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Anheyer M, Cramer H, Ostermann T, Anheyer D. Herbal Medicine in Children and Adults With Atopic Dermatitis: A Systematic Review and Meta-Analysis. Dermatitis 2024. [PMID: 38963342 DOI: 10.1089/derm.2024.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
Herbal medicine is widely used for dermatological diseases, particularly atopic dermatitis. This study aims to systematically review existing literature on the efficacy of both topical and systemic herbal interventions for atopic dermatitis across various age groups. Conducting a comprehensive search on MEDLINE/PubMed, Scopus, and the Cochrane Central Register of Controlled Trials (Central) until April 12, 2023, only randomized controlled trials (RCTs) were included. The review is reported following the PRISMA guidelines and was conducted in accordance to Cochrane recommendations. Two authors independently extracted details, including demographics, medication, control/placebo groups, outcomes, adverse events, and results, with quality assessment using the Cochrane risk of bias tool 2.0. A meta-analysis, utilizing the random-effects model, was conducted, and publication bias was assessed through funnel plot inspection. The quality of evidence adhered to GRADE working group recommendations. The primary focus was evaluating atopic dermatitis or pruritus severity. The review encompassed 51 RCTs (3763 participants). Of these, 31 RCTs explored 19 distinct herbs and five complex remedies, whereas 20 RCTs (1088 participants) specifically investigated evening primrose oil (EPO). Herbs such as sunflower, licorice, figs, coconut, EPO, indigo naturalis, licorice, mauve, St. John's wort, and a combination of aloe vera and olive oil were found to have evidence of efficacy in the local treatment of atopic dermatitis. A meta-analysis on systemic used EPO, involving 13 RCTs, found no significant difference in atopic dermatitis severity compared with placebo (SMD: 0.14; 95% CI [-0.45; 0.73], 13 RCTs). In conclusion, this review provides a nuanced perspective on herbal substance efficacy for atopic dermatitis. While the EPO meta-analysis failed to show a discernible benefit beyond placebo, individual herbal preparations showed promising results in RCTs included in this review. Nevertheless, larger, methodologically rigorous studies are essential to establish evidence for herbal remedies in atopic dermatitis treatment.
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Affiliation(s)
- Melanie Anheyer
- From the Department for Pediatric and Adolescent Medicine, Elisabeth Hospital Essen, Essen, Germany
- Professorship of integrative pediatrics, Faculty of Health, University Witten/Herdecke, Witten/Herdecke, Germany
| | - Holger Cramer
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
| | - Thomas Ostermann
- Department of Psychology and Psychotherapy, Chair of Research Methodology and Statistics in Psychology, University Witten/Herdecke, Witten/Herdecke, Germany
| | - Dennis Anheyer
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
- Department of Psychology and Psychotherapy, Chair of Research Methodology and Statistics in Psychology, University Witten/Herdecke, Witten/Herdecke, Germany
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Baczynski AO, Pak C, Bain M. A case of melanonychia and stained plaques in a pediatric patient: consider potassium permanganate. Int J Dermatol 2024; 63:258-259. [PMID: 37920976 DOI: 10.1111/ijd.16897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/03/2023] [Accepted: 10/24/2023] [Indexed: 11/04/2023]
Affiliation(s)
| | - Christine Pak
- Department of Dermatology, University of Illinois in Chicago, Chicago, IL, USA
| | - Michelle Bain
- Department of Dermatology, University of Illinois in Chicago, Chicago, IL, USA
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Puglia LT, Lowry J, Tamagno G. Vitex agnus castus effects on hyperprolactinaemia. Front Endocrinol (Lausanne) 2023; 14:1269781. [PMID: 38075075 PMCID: PMC10702745 DOI: 10.3389/fendo.2023.1269781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 11/02/2023] [Indexed: 12/18/2023] Open
