Cannabinoid Treatment for Psoriasis Symptoms

Published by Jan

 

Psoriasis

 

Psoriasis (  /s?'ra?.?s?s/) is a chronic immune-mediated disease that appears on the skin. It occurs when the immune system sends out faulty signals that speed up the growth cycle of skin cells.  Psoriasis is not contagious.  There are five types of psoriasis:  plaque, guttate, inverse, pustular and erythrodermic.  The most common form, plaque psoriasis, is commonly seen as red and white hues of scaly patches appearing on the top first layer of the epidermis (skin).  Some patients, though, have no dermatological symptoms.
In plaque psoriasis, skin rapidly accumulates at these sites, which gives it a silvery-white appearance.  Plaques frequently occur on the skin of the elbows and knees, but can affect any area, including the scalp, palms of hands and soles of feet, and genitals.  In contrast to eczema, psoriasis is more likely to be found on the outer side of the joint.
The disorder is a chronic recurring condition that varies in severity from minor localized patches to complete body coverage.  Fingernails and toenails are frequently affected (psoriatic nail dystrophy) and can be seen as an isolated symptom.  Psoriasis can also cause inflammation of the joints, which is known as psoriatic arthritis.  Between ten and forty percent of all people with psoriasis have psoriatic arthritis.
The cause of psoriasis is not fully understood, but it is believed to have a genetic component and local psoriatic changes can be triggered by an injury to the skin known as the Koebner phenomenon .  Various environmental factors have been suggested as aggravating to psoriasis, including stress, withdrawal of systemic corticosteroid, as well as other environmental factors, but few have shown statistical significance.  There are many treatments available, but because of its chronic recurrent nature, psoriasis is a challenge to treat.

 

Causes, incidence, and risk factors

Psoriasis is a very common condition.  The disorder may affect people of any age, but it most commonly begins between ages 15 and 35.  The condition cannot be spread to others.  It does seem to be passed down through families.  .  Doctors think it probably occurs when the body's immune system mistakes healthy cells for dangerous substances 
Skin cells grow deep in the skin and normally rise to the surface about once a month.  In persons with psoriasis, this process is too fast (about 2 weeks instead of 4 weeks) and dead skin cells build up on the skin's surface.
The following may trigger an attack of psoriasis or make the condition more difficult to treat:
• Bacteria or viral infections, including strep throat and upper respiratory infections
• Dry air or dry skin
• Injury to the skin, including cuts, burns, and insect bites
• Some medicines, including antimalaria drugs, beta-blockers, and lithium
• Stress
• Too little sunlight
• Too much sunlight (sunburn)
• Too much alcohol
In general, psoriasis may be severe in people who have a weakened immune system.  This may include persons who have:
• AIDS
• Autoimmune disorders (such as rheumatoid arthritis)
• Cancer chemotherapy
Up to one-third of people with psoriasis may also have arthritis, a condition known as psoriatic arthritis.

 

