Eczematous and Psoriatic Skin Disorders

Information Resources: Additional Information and Links to Scientific Studies

1. An overview of the pathophysiology of itching (pruritis) is presented by the journal American Family Physician and Dr. Scott Moses of Lino Lakes, Minnesota, emphasizing that even in standard medicine that advice to the patient should be to properly understand the individual underlying reasons for chronic itching and focus treatment on these underlying health problems. Obviously, integration of Complementary Medicine is sensible to achieve this goal: http://www.aafp.org/afp/2003/0915/p1135.html
2. A 2009 consensus statement on the management of chronic hand eczema with standard medicine, published in the medical journal Clinical Experience in Dermatology, states that current treatment is often inadequate, and is limited to emollients, barriers, soap substitutes, topical steroids and calcineurin inhibitors: http://www.ncbi.nlm.nih.gov/pubmed/19747339
3. A 2009 study at Yonsei University Department of Dermatology in Korea finds that topical calcineurin inhibitors induce serious negative effects in the skin, exposing the patient to risk of infection and dryness. Since calcineurin is found systemically in the body, and a deficiency of calcineurin may be linked to CNS diseases involving receptors for dopamine, GABA and NMDA, such as ADHD and schizophrenia, and calcineurin has been found to improve the function of pancreatic beta cells, the chronic use of calcineurin inhibitors may be problematic in this regard as well: http://www.ncbi.nlm.nih.gov/pubmed/19703225
4. A 1999 meta-review of all studies by the State University of New York at Stony Brook found that at that time the use of antihistamines to treat eczema / atopic dermatitis was common, but that little objective evidence was available to support its use: http://www.ncbi.nlm.nih.gov/pubmed/10606058
5. A 2010 meta-review of all studies by the esteemed Mount Sinai Medical Center School of Medicine, in New York, New York, U.S.A. found that antihistamine medication was still widely used to treat eczema / Atopic Dermatitis, but usually in the form of a topical antihistamine for itching, yet the evidence to support their use was still lacking. Even the widely prescribed Benadryl (diphenhydramine) lacked supporting evidence: http://www.ncbi.nlm.nih.gov/pubmed/20684150
6. A 2013 updated meta-review of all treatments studied and published for the treatment of atopic dermatitis, or eczema, by the Alan Lyell Center for Dermatology, Glasgow, United Kingdom, found that there was still almost no treatments studied with proven efficacy, and that tacrolimus, an immunosuppressive drug, topically performed as well as corticosteroid creams. Antibiotics in early childhood may increase the risk, but childhood exposure to bacterial endotoxins, unpasteurized milk, and early exposure to dogs, and other children in daycare decreased the risk (building the learned immune system). Patient education may be proven effective in management. There were no studies that met criteria in Western medical journals concerning herbal or nutrient medicine, and so standard medicine still has no idea whether these protocols are effective, and apparently doesn't care: http://www.ncbi.nlm.nih.gov/pubmed/23750610
7. A 2016 meta-review of studies of treatments for eczema, or atopic dermatitis, by experts at the Northwestern University Feinberg School of Medicine, in Chicago, Illinois, U.S.A. found that randomized controlled human clinical trials now support acupuncture, herbal medicine, botanical oils, hormone Vitamin D supplements, and topical B12, all of which could easily be combined in a single protocol with a Licensed Acupuncturist and herbalist: http://www.ncbi.nlm.nih.gov/pu...http://www.ncbi.nlm.nih.gov/pubmed/27388911
8. Currently, the Allergy Society of South Africa, and other organizations worldwide, reluctantly acknowledge that treatment with Chinese herbs is known to be clinically effective in treating eczema, although very problematic to study due to the complex pharmacology of herbal formulas. The page link acknowledging Chinese herbal medicine has since been taken down, but this page, showing that the medical society acknowleged efficacy of herbal medicine to treat eczema as far back as 1995, is still up: http://www.allergysa.org/C_OL_Alternative.asp
9. A 2010 review of Chinese herbs in the treatment of skin disorders at the University Medical Center Freiburg, Germany, found that a large number of controlled clinical trials have now shown efficacy of Chinese herbal medicine in the treatment of most common skin pathologies, and are becoming standard therapies in Europe: http://www.ncbi.nlm.nih.gov/pubmed/20509719
10. A current guideline for the treatment of eczema, or atopic dermatitis, by the University of Maryland Medical Center, shows that there are still few proven standard treatments for this array of skin disorders, with more emphasis on diet and lifestyle as a result, and acknowledgement finally that TCM herbal medicine and acupuncture is proven effective, but especially some topical herbal ointments and creams, with proof of efficacy for topical Chickweed (Yin chai hu), St. Johns Wort, and Calendula: http://umm.edu/health/medical/altmed/condition/eczema
11. In 2015, researchers at the major University Medical Schools in Taiwan reviewed the research database for the use of Chinese Herbal Medicine as integrative care for eczema, or atopic dermatitis, a difficult to treat set of diseases. This study produced a consensus agreement among Taiwan Medical Doctors that a database and network should be set up for the use and guidelines integrating this TCM therapy, as sound research has proven efficacy and safety. The most common herbal medicines used in practice were Xiao Feng San formula or variations, Lonicera japonica (Jin yin hua or Ren dong teng), and Forsythia suspensa (Lian qiao), which can be found in Yin Qiao San formulas: http://www.hindawi.com/journals/ecam/2015/347164/