Abstract
Background Vitex agnus castus (VAC), also known as chaste tree, is a plant from the Mediterranean area, Crimea, and central Asia. Its fruit has been used for more than 2500 years as phytotherapic agent. In the last century, VAC has been mostly used for the treatment of premenstrual syndrome (PMS), menstrual irregularities, fertility disorders, and symptoms of menopause. Since some degree of hyperprolactinaemia may be observed in patients with such disorders, VAC effects on hyperprolactinaemia have been assessed in a small number of studies and in some patient series or single case reports. It has been postulated that the diterpenes contained in VAC extract may interact with dopamine D2 receptors (D2R) and inhibit prolactin release via dopamine D2R activation in the anterior pituitary. Most of the published papers focus on the use of VAC for the management of PMS or infertility. However, due to its action on D2R, VAC could have a role in the treatment of mild hyperprolactinaemia, including patients with idiopathic hyperprolactinaemia, microprolactinoma, drug-induced hyperprolactinaemia, or polycystic ovary syndrome. Methods We have reviewed and analysed the data from the literature concerning the use of VAC extracts in patients with hyperprolactinaemia. Results Some evidence suggests a possible role of VAC for the management of hyperprolactinaemia in selected patients, though in an inhomogeneous way. However, there are not any large randomized controlled trials supporting the same and the precise pharmacological aspects of VAC extract in such a clinical setting still remain obscure. Conclusion It appears that VAC may represent a potentially useful and safe phytotherapic option for the management of selected patients with mild hyperprolactinaemia who wish to be treated with phytotherapy. However, larger studies of high quality are needed to corroborate it.
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Affiliation(s)
- Lídice Tavares Puglia
- Department of Endocrinology/Diabetes Mellitus, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Jean Lowry
- Department of Endocrinology/Diabetes Mellitus, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Gianluca Tamagno
- Department of Medicine, Blackrock Clinic and Hermitage Clinic - Blackrock Health, Dublin, Ireland
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Filipiuc SI, Neagu AN, Uritu CM, Tamba BI, Filipiuc LE, Tudorancea IM, Boca AN, Hâncu MF, Porumb V, Bild W. The Skin and Natural Cannabinoids-Topical and Transdermal Applications. Pharmaceuticals (Basel) 2023; 16:1049. [PMID: 37513960 PMCID: PMC10386449 DOI: 10.3390/ph16071049] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/02/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
The chemical constituents of the Cannabis plant known as cannabinoids have been extensively researched for their potential therapeutic benefits. The use of cannabinoids applied to the skin as a potential method for both skin-related benefits and systemic administration has attracted increasing interest in recent years. This review aims to present an overview of the most recent scientific research on cannabinoids used topically, including their potential advantages for treating a number of skin conditions like psoriasis, atopic dermatitis, and acne. Additionally, with a focus on the pharmacokinetics and security of this route of administration, we investigate the potential of the transdermal delivery of cannabinoids as a method of systemic administration. The review also discusses the restrictions and difficulties related to the application of cannabinoids on the skin, emphasizing the potential of topical cannabinoids as a promising route for both localized and systemic administration. More studies are required to fully comprehend the efficacy and safety of cannabinoids in various settings.