Symptoms

The symptoms of psoriasis can manifest in a variety of forms.  Variants include plaque, pustular, guttate and flexural psoriasis.  This section describes each type
Psoriasis is a chronic relapsing disease of the skin that may be classified into nonpustular and pustular types as follows
Nonpustular
Psoriasis vulgaris (chronic stationary psoriasis, plaque-like psoriasis) (L40.0) is the most common form of psoriasis.  It affects 80 to 90% of people with psoriasis.  Plaque psoriasis typically appears as raised areas of inflamed skin covered with silvery white scaly skin.  These areas are called plaques.
Psoriatic erythroderma (erythrodermic psoriasis) (L40.85) involves the widespread inflammation and exfoliation of the skin over most of the body surface.  It may be accompanied by severe itching, swelling and pain.  It is often the result of an exacerbation of unstable plaque psoriasis, particularly following the abrupt withdrawal of systemic treatment.  This form of psoriasis can be fatal, as the extreme inflammation and exfoliation disrupt the body's ability to regulate temperature and for the skin to perform barrier functioning.
Pustular
Pustular psoriasis appears as raised bumps that are filled with noninfectious pus (pustules).  The skin under and surrounding the pustule is red and tender.  Pustular psoriasis can be localized, commonly to the hands and feet (palmoplantar pustulosis), or generalized with widespread patches occurring randomly on any part of the body.  Types include:
• Generalized pustular psoriasis (pustular psoriasis of von Zumbusch)
• Pustulosis Palmaris et plantaris (persistent palmoplantar pustulosis, pustular psoriasis of the Barber type, pustular psoriasis of the extremities)
• Annular pustular psoriasis
• Acrodermatitis continua
• Impetigo herpetiformis
• Other
Additional types of psoriasis include:
Drug-induced psoriasis
Inverse psoriasis (flexural psoriasis, inverse psoriasis.  It   appears as smooth inflamed patches of skin.  It occurs in skin folds, particularly around the genitals (between the thigh and groin), the armpits, under an overweight abdomen (panniculus), and under the breasts (inframammary fold).  It is aggravated by friction and sweat, and is vulnerable to fungal infections.
Napkin psoriasis
Seborrheic-like psoriasis
Guttate psoriasis is characterized by numerous small, scaly, red or pink, teardrop-shaped lesions.  These numerous spots of psoriasis appear over large areas of the body, primarily the trunk, but also the limbs and scalp.  Guttate psoriasis is often preceded by a streptococcal infection, typically streptococcal pharyngitis.  The reverse is not true.
Nail psoriasis  produces a variety of changes in the appearance of finger and toenails.  These changes include discoloring under the nail plate, pitting of the nails, lines going across the nails, thickening of the skin under the nail, and the loosening (onycholysis) and crumbling of the nail.
Psoriatic arthritis  involves joint and connective tissue inflammation.  Psoriatic arthritis can affect any joint, but is most common in the joints of the fingers and toes.  This can result in a sausage-shaped swelling of the fingers and toes known as dactylitis.  Psoriatic arthritis can also affect the hips, knees and spine (spondylitis).  About ten to fifteen percent of people who have psoriasis also have psoriatic arthritis.
The migratory stomatitis in the oral cavity mucosa and the geographic tongue that confined to the dorsal and lateral aspects of the tongue mucosa, are believed to be oral manifestations of psoriasis, as being histologically identical to cutaneous psoriasis lesions and more prevalent among psoriasis patients, although these conditions are quite common in the non-psoriatic population, affecting  (1% to 2.5%)  of the general population.
Psoriasis is usually graded as mild (affecting less than 3% of the body), moderate (affecting 3–10% of the body) or severe.  Several scales exist for measuring the severity of psoriasis.  The degree of severity is generally based on the following factors:  the proportion of body surface area affected; disease activity (degree of plaque redness, thickness and scaling); response to previous therapies; and the impact of the disease on the person.
Psoriasis can appear suddenly or slowly.  In many cases, psoriasis goes away and then flares up again repeatedly.
People with psoriasis have irritated patches of skin.  The redness is most often seen on the elbows, knees, and trunk, but it can appear anywhere on the body.  For example, there may be flaky patches on the scalp.

The skin patches or dots may be:
• Itchy
• Dry and covered with silver, flaky skin (scales)
• Pink-red in color (like the color of salmon)
• Raised and thick
• Other symptoms may include:
• Genital lesions in males
• Joint pain or aching (psoriatic arthritis)
• Nail changes, including nail thickening, yellow-brown spots, dents (pits) on the nail surface, and separation of the nail from the base
• Severe dandruff on the scalp
Psoriasis may affect any or all parts of the skin.  T here are five main types of psoriasis:

  1.  Erythrodermic -- The skin redness is very intense and covers a large area.
  2. Guttate -- Small, pink-red spots appear on the skin.
  3. Inverse -- Skin redness and irritation occurs in the armpits, groin, and in between overlapping skin.
  4. Plaque -- Thick, red patches of skin are covered by flaky, silver-white scales.  This is the most common type of psoriasis.
  5.  Pustular -- White blisters are surrounded by red, irritated skin.


