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- Turmeric (Curcuma longa, Zingiberaceae)
- Plaque Psoriasis
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Date:
01-29-2016 | HC# 011621-537
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Re: Topical Application of Turmeric Extract Reduces the Severity of Psoriasis Lesions
Sarafian
G, Afshar M, Mansouri P, Asgarpanah J, Raoufinejad K, Rajabi M. Topical turmeric microemulgel in the management
of plaque psoriasis; a clinical evaluation. Iran J Pharm Res. Summer
2015;14(3):865-876.
Plaque psoriasis is an autoimmune,
inflammatory skin disorder that causes patches of inflamed, thickened skin
lesions. Many patients with psoriasis have other inflammatory disorders, such
as metabolic syndrome, Crohn's disease, and cardiovascular disease. Mildly to
moderately severe psoriasis is often treated effectively with prescription
topical and systemic medications. Topical medications may have undesirable side
effects, which include burning, atrophy, and staining of skin and clothes. Turmeric
(Curcuma longa, Zingiberaceae) has
been used in traditional medicine and found to have anti-inflammatory,
antimicrobial, and antioxidant properties. Turmeric extract can decrease the
cytokine pro-inflammatory response by inactivating and decreasing the
expression of key enzymes in the pro-inflammatory pathway in human cells.
Several studies have shown that turmeric extract applied topically can reduce
the severity of psoriasis lesions. The goal of this double-blind,
placebo-controlled study was to measure the efficacy of turmeric extract
microemulgel on the symptoms of psoriasis in patients with mild to moderate
plaque psoriasis.
Forty patients between the ages of 18 and 60
years of age with mild to moderate psoriasis on their legs and arms were
recruited for the study. Patients were included if the extent and severity of
their psoriasis had been stable for at least 2 months. Patients could be taking
systemic treatments for psoriasis but were excluded if they were using topical
psoriasis treatments. Patients were also excluded if they were taking beta-blockers,
had lymphoma, or were pregnant or lactating. Lesions were assessed on each
patient. Lesions that were similar in appearance were chosen from the left and
right arm and leg. Patients applied a placebo cream to either the left or right
side and the turmeric treatment cream to the opposite side. The authors note
that the side of the body chosen was randomized, but not whether randomization
was done within each patient. The data presented suggest that the turmeric microemulgel
was always applied to the right arm and leg and that the placebo was applied to
the left side of each patient. The microemulgel was applied twice per day for 9
weeks. The placebo contained only the microemulgel, whereas the treatment
contained the microemulgel plus 0.5% of turmeric extracted with water and
alcohol (SOHA JISSA Co.; Salman Shahr, Mazandaran, Iran). Curcuminoid
concentration of the extract was measured with high-performance liquid chromatography.
The redness, thickness, scaling, and area of lesions in each body area were
measured with the Psoriasis Area and Severity Index (PASI) every 3 weeks. In
addition, patient quality of life was measured at the same time with the
Dermatology Life Quality Index (DLQI). Compliance was checked weekly. Data were
analyzed with t-tests and chi-squared tests.
Thirty-four patients completed the study.
Reasons were not given for the loss of the other patients from the study. The
patients noted that stress, changes in temperature, and sun exposure were the
most important psoriasis triggers. Within this group of patients, 14.7% had
metabolic syndrome, and another 11.8% had diabetes. The number of patients
experiencing itching, pain, and social discomfort decreased over the course of
the study (P values not given). The redness, thickness, and scaling of lesions
on the arms decreased significantly with turmeric treatment over the course of
the study (P < 0.05). The scaling of lesions on the legs also decreased
significantly with turmeric treatment (P < 0.05). The mean PASI score with
turmeric treatment decreased significantly from 3.6 to 1.4 over the course of
the study (P < 0.05). The mean PASI score was also significantly lower with
the turmeric treatment than with the placebo (P < 0.05). The placebo
microemulgel did result in a decrease in the PASI score metrics over the first
3 weeks of the study, but this decrease was not significant. Adverse effects were
similar between the turmeric and placebo microemulgels and included dryness and
burning.
Turmeric microemulgel significantly reduced
the symptoms of psoriasis over a 9-week course of treatment. This treatment
also improved quality-of-life indices, although statistical analysis of these
indices was not provided. In addition, the turmeric microemulgel was well
tolerated with few adverse effects. Other studies have found that phosphorylase
kinase (PK) expression is higher in patients with psoriasis and that
curcuminoids inhibit PK activity. PK is integral to the pro-inflammatory
response, and its inhibition should result in a decrease in inflammation. This
study may have been limited by the small sample size and type of randomization
used. The type of randomization is not adequately described, but the results
suggest that the use of the turmeric microemulgel was randomized to the right
side of the body for all patients. This may cause unwanted bias. The results of
this study suggest that turmeric may be an effective topical treatment for
psoriasis with few side effects.
—Cheryl
McCutchan, PhD
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