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Affiliation(s)
- Silviu-Iulian Filipiuc
- Advanced Research and Development Center for Experimental Medicine (CEMEX), Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
- Department of Physiology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Anca-Narcisa Neagu
- Laboratory of Animal Histology, Faculty of Biology, "Alexandru Ioan Cuza" University of Iasi, Carol I bvd, No. 20A, 700505 Iasi, Romania
| | - Cristina Mariana Uritu
- Advanced Research and Development Center for Experimental Medicine (CEMEX), Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
| | - Bogdan-Ionel Tamba
- Advanced Research and Development Center for Experimental Medicine (CEMEX), Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
- Department of Pharmacology, Clinical Pharmacology and Algesiology, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
| | - Leontina-Elena Filipiuc
- Advanced Research and Development Center for Experimental Medicine (CEMEX), Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
- Department of Pharmacology, Clinical Pharmacology and Algesiology, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
| | - Ivona Maria Tudorancea
- Advanced Research and Development Center for Experimental Medicine (CEMEX), Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
- Department of Pharmacology, Clinical Pharmacology and Algesiology, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
| | - Andreea Nicoleta Boca
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | | | - Vlad Porumb
- Department Surgery, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
| | - Walther Bild
- Department of Physiology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Center of Biomedical Research of the Romanian Academy, 700506 Iasi, Romania
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Kim S, Lee YS, Yeo J, Lee D, Ko DK, Ha IH. Healthcare utilization for atopic dermatitis: An analysis of the 2010-2018 health insurance review and assessment service national patient sample data. PLoS One 2023; 18:e0286449. [PMID: 37363912 DOI: 10.1371/journal.pone.0286449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
This cross-sectional, retrospective, observational study aimed to analyze the distribution and healthcare usage patterns of patients with atopic dermatitis using the 2010-2018 Health Insurance Review and Assessment Service data. Patients diagnosed with atopic dermatitis in Korea between January 2010 and December 2018 and registered in the Health Insurance Review and Assessment national database were identified, and 270,008 patients who used healthcare services at least once during this period were evaluated to ascertain the healthcare usage patterns and treatment methods for atopic dermatitis. The number of patients with atopic dermatitis plateaued during the study period, while the number of claims and total expenses increased by a small margin. Atopic dermatitis prevalence was the highest among patients aged <5 years (31.4%), followed by those aged 5-14 years (23.53%) and 15-24 years (15.33%). However, the prevalence in these age groups showed a decreasing trend over time. The most used Western medicine treatments were injections and oral medications involving topical corticosteroids, antihistamine agents, and oral steroids, while it was acupuncture therapy in Korean medicine. The frequency of the most frequently prescribed medication, topical corticosteroid, showed a decreasing trend over time. The findings in this study will inform healthcare policy makers and clinicians across different countries on the usage trends of Western medicine and Korean medicine treatment.
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Affiliation(s)
- Sowon Kim
- Jaseng Hospital of Korean Medicine, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Ye-Seul Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Jiyoon Yeo
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Donghyo Lee
- Department of Ophthalmology, Otolaryngology, and Dermatology, College of Korean Medicine, Woo-Suk University, Jeonju, Korea
| | - Dong Kun Ko
- Jayeonsaeng Korean Medicine Clinic, Yongin, Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
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Al-Atif HM, AL-Ghamdi HS, Alzubaidi WA, Alnaem NM, Qahtani SH. The Prevalence of Complementary and Alternative Medications Use Among Dermatology Patients in Aseer Region, Saudi Arabia. Clin Cosmet Investig Dermatol 2022; 15:2607-2615. [PMID: 36510606 PMCID: PMC9738093 DOI: 10.2147/ccid.s381199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022]
Abstract
Purpose The utilization rate of complementary and alternative medication (CAM) is on the rise, especially for the general population. Despite the lack of scientific support, CAM has been used for decades and is more often used among chronic patients. This research examines the prevalence of CAM use in dermatology patients in the area of Aseer, Saudi Arabia. Materials and Methods This research was done using a descriptive hospital-based cross-sectional survey among adults who attended the dermatological clinics at the major hospitals in the Aseer area of Southern Saudi Arabia. The dermatology outpatients were approached individually and were asked to fill out a survey about their usage of CAM therapies in the preceding year. The questionnaire included questions on patients' socio-demographic data and clinical data on their dermatological condition, including duration and the effect on their daily life. The occurrence and pattern of CAM use and the type of CAM utilized were also examined. Results 353 dermatological patients filled out the study questionnaire. Patients varied in age from 18 to above 60 years, with an average of 26.1 ± 12.9 years. 203 (57.5%) patients were females. 120 (34%) of the study patients reported using folk medicine with doctor medication for their dermatological disorder, 84 (23.8%) used folk medicine and stopped using medications prescribed by a doctor, while 149 (42.2%) never used folk medicine. The most used CAM was olive oil (22%), followed by sidr (21%), honey (19%), cactus (15%), henna (14%), and garlic (13%). Conclusion More than half of the participants in this study used CAM, with nearly 1 out of 5 patients not using the medications prescribed by their physicians. Females with long-lasting diseases were the main users who reported using a variety of CAMs. Satisfactory results were experienced by nearly half of the patients.