Treatment

The goal of treatment is to control your symptoms and prevent infections.
In general, three treatment options are used for patients with psoriasis:
1. Topical medications such as lotions, ointments, creams, and shampoos
2. Body-wide (systemic) medications, which are pills or injections that affect the whole body, not just the skin
3. Phototherapy, which uses light to treat psoriasis
Most cases of psoriasis are treated with medications that are placed directly on the skin or scalp:

  •  Cortisone creams and ointments
  •  Creams or ointments that contain coal tar or anthralin
  •  Creams to remove the scaling (usually salicylic acid or lactic acid)
  •  Dandruff shampoos (over-the-counter or prescription)
  •  Moisturizers
  •  Prescription medicines containing vitamin D or vitamin A (retinoids)


If you have an infection, your doctor will prescribe antibiotics.
You may try the following self-care at home:
Oatmeal baths may be soothing and may help to loosen scales.  You can use over-the-counter oatmeal bath products.  Alternatively, you can mix 1 cup of oatmeal into a tub of warm water.
Sunlight may help your symptoms go away.  Be careful not to get sunburned.
Relaxation and antistress techniques may be helpful.  The link between stress and flares of psoriasis is not well understood.  Some people may choose to have phototherapy.
Phototherapy is a medical treatment in which your skin is carefully exposed to ultraviolet light.
Phototherapy may be given alone or after you take a drug that makes the skin sensitive to light.
Phototherapy for psoriasis can be given as ultraviolet A (UVA) or ultraviolet B (UVB) light.

 

Systemic Treatment

Persons with very severe psoriasis may receive medicines to suppress the body's immune response.  These medicines include methotrexate or cyclosporine.  (Persons who have psoriatic arthritis may also receive these drugs.)  Retinoids such as acitretin can also be used.
Newer drugs called biologics specifically target the body's immune response, which is thought to play a role in psoriasis.  These drugs are used when other treatments do not work.  Biologics approved for the treatment of psoriasis include:
1. Adalimumab (Humira)
2. Alefacept (Amevive)
3. Etanercept (Enbrel)
4. Infliximab (Remicade)
5. Stelara


Expectations (prognosis)

Psoriasis is a life-long condition that can be controlled with treatment.  It may go away for a long time and then return.  With appropriate treatment, it usually does not affect your general physical health.


Complications

  •  Arthritis
  • Pain
  • Severe itching
  • Secondary skin infections
  •  Side effects from medicines used to treat psoriasis
  • Skin cancer from light therapy


Prevention

There is no known way to prevent psoriasis.  Keeping the skin clean and moist and avoiding your specific psoriasis triggers may help reduce the number of flare-ups.
Doctors recommend daily baths or showers for persons with psoriasis.  Avoid scrubbing too hard, because this can irritate the skin and trigger an attack.


Genetics

Psoriasis has a large hereditary component, and many genes are associated with it, but it is not clear how those genes work together.  Most of them involve the immune system, particularly the major histocompatibility complex (MHC) and T cells.  The main value of genetic studies is they identify molecular mechanisms and pathways.  for further study and potential drug targets.
Classic genome wide linkage analysis has identified nine locations (loci) on different chromosomes associated with psoriasis.  They are called psoriasis susceptibility 1 through 9 (PSORS1 through PSORS9).  Within those loci are genes.  Many of those genes are on pathways that lead to inflammation.  Certain variations (mutations) of those genes are commonly found in psoriasis.
Genome-wide association scans have identified other genes that are altered to characteristic variants in psoriasis.  Some of these genes express inflammatory signal proteins, which affect cells in the immune system that are also involved in psoriasis.  Some of these genes are also involved in other autoimmune diseases.
Two major genes under investigation are IL12B on chromosome 5q, which expresses interleukin-12B; and IL23R on chromosome 1p, which expresses the interleukin-23 receptor, and is involved in T cell differentiation.  T cells are involved in the inflammatory process that leads to psoriasis.
These genes are on the pathway that ends up regulating tumor necrosis factor-α and nuclear factor κB, two genes that are involved in inflammation.


