Psoriasis successfully treated with topical Cannabinoids
Adam J. Friedman and his team, attached to the Department of Dermatology, The George Washington Medical Faculty Associates, Washington, DC, have reported a recent case of psoriasis which has been successfully managed by medical cannabis.
The case has been published in the Journal of Drugs in Dermatology.
Psoriasis
is a common skin disorder characterized by hyperproliferation of keratinocytes.
Although the exact pathophysiology of psoriasis is not entirely understood, the
immune system and its interaction with the nervous system have been postulated
and investigated as the underlying mechanism. The interaction between these two
systems through the cholinergic anti-inflammatory pathway and also the
endocannabinoid system may suggest cannabinoids as a potential addition to the
antipsoriatic armamentarium.
Activation of the endocannabinoid system in the skin reduces inflammation
through shifting the pro-inflammatory Th1 response to an anti-inflammatory Th2
response via cannabinoid receptor type 2 (CBr2) activation. he endocannabinoid
system also plays a role in regulating keratinocyte proliferation and
differentiation, which are pathologically increased in psoriasis.
Globally there has been an exponential rise in the use of medical cannabis for
chronic dermatologic conditions such as psoriasis, eczema, and acne has been
growing mostly owing to rapidly emerging decriminalization across the country
and impressive commercially driven popularization of a variety of cannabinoid
preparations including topical forms such as creams, salves, lotions,
lubricants, and many others.
A
33-year-old male patient, presented with a one-year history of psoriasis, with
erythematous, scaly plaques in sebaceous areas, which progressively worsened.
He also reported a strong family history of psoriasis with his sister and his
father. On trying over-the-counter topical hydrocortisone steroid cream which
had failed to control his symptoms, he was initially prescribed triamcinolone
acetonide cream 0.1%. Though erythema reduced on the patient's face, for only a
short time and the disease spread to his trunk and other areas of his body.
After assessing the pros and cons, chain triglyceride (MCT) oil, beeswax, and
sunflower lecithin, THC soap infused with a scent-free hemp soap, 5 mg/ml, and
hair oil with THC distillate dissolved into jojoba oil, 5 mg/mL was prescribed
to him with advice to apply the cream and oil to patches on body skin and to
use the oil on the hair-baring areas daily as well as to use the soap when
showering.
Improvement
was noted within two days of initiating this regimen. Following 2 weeks of use,
the patient reported continued improvement and clearance.No adverse side
effects and flare-ups were noted until the complete resolution of symptoms.
"Through the literature supporting the use of cannabis for the treatment
and management of psoriasis is still in its infancy, there is evidence showing
that cannabis may be an effective treatment through multiple potential
mechanisms. More research, investment, and acceptance are needed to fully
capitalize on the potential of cannabinoids in dermatology." concluded the
research team.