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Affiliation(s)
- Hend M Al-Atif
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha City, Kingdom of Saudi Arabia,Correspondence: Hend M Al-Atif, Tel +966556464612, Email
| | - Hasan S AL-Ghamdi
- Internal Medicine Department, Division of Dermatology, Faculty of medicine, Albaha University, Albaha City, Kingdom of Saudi Arabia
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Aravind P, Adikrishna S, Sarvesh S, Ragupathi R, Rajesh G, Rema Premi R, Rajanandh M. Pattern of Complementary and Alternative Medicines Use in Patients with Chronic Dermatological Conditions. JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.3923/jms.2022.73.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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>Saxena A, Dey V, Srivastava P, Hemnani S, Kushwaha S, Sharma S. Treatment-seeking behavior of patients attending department of dermatology in a tertiary care hospital and their impact on disease. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_123_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Elzahrani M, Aleid A, Alhwimani A, Altamamy S, Almalki R, AlKushi A, AlJasser M, Feroz Z. Perceptions, knowledge, and attitudes toward complementary and alternative medicine among Saudi patients with vitiligo. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2020. [DOI: 10.15570/actaapa.2020.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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10
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Abstract
Dermatology patients are expressing a growing interest in complementary and alternative medicine (CAM) and natural treatment options for management of dermatologic conditions. Counseling on the optimal integration of CAM with conventional therapeutic approaches can be daunting for practitioners who do not feel well-versed in these modalities. A productive conversation between the clinician and patient seeking natural treatments should address the appropriate role and scope of CAM in a therapeutic plan, which is best suited for use as maintenance therapy or to augment traditional pharmaceutical or procedural interventions. Understanding the patient's goals, discussing evidence-based conventional and complementary treatment options, and employing shared decision making can enhance the clinical encounter and strengthen the physician-patient relationship.
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Affiliation(s)
- Aunna Pourang
- Department of Dermatology, University of California-Irvine College of Medicine, Irvine, California, USA; Department of Dermatology, University of California-Davis School of Medicine, Sacramento, California, USA
| | | | - Vivian Y Shi
- Department of Medicine, Division of Dermatology, University of Arizona College of Medicine, Tucson, Arizona, USA.
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11
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Gamret AC, Price A, Fertig RM, Lev-Tov H, Nichols AJ. Complementary and Alternative Medicine Therapies for Psoriasis: A Systematic Review. JAMA Dermatol 2019; 154:1330-1337. [PMID: 30193251 DOI: 10.1001/jamadermatol.2018.2972] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Importance Up to 51% of patients with psoriasis report the use of complementary and alternative medicine (CAM) in their treatment regimen, although it is unclear which CAM therapies are effective for treatment of psoriasis. Objective This review compiles the evidence on the efficacy of the most studied CAM modalities for treatment of patients with plaque psoriasis and discusses those therapies with the most robust available evidence. Evidence Review PubMed, Embase, and ClinicalTrials.gov searches (1950-2017) were used to identify all documented CAM psoriasis interventions in the literature. The criteria were further refined to focus on those treatments identified in the first step that had the highest level of evidence for plaque psoriasis with more than 1 randomized clinical trial supporting their use. This excluded therapies lacking randomized clinical trial (RCT) data or showing consistent inefficacy. Findings Primary CAM therapy searches identified 457 articles, of which 107 articles were retrieved for closer examination. Of those articles, 54 were excluded because the CAM therapy did not have more than 1 RCT on the subject or showed consistent lack of efficacy. An additional 7 articles were found using references of the included studies, resulting in a total of 44 RCTs (17 double-blind, 13 single-blind, and 14 nonblind), 10 uncontrolled trials, 2 open-label nonrandomized controlled trials, 1 prospective controlled trial, and 3 meta-analyses. Compared with placebo, application of topical indigo naturalis, studied in 5 RCTs with 215 participants, showed significant improvements in the treatment of psoriasis. Treatment with curcumin, examined in 3 RCTs (with a total of 118 participants), 1 nonrandomized controlled study, and 1 uncontrolled study, conferred statistically and clinically significant improvements in psoriasis plaques. Fish oil treatment was evaluated in 20 studies (12 RCTs, 1 open-label nonrandomized controlled trial, and 7 uncontrolled studies); most of the RCTs showed no significant improvement in psoriasis, whereas most of the uncontrolled studies showed benefit when fish oil was used daily. Meditation and guided imagery therapies were studied in 3 single-blind RCTs (with a total of 112 patients) and showed modest efficacy in treatment of psoriasis. One meta-analysis of 13 RCTs examined the association of acupuncture with improvement in psoriasis and showed significant improvement with acupuncture compared with placebo. Conclusions and Relevance The CAM therapies with the most robust evidence of efficacy for treatment of psoriasis are indigo naturalis, curcumin, dietary modification, fish oil, meditation, and acupuncture. This review will aid practitioners in advising patients seeking unconventional approaches for treatment of psoriasis.