Immunology

In psoriasis, immune cells move from the dermis to the epidermis, where they stimulate skin cells (keratinocytes) to proliferate.  Psoriasis does not seem to be a true autoimmune disease.  In an autoimmune disease, the immune system confuses an outside antigen with a normal body component, and attacks them both.  However, in psoriasis, the inflammation does not seem to be caused by outside antigens (although DNA does have an immunostimulatory effect).  Researchers have identified many of the immune cells involved in psoriasis, and the chemical signals they send to each other to coordinate inflammation.  At the end of this process, immune cells, such as dendritic cells and T cells, move from the dermis to the epidermis, secreting chemical signals, such as tumor necrosis factor-α, interleukin-1β, and interleukin-6, which cause inflammation, and interleukin-22, which causes keratinocytes to proliferate.
The immune system consists of an innate immune system, and an adaptive immune system.
In the innate system, immune cells have receptors that have evolved to target specific proteins and other antigens that are commonly found on pathogens.  In the adaptive immune system, immune cells respond to proteins and other antigens that they may never have seen before, which are presented to them by other cells.  The innate system often passes antigens on to the adaptive system.  When the immune system makes a mistake, and identifies a healthy part of the body as a foreign antigen, the immune system attacks that protein, as it does in autoimmunity.
In psoriasis, DNA is an inflammatory stimulus.  DNA stimulates the receptors on plasmacytoid dendritic cells, which produce interferon-α, an immune stimulatory signal (cytokine).  In psoriasis, keratinocytes produce antimicrobial peptides.  In response to dendritic cells and T cells, they also produce cytokines, such as interleukin-1, interleukin-6, and tumor necrosis factor-α, which signals more inflammatory cells to arrive and produces further inflammation.
Dendritic cells bridge the innate and adaptive immune system.  They are increased in psoriatic lesions, induce the proliferation of T cells, and type 1 helper T cells.  Certain dendritic cells can produce tumor necrosis factor-α, which calls more immune cells and stimulates more inflammation.  Targeted immunotherapy, and psoralen and ultraviolet A (PUVA) therapy, reduces the number of dendritic cells.
T cells move from the dermis into the epidermis.  They are attracted to the epidermis by alpha-1 beta-1 integrin, a signaling molecule on the collagen in the epidermis.  Psoriatic T cells secrete interferon-γ and interleukin-17.  Interleukin-17 is also associated with interleukin-22.  Interleukin-22 induces keratocytes to proliferate.  One hypothesis is that psoriasis involves a defect in regulatory T cells, and in the regulatory cytokine interleukin-10


Prognosis

Psoriasis is typically a lifelong condition.  There is currently no cure, but various treatments can help to control the symptoms.  Many of the most effective agents used to treat severe psoriasis carry an increased risk of significant morbidity including skin cancers, lymphoma and liver disease.  However, the majority of people's experience of psoriasis is that of minor localized patches, particularly on the elbows and knees, which can be treated with topical medication.  Psoriasis can get worse over time, but it is not possible to predict who will go on to develop extensive psoriasis or those in whom the disease may appear to vanish.  Individuals will often experience flares and remissions throughout their lives.  Controlling the signs and symptoms typically requires lifelong therapy.


