Scales\u2013a Measure of the Impact of Skin Diseases","volume":"136","author":"Morgan M.","year":"1997","journal-title":"British Journal of Dermatology"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v050.i12"},{"issue":"5","key":"e_1_2_8_18_1","first-page":"1","article-title":"Dunn Test: Dunn's Test of Multiple Comparisons Using Rank Sums","volume":"1","author":"Dinno A.","year":"2017","journal-title":"R Package Version"},{"key":"e_1_2_8_19_1","unstructured":"R.Scherer R.Scherer andR.Scherer \u201cPropCIs: Various Confidence Interval Methods for Proportions. 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