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Affiliation(s)
- A Caresse Gamret
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida
| | - Alexandra Price
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida
| | - Raymond M Fertig
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida
| | - Hadar Lev-Tov
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida
| | - Anna J Nichols
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida
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Holm J, Clausen ML, Agner T, Thomsen S. Use of Complementary and Alternative Therapies in Outpatients with Atopic Dermatitis from a Dermatological University Department. Dermatology 2019; 235:189-195. [DOI: 10.1159/000496274] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 12/14/2018] [Indexed: 11/19/2022] Open
Abstract
Background: Treatment of atopic dermatitis (AD) may be challenging, therefore some patients seek complementary and alternative medications (CAM). We determined prevalence and predictors for CAM use in a hospital cohort of AD patients. Material and Methods: Between January 1, 2012, and December 31, 2017, AD patients referred to the dermatological outpatient clinic at Bispebjerg Hospital were included in the study. Information on CAM use, demographics and disease characteristics were obtained by questionnaire, and associations were determined by χ2 and t test separately for children (< 16 years) and adults (≥16 years). Results: In total 441 filled in the questionnaire on AD, and 433 patients responded to the questions about CAM use: 198 children and 235 adults. A total of 137 (31.6%) had used one or more CAM. CAM use in children was significantly associated with prior use of ≥2 conventional treatments (p = 0.047) and topical calcineurin inhibitors (p = 0.021), a higher number of affected eczema sites (p < 0.001) including more frequent affection of the face and extremities, a higher SCORAD score (p = 0.045), and low mean overall self-rated health (p = 0.003). CAM use in adults was significantly associated with lower age of onset of AD (p = 0.004), comorbid allergic rhinoconjunctivitis (p = 0.039), frequent use of moisturizing cream (p = 0.024), facial and neck eczema (p = 0.005) and high educational level (p = 0.043). Conclusion: CAM use is frequent in both children and adult AD patients. CAM users are characterized by long disease duration, a significant disease burden and by having a longer education. The high prevalence of CAM may indicate that patients’ expectations regarding treatment of AD are not redeemed in the conventional health care system.