Quality of life

Severe cases of psoriasis has been shown to affect health-related quality of life to an extent similar to the effects of other chronic diseases, such as depression, hypertension, congestive heart failure or type 2 diabetes.   Depending on the severity and location of outbreaks, individuals may experience significant physical discomfort and some disability.  Itching and pain can interfere with basic functions, such as self-care, walking, and sleep.  Plaques on hands and feet can prevent individuals from working at certain occupations, playing some sports, and caring for family members or a home.  Plaques on the scalp can be particularly embarrassing, as flaky plaque in the hair can be mistaken for dandruff.  Medical care can be costly and time-consuming, and can interfere with an employment or school schedule.
Individuals with psoriasis may also feel self-conscious about their appearance and have a poor self-image that stems from fear of public rejection and psychosexual concerns.  Psychological distress can lead to significant depression and social isolation.


Cause

The cause of psoriasis is not fully understood.  There are two main hypotheses about the process that occurs in the development of the disease.  The first considers psoriasis as primarily a disorder of excessive growth and reproduction of skin cells.  The problem is simply seen as a fault of the epidermis and its keratinocytes.  The second hypothesis sees the disease as being an immune-mediated disorder in which the excessive reproduction of skin cells is secondary to factors produced by the immune system.  T cells (which normally help protect the body against infection) become active, migrate to the dermis and trigger the release of cytokines (tumor necrosis factor-alpha TNFα, in particular) which cause inflammation and the rapid production of skin cells.  It is not known what initiates the activation of the T cells.
The immune-mediated model of psoriasis has been supported by the observation that immunosuppressant medications can clear psoriasis plaques.  However, the role of the immune system is not fully understood, and it has recently been reported that an animal of psoriasis can be triggered in mice lacking T cells.  Animal models, however, reveal only a few aspects resembling human psoriasis.
Psoriasis is a fairly idiosyncratic  disease.  The majority of people's experience of psoriasis is one in which it may worsen or improve for no apparent reason.  .  Nevertheless, the first outbreak is sometimes reported following stress (physical and mental), skin injury, and streptococcal infection.  Conditions that have been reported as accompanying a worsening of the disease include infections, stress, and changes in season and climate.  Certain medicines, including lithium salt, beta-blockers and the antimalarial drug chloroquine have been reported to trigger or aggravate the disease.  Excessive alcohol consumption, smoking and obesity may exacerbate psoriasis or make the management of the condition difficult or perhaps these co morbidities are effects rather than causes   Hairspray, some face creams and hand lotions, can also cause an outbreak of psoriasis  In 1975, Stefania Jablonska and collaborators advanced a new theory that special antibodies tend to break through into the lower layers of the skin and set up a complex series of chemical reactions.
Individuals suffering from the advanced effects of the human immunodeficiency virus, or HIV, often exhibit psoriasis.  This presents a paradox to researchers, as traditional therapies that reduce T-cell counts generally cause psoriasis to improve.  Yet, as CD4-T-cell counts decrease with the progression of HIV, psoriasis worsens.  In addition, HIV is typically characterized by a strong Th2 cytokine profile, whereas psoriasis vulgaris is characterized by a strong Th1 secretion pattern.  The prevalence of psoriasis in the HIV positive population ranges from one to six percent, which is about three times higher than the normal population.  Psoriasis in AIDS sufferers is often severe, and untreatable with conventional therapy.
Psoriasis occurs more likely in dry skin than oily or well-moisturized skin, and specifically after an external skin injury such as a scratch or cut (see Koebner phenomenon).  This is believed to be caused by an infection, in which the infecting organism thrives under dry skin conditions with minimal skin oil, which otherwise protects skin from infections.  The case for psoriasis is opposite to the case of athlete's foot, which occurs because of a fungus infection under wet conditions as opposed to dry in psoriasis.  This infection induces inflammation, which causes the symptoms commonly associated with psoriasis, such as itching and rapid skin turnover, and leads to drier skin, as the infecting organism absorbs the moisture that would otherwise go to the skin.  To prevent dry skin and reduce psoriasis symptoms, it is advised to not use shower scrubs, as they not only damage skin by leaving tiny scratches, but they also scrape off the naturally occurring skin oil.  It is recommended to use talc powder after washing, as that helps absorb excess moisture that would otherwise go to the infecting agent.  Additionally, moisturizers can be applied to moisturize the skin, and lotions used to promote skin oil gland functions.