12. As far back as 1995, scientific research has understood that specific allergens produce altered immune responses that are tied to eczematous atopic dermatitis, yet the identification and avoidance of allergens to resolve eczema is not widely practiced. Here, German researchers show that dust mites and milk casein produced specific T-cell responses that caused eczema symptoms. Mast cells in the skin induce increased migration of T-cells to the area and present the antigen or allergen to the T-cells that are stimulated by specific allergens. http://www.sciencedirect.com/
13. A 2000 statement by the University of Colorado Health Services Center points to the need for a more complex multidisciplinary and holistic approach to atopic eczema, especially as public health studies showed that eczema, or atopic dermatitis, preceded the onset of allergies and asthma in a high percentage of patients, and seems to be associated with a number of physiological systems in the body: http://www.sciencedirect.com/
14. A 1993 study found that increased fibrinogen and clotting factors were evident in the blood of eczema patients during times of active symptoms. The enzymes nattokinase and serratiopeptidase, as well as various herbs other nutrient medicines may address this aspect of the disease: http://www.ncbi.nlm.nih.gov/pubmed/8108797
15. A 2006 study found a consistent deficiency of selenium and an excess of copper in the blood of patients with eczema: http://www3.interscience.wiley.com/journal/119478134/abstract
16. An overview of nutritional medicine in eczema treatment can be seen at sites such as this: http://findarticles.com/p/articles/mi_m0ISW/is_2003_May/ai_100767893/
17. A 2008 study found that a Chinese herbal formula with Mu dan pi, Chi shao, Huang bai, Jin yin hua, and Bo he significantly attentuated histamine release and prostaglandin synthesis from mast cells activated by IgE antibodies, explaining the efficacy of the formula in treating eczema http://www.ncbi.nlm.nih.gov/pubmed/18725279?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2
18. A 2014 meta-review of scientific studies of topical herbs used to treat atopic eczema by Kyung Hee University, South Korea, found 22 such studies on the PubMed and EMBASE medical databases that were of high quality, and 21 herbs that were found to reduce atopic dermatitis in animal studies by suppressing Th2 responses: http://www.ncbi.nlm.nih.gov/pubmed/25024511
19. A 2013 meta-review of randomized controlled human clinical trials of Chinese herbal medicine to treat atopic eczema, by the Royal Melbourne Institute of Technology University, in Victoria, Australia, found that Chinese herbal medicine signifcantly improved symptoms and severity and was well tolerated, and that integrating such herbal treatment was superior to standard treatment alone: http://www.ncbi.nlm.nih.gov/pubmed/23759835
20. A 2014 study at the Korea Institute of Oriental Medicine, in Daejeon, South Korea, found that an alcohol extract of the Chinese herb Gardenia jasminoides, or Zhi Zi, significantly inhibited histamine response from MC/9 mast cells, and both the water and alcohol extracts inhibited Tumor Necrosis Factor (TNF-alpha), IL-4, IL-6, and adhesion molecules that play a role in the pathogenesis of atopic dermatitis, or eczema. Both topical and oral medicines with this Chinese herb were found effective as part of the holistic protocol to treat eczema: http://www.ncbi.nlm.nih.gov/pubmed/25153023
21. A 2011 study of acupuncture to treat symptoms of atopic eczema, by the Technical University in Munich, Department of Dermatology and Allergy, found that a short course of acupuncture significantly reduced the intensity of itch and attenuated basophil activation. The success of this pilot trial prompted a second human clinical study that was larger. In clinical TCM treatment, these short courses of acupuncture are combined with both herbal formulas and topical herbs to provide a more effective protocol: http://www.ncbi.nlm.nih.gov/pubmed/21443446
22. A 2008 study found that the hypothalamus was integral to the cyclic guanosine monophosphate immunoreactivity in our bodies, which has long been associated with psoriasis and the mechanism of the shortened cell cycle in the skin: http://ajpregu.physiology.org/cgi/content/abstract/295/4/R1341
23. A 2010 article in Canada describes recent findings by Harvard University researcher Dr. Zinaida Lima that psoriasis is linked to increased risk of micarriage, preeclampsia and ectopic pregnancy, and that many standard drugs used to treat psoriasis carry such risks themselves. The article covers a Canadian doctor who specializes in herbal therapies to treat psoriasis and cites a high percentage of success, as well as an article in the International Journal of Dermatology in 2004 that cites a 75% rate of improvement in symptoms with Chinese herbal therapies: http://www.streetinsider.com
24. A new medication approved in 2015 by the U.S. FDA, Cosentyx, has the biologic Secukinumab, a monoclonal antibody that inhibits expression of IL-17A, as its main ingredient. A large multicenter human clinical trial of Secukinumab in 2012, led by experts at Mount Sinai Medical Centre in New York, the Medical University of Vienna, in Austria, the University of Western Ontario, in Canada, and the University of Oxford, in the UK, found that in a randomized clinical trial with 59 patients with Crohn's Disease, that 31 patients discontinued the drug during the trial, with 14 serious adverse effects noted in 10 patients of the 59, including 4 serious fungal infections. These researchers concluded the Secukinumab was ineffective and that high rates of adverse health effects occurred. The approval in 2015 for treatment of psoriasis involves localized injections but warnings by the U.S. FDA that caution should be applied for patients with Crohn's disease and a history chronic or recurrent infection, and that the most common side effects reported were diarrhea and upper respiratory sinus and bronchial infections. The long-term outcomes related to specific immune suppression such as this will be determined: http://gut.bmj.com/content/61/12/1693.short
25. A 2015 study in China found that the main active chemical in the Chinese herb Zi cao (Lithospermum erythrorhizon), Shikonin, was