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Sun W, Gao Y, Yu X, Yuan Y, Yi J, Zhang Z, Cheng Y, Li Y, Peng X, Cha X. 'Psoriasis 1' reduces psoriasis‑like skin inflammation by inhibiting the VDR‑mediated nuclear NF‑κB and STAT signaling pathways. Mol Med Rep 2018; 18:2733-2743. [PMID: 30015892 PMCID: PMC6102645 DOI: 10.3892/mmr.2018.9262] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 02/06/2018] [Indexed: 12/23/2022] Open
Abstract
‘Psoriasis 1’, a Chinese herbal medicine (CHM) formulation, is extensively used to treat psoriasis in China. Although this CHM formulation yields good therapeutic effect, the underlying mechanism of how this works remains unknown. The present study aimed to test the hypothesis that the CHM formulation ‘psoriasis 1’ inhibits vitamin D receptor (VDR)-mediated inflammation in psoriasis. To test this, a model of psoriasis was established by stimulating keratinocytes (HaCaT cells) with tumor necrosis factor (TNF)-α; these cells were subsequently transfected with a lentiviral VDR RNA interference expression vector. The expression levels of 25-hydroxyvitamin D3 (25HVD3), TNF-α, interleukin (IL)-4, IL-1, IL-17C, IL-23 and IL-6 were measured using ELISA, and the expression levels of VDR, inhibitor of nuclear factor (NF)-κB (IKK), NF-κB, signal transducer and activator of transcription (STAT) 3 and STAT4 were measured using reverse transcription-quantitative polymerase chain reaction analysis and western blotting. It was observed that ‘psoriasis 1’ downregulated the concentrations of TNF-α, IFN-γ, IL-22, IL-17C, IL-1β and IL-4, and upregulated the concentration of 25HVD3; furthermore, ‘psoriasis 1’ downregulated the expression levels of NF-κB, phosphorylated (p)-NF-κB, IKK, p-IKK, STAT3, p-STAT3, STAT4 and p-STAT4, and upregulated the expression level of VDR in TNF-α-induced HaCaT cells. These results suggested that ‘psoriasis 1’ suppressed the inflammatory response and the activation of the NF-κB and STAT signaling pathways. In addition, it was identified that silencing VDR expression decreased the levels of TNF-α, IFN-γ, IL-22, IL-17C, IL-1β and IL-4, and increased the level of 25HVD3; silencing VDR expression additionally downregulated the expression levels of NF-кB, p-NF-кB, IKK, p-IKK, STAT3, p-STAT3, STAT4 and p-STAT4, and upregulated the level of VDR in TNF-α-induced HaCaT cells. It was concluded that ‘psoriasis 1’ exerts inflammation-suppressive effects in psoriasis by suppressing the NF-кB and STAT signaling pathways.
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Affiliation(s)
- Wen Sun
- Department of Dermatology, The First People's Hospital of Jingmen, Jingmen, Hubei 448000, P.R. China
| | - Yang Gao
- Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China
| | - Xianhua Yu
- Department of Dermatology, The First People's Hospital of Jingmen, Jingmen, Hubei 448000, P.R. China
| | - Yuan Yuan
- Department of Anesthesiology, The First People's Hospital of Jingmen, Jingmen, Hubei 448000, P.R. China
| | - Jun Yi
- Department of Vascular Surgery, The First People's Hospital of Jingmen, Jingmen, Hubei 448000, P.R. China
| | - Zhen Zhang
- Department of Spine Surgery, Shenzhen Baoan Shajing People's Hospital, Shenzhen, Guangdong 518104, P.R. China
| | - Yuxing Cheng
- Department of Surgery, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China
| | - Yong Li
- Department of Dermatology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China
| | - Xing Peng
- Department of Dermatology, The First People's Hospital of Jingmen, Jingmen, Hubei 448000, P.R. China
| | - Xushan Cha
- Department of Dermatology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China
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Tirant M, Lotti T, Gianfaldoni S, Tchernev G, Wollina U, Bayer P. Integrative Dermatology - The Use of Herbals and Nutritional Supplements to Treat Dermatological Conditions. Open Access Maced J Med Sci 2018; 6:185-202. [PMID: 29484023 PMCID: PMC5816298 DOI: 10.3889/oamjms.2018.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/27/2017] [Accepted: 10/29/2017] [Indexed: 01/15/2023] Open
Abstract
From humble beginnings at the dawn of time to it's advanced and successful status today, this essay traces the history of natural medicine and the development of integrated dermatology to what it is today. Some of the most well-known natural (international and Australian) products with an application in dermatology are discussed. The history and functions of the Psoriasis Eczema Clinic and the products developed by its founder, Prof. Michael Tirant, are explained.