There are a number of different treatment options for psoriasis.  Typically, topical agents are used for mild disease, phototherapy for moderate disease, and systemic agents for severe disease
Topical agents
Bath solutions and moisturizers, mineral oil, and petroleum jelly may help soothe affected skin and reduce the dryness that accompanies the build-up of skin on psoriatic plaques.  Medicated creams and ointments applied directly to psoriatic plaques can help reduce inflammation, remove built-up scale, reduce skin turn over, and clear affected skin of plaques.  Ointment and creams containing coal tar, dithranol (anthralin), corticosteroids like desoximetasone (Topicort), fluocinonide, vitamin D3analogues (for example, calcipotriol), and retinoids are routinely used. The use of the Fingertip unit may be helpful in guiding how much topical treatment to use.[31] The mechanism of action of each is probably different, but they all help to normalize skin cell production and reduce inflammation.  Activated vitamin D and its analogues can inhibit skin cell proliferation.
Apricus Biosciences is currently developing PsoriaVa, a topical cream for the treatment of psoriasis.  It contains Calcipotriol and Betamethasone as the active ingredients and a permeation enhancer DDAIP that facilitates the delivery of the drug into the blood stream.
Phototherapy
Phototherapy in the form of sunlight has long been used effectively for treatment.[30] Wavelengths of 311–313 nm are most effective and special lamps have been developed for this application.[30] The amount of light used is determined by a person’s skin type.[30] Increased rates of cancer from treatment appear to be small.[30]
Psoralen and ultraviolet A phototherapy (PUVA) combines the oral or topical administration of psoralen with exposure to ultraviolet A (UVA) light.  The mechanism of action of PUVA is unknown, but probably involves activation of psoralen by UVA light, which inhibits the abnormally rapid production of the cells in psoriatic skin.  There are multiple mechanisms of action associated with PUVA, including effects on the skin immune system.
PUVA is associated with nausea, headache, fatigue, burning, and itching.  Long-term treatment is associated with squamous cell carcinoma (not with melanoma).
Systemic agents
Psoriasis that is resistant to topical treatment and phototherapy is treated by medications taken internally by pill or injection (systemic). Patients undergoing systemic treatment are required to have regular blood and liver function tests because of the toxicity of the medication.  Pregnancy must be avoided for the majority of these treatments.  Most people experience a recurrence of psoriasis after systemic treatment is discontinued.
The three main traditional systemic treatments are methotrexate, cyclosporine and retinoids.  Methotrexate and cyclosporine are immunosuppressant drugs; retinoids are synthetic forms of vitamin A.  Patients taking methotrexate are prone to ulcerations
Biologics are manufactured proteins that interrupt the immune process involved in psoriasis.  Unlike generalized immunosuppressant therapies such as methotrexate, biologics focus on specific aspects of the immune function leading to psoriasis.  These drugs (interleukin antagonists) are relatively new, and their long-term impact on immune function is unknown, but they have proven effective in treating psoriasis and psoriatic arthritis.  Biologics are usually given by self-injection or in a doctor's office.  In the United Kingdom in 2005, the British Association of Dermatologists (BAD) published guidelines for use of biological interventions in psoriasis.  A UK national register called the BAD Biological Register (BADBIR) has been set up to collect valuable information on side effects (and benefits) and will be used to inform doctors on how best to use biological agents and similar drugs.
In 2008, the FDA approved three new treatment options available to psoriasis patients:   1) Taclonex Scalp, a new topical ointment for treating scalp psoriasis; 2) the Xtrac Velocity excimer laser system, which emits a high-intensity beam of ultraviolet light, can treat moderate to severe psoriasis; and 3) the biologic drug adalimumab (brand name Humira) was also approved to treat moderate to severe psoriasis.  Adalimumab had already been approved to treat psoriatic arthritis.  The most recent biologic drug that has been approved to treat moderate to severe psoriasis, as of 2010, is ustekinumab (brand name Stelara).
Medications with the least potential for adverse reactions are preferentially employed.  If the treatment goal is not achieved, then therapies with greater potential toxicity may be used.  Medications with significant toxicity are reserved for severe unresponsive psoriasis.  This is called the psoriasis treatment ladder.  As a first step, medicated ointments or creams, called topical treatments, are applied to the skin.  If topical treatment fails to achieve the desired goal, then the next step would be to expose the skin to ultraviolet (UV) radiation.  This type of treatment is called phototherapy.  The third step involves the use of medications that are taken internally by pill or injection.  This approach is called systemic treatment.
Alternative therapy
Some studies suggest psoriasis symptoms can be relieved by changes in diet and lifestyle.  Fasting periods, low energy diets and vegetarian diets have improved psoriasis symptoms in some studies, and diets supplemented with fish oil (in this study cod liver oil) have shown beneficial effects.  Fish oils are rich in the two omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and contain Vitamin E, furthermore cod liver oil contains Vitamin A and Vitamin D.
The severity of psoriasis symptoms may also be influenced by lifestyle habits related to alcohol, smoking, weight, sleep, stress and exercise.
Another treatment is ichthyotherapy, which is practiced at some spas in Turkey, Croatia, Ireland, Hungary and Serbia. Doctor fish living in outdoor thermal pools are encouraged to feed on the psoriatic skin, only consuming the affected areas.  The outdoor location of the spa may also have a beneficial effect.  This treatment can provide temporary relief of symptoms.  A revisit to the spas every few months is often required.  This treatment has been examined in two small clinical trials, with positive results.
Hypnotherapy may be effective for psoriasis.
A psychological symptom management program has been reported as being a helpful adjunct to traditional therapies in the management of psoriasis.  It has been suggested that cannabis might treat psoriasis, due to the anti-inflammatory properties of its cannabinoids, and the regulatory effects of THC on the immune system.  
On 17 November 2008, researchers led by Yin-Ku Lin of Chang Gung Memorial Hospital and Chang Gung University in Taiyuan, Taiwan, told Reuters by telephone that Indigo naturalis (Qing dai, ??), a dark blue plant used in traditional Chinese medicine, appears to be effective in treating psoriasis.  In the latest issue of Archives of Dermatology, they wrote, "The Indigo naturalis ointment-treated lesions showed an eighty one percent improvement over placebo.


Cannabinoids as Treatment for Psoriasis Symptoms

Research:
cannabinoids inhibit keratinocyte proliferation, and therefore support a potential role for cannabinoids in the treatment of psoriasis.
Cannabis might treat psoriasis, due to the anti-inflammatory properties of its cannabinoids, and the regulatory effects of THC on the immune system.  The adverse effects of cannabis might be overcome by use of more specific cannabinoid receptor medications, to inhibit keratinocyte proliferation.  Moreover, they observe that cannabinoids are readily absorbed through the skin.  This is the ideal method of treating psoriasis, as it avoids some of the toxicity associated with systemic therapies.
The researchers tested the effects of four plant cannabinoids – Δ-9 tetrahydrocannabinol, cannabidiol, cannabinol and cannabigerol – on rapidly proliferating, cultured human keratinocytes.
All four cannabinoids inhibited keratinocyte growth in a dose-dependent manner, they report.
Despite varying degrees of affinity for cannabinoid receptors (CBs) among the substances tested, the extent of growth inhibition was similar with all four cannabinoids, implying a non-specific effect.
In confirmation of this, the investigators found that selective CB2 agonists only partially inhibited keratinocyte growth, while a non-selective CB agonist had a concentration-dependent effect.
Neither CB1 nor CB2 antagonists attenuated the effects of the CB agonists or the cannabinoids, however.  Furthermore, these antagonists actually exhibited direct dose-dependent inhibition of keratinocyte growth.
Cannabinoids, as novel additions to the antipsoriatic ammunition.
Source
Dermatology Department, Shiraz University of Medical Sciences, Shiraz, Iran.  namazi_mr@yahoo.com
cannabinoids, which exert inhibitory effects on antigen processing and macrophage/T-cell interaction and on the release of IL-2, TNF-alpha and nitric oxide from immune cells.
Testimonials:
Cannabinoids extracted with grape seed oil:  can be taken orally or topically applied or both.
“Smoking marijuana keeps me from having flare-ups of psoriasis.”
““HempEase” made from cannabis roots (no THC) has powerful skin treating qualities”.  
Cannabinoids can be taken orally, and applied topically for the treatment of psoriasis symptoms with little to no side effects.         
Sativa x Indica hybrid