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Affiliation(s)
- Michael Tirant
- Psoriasis & Skin Clinic, 374 Nepean Highway Frankston Victoria, Melbourne 3199, Australia
| | - Torello Lotti
- University G. Marconi of Rome - Dermatology and Venereology, Rome, Italy
| | - Serena Gianfaldoni
- University G. Marconi of Rome - Dermatology and Venereology, Rome, Italy
| | - Georgi Tchernev
- Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria
- ”Onkoderma”- Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
| | - Uwe Wollina
- Städtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen, Germany
| | - Philip Bayer
- Psoriasis & Skin Clinic, 374 Nepean Highway Frankston Victoria, Melbourne 3199, Australia
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The use of complementary medicine among acne valguris patients: Cross sectional study. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2017. [DOI: 10.1016/j.jdds.2017.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Traditional Chinese Medicine Use among Patients with Psoriasis in Taiwan: A Nationwide Population-Based Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:3164105. [PMID: 27822287 PMCID: PMC5086381 DOI: 10.1155/2016/3164105] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/05/2016] [Indexed: 12/18/2022]
Abstract
Traditional Chinese medicine (TCM) has long been used for patients with psoriasis. This study aimed to investigate TCM usage in patients with psoriasis. We analyzed a cohort of one million individuals representing the 23 million enrollees randomly selected from the National Health Insurance Research Database in Taiwan. We identified 28,510 patients newly diagnosed with psoriasis between 2000 and 2010. Among them, 20,084 (70.4%) patients were TCM users. Patients who were female, younger, white-collar workers and lived in urbanized area tended to be TCM users. The median interval between the initial diagnosis of psoriasis to the first TCM consultation was 12 months. More than half (N = 11,609; 57.8%) of the TCM users received only Chinese herbal medicine. Win-qing-yin and Bai-xian-pi were the most commonly prescribed Chinese herbal formula and single herb, respectively. The core prescription pattern comprised Mu-dan-pi, Wen-qing-yin, Zi-cao, Bai-xian-pi, and Di-fu-zi. Patients preferred TCM than Western medicine consultations when they had metabolic syndrome, hepatitis, rheumatoid arthritis, alopecia areata, Crohn's disease, cancer, depression, fatty liver, chronic airway obstruction, sleep disorder, and allergic rhinitis. In conclusion, TCM use is popular among patients with psoriasis in Taiwan. Future clinical trials to investigate its efficacy are warranted.
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MANSOURI P, KHADEMI A, PAHLEVAN D, MEMARIANI Z, ALIASL J, SHIRBEIGII L. Review of Medicinal Remedies on Hand Eczema Based on Iranian Traditional Medicine: A Narrative Review Article. IRANIAN JOURNAL OF PUBLIC HEALTH 2016; 45:986-996. [PMID: 27928524 PMCID: PMC5139979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Hand Eczema (HE) is a dermatological disorder with frequent relapses and multiple causes such as atopic, allergic and irritant contact dermatitis. The management is complex because of the wide range of different pathogenesis. Efficacy of some of available treatments is not well established and it can affect patients' quality of life significantly. METHODS Reports on HE such as diagnosis, pathophysiology, pharmacological and nonpharmacological therapy that described in medieval Iranian medicine, were gathered and analyzed from selected medical and pharmaceutical textbooks of Iranian Traditional Medicine (ITM). The search of databases such as PubMed, EMBASE/Excerpta Medica, Science direct, Scopus, Google scholar, Web of science, Sid, Iran medex, Irandoc, was performed to reconfirm the efficacy of ITM remedies in conventional medicine from 1980-Jan-1 to 2015-Dec-30. RESULTS According to their opinion, HE is highly associated with liver function. This disorder was categorized into two main types as wet and dry ones. Most Iranian textbook explained signs of HE, as excessive skin itching, redness, burning and dryness. Treatments recommended by Iranian scientists were lifestyle modification, dietary intervention and performing the rules of prevention as well as herbal therapy and special manipulations. CONCLUSION Iranian practitioners believed that, six essential principles, diet therapy and medicinal plants have high impact on treatment of HE. These remedies based on Iranian scholar's experiences might be useful for further studies to the management of HE.
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Affiliation(s)
- Parvin MANSOURI
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Aleme KHADEMI
- Dept. of Iranian Traditional Medicine, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Daryoush PAHLEVAN
- Research Center for Social Determinants of Health, Semnan University of Medical Sciences, Semnan, Iran
| | - Zahra MEMARIANI
- Dept. of Traditional Pharmacy, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Jale ALIASL
- The Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Laila SHIRBEIGII
- Dept. of Iranian Traditional Medicine, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author:
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Müller SM, Tomaschett D, Euler S, Vogt DR, Herzog L, Itin P. Topical Corticosteroid Concerns in Dermatological Outpatients: A Cross-Sectional and Interventional Study. Dermatology 2016; 232:444-52. [PMID: 27322385 DOI: 10.1159/000446068] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 04/11/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Topical corticosteroid concerns (TCC) are an important issue in patients with atopic dermatitis, leading to non-adherence with poor disease control and increased health care costs. However, neither the prevalence of TCC in a more comprehensible dermatological population nor the impact of patient information on topical corticosteroids given by clinicians is known. Therefore, we assessed the prevalence, characteristics, and sources of TCC in a dermatological population and the impact of written and oral patient information on TCC. METHODS A total of 643 outpatients with various skin diseases answered a 12-item questionnaire while waiting for the doctor's visit. Patients with TCC quantified their concerns on a discrete visual analogue scale before and after patient information, which consisted of written and oral information about topical corticosteroids (TCS) given by dermatologists. RESULTS The prevalence of TCC was 41.5%, and that of TCC-related non-adherence was 28.3%. TCC was positively associated with age <60 years, female gender, use of complementary and alternative medicine (CAM) and non-physician health care profession. The leading concerns were skin atrophy, systemic effects, and impairment of the immune system. The most frequent sources of TCC were negative reports by media, family, or friends. Both written and oral patient information significantly reduced TCC. The number needed to benefit from patient information was approximately 2. Non-responders were more often female, TCS-inexperienced, and users of CAM with an intermediate level of education. CONCLUSIONS TCC are highly prevalent in dermatological patients. Patient information may lower TCC in almost every second patient.
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Affiliation(s)
- Simon M Müller
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
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Talbott W, Duffy N. Complementary and alternative medicine for psoriasis: what the dermatologist needs to know. Am J Clin Dermatol 2015; 16:147-65. [PMID: 25904522 DOI: 10.1007/s40257-015-0128-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Complementary and alternative medicine (CAM) use is common among patients with psoriasis. CAM modalities include traditional Chinese medicine (TCM), herbal therapies, dietary supplements, climatotherapy, and mind/body interventions. In this review, evidence from clinical trials investigating the efficacy of CAM for psoriasis is reviewed. There is a large amount of evidence from controlled trials that have shown that the combination of TCM with traditional therapies for psoriasis is more efficacious than traditional therapies alone. Herbal therapies that have the most evidence for efficacy are Mahonia aquifolium and indigo naturalis, while there is a smaller amount of evidence for aloe vera, neem, and extracts of sweet whey. Dietary supplementation in patients with psoriasis demonstrates consistent evidence supporting the efficacy of fish oil supplements. Zinc supplementation has not been shown to be effective; however, some evidence is available (albeit conflicting) for vitamin D, vitamin B12, and selenium supplementation. Overwhelming evidence supports the effectiveness of Dead Sea climatotherapy. Finally, mindfulness-based stress reduction can be helpful as adjuvant treatment of psoriasis. There are potential benefits to these modalities, but also potential side issues. Concerns with CAM include, but are not limited to, contamination of TCM products with heavy metals or corticosteroids, systemic toxicity or contact dermatitis from herbal supplements, and ultraviolet light-induced carcinomas from climatotherapy. Dermatologists should be aware of these benefits and side effects to allow for informed discussions with their patients.
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