 

 

Side effects of psoriasis medication s (pharmaceuticals) include:
? Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stools; blood in the urine; change in the appearance of a mole; chest pain; confusion; dark urine; diarrhea; fast or irregular heartbeat; flushing of the face, chest, back, or abdomen; gum disease or overgrowth; increased or decreased urination; loss of coordination; mental or mood changes; muscle cramps; numbness or tingling of the skin; seizures; severe or persistent headache or dizziness; shortness of breath; symptoms of infection (eg, chills, cough, fever, painful urination, sore throat); tremors; unusual bleeding or bruising; unusual lumps; unusual thickening or growth on the skin; unusual tiredness or weakness; vision changes; wheezing; yellowing of the skin or eyes, acne, dizziness, headache, increased hair growth, runny nose, sleeplessness, vomiting and stomach discomfort.

 

References_________________________________________________________________________________
1. Gottlieb A, Korman NJ, Gordon KB, Feldman SR, Lebwohl M, Koo JY, et al. Guidelines for the management of psoriasis and psoriatic arthritis.  Section 2.  Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on biologics.  J Am Acad Dermatol.  2008; 58:851-864.  [PubMed]
2. Menter A, Korman NJ, Elmets Ca, Feldman SR, Gelfand JM, Gordon KB, et al. American Academy of Dermatology guidelines of care for the management of psoriasis and psoriatic arthritis.  Section 3.  Guidelines of care for the management and treatment of psoriasis with topical therapies.  J Am Acad Dermatol.  2009; 60:643-659.  [PubMed]
3. Menter A, Gottlieb A, Feldman SR, Voorhees ASV, Leonardi CL, Gordon KB, et al. Guidelines for the management of psoriasis and psoriatic arthritis.  Section 1.  Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics.  J Am Acad Dermatol.  2008; 5:826-850.  [PubMed]
4. Stern RS.  Psoralen and ultraviolet a light therapy for psoriasis.  N Engl J Med. 2007; 357(7):682-690.  [PubMed]
Writing in the Journal of Dermatological Science, Jonathan Wilkinson (Nottingham University) and Elizabeth Williamson (Reading University) say that cannabinoids have anti-inflammatory properties and can inhibit the growth of cancer cell lines.

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2 years 3 months ago slantedandenchantedthanks for the post have not been able too find too many good articles on this subject that concern cannabis (I have had very little help from pharmaceuticals with my psoriasis, cannabis seems to help more then the pharmaceuticals I have been given. thanks for the info psoriasis sucks!

6 months 3 days ago richardechevarria73thank you for the article it was very helpful I've been suffering for psoriasis for 4 years now and I just recently stop smoking pot because of drug tests for employment and now I am breaking out really bad because I cannot smoke anymore do to random testing. when I was smoking pot I did not have the breakouts that I'm having now I am hoping that I can get a prescription for medical marijuana can anyone give me some information on obtaining a prescription for psoriasis?

5 months 27 days ago EricaMarijuana_3957Are there any topicals with substantial results on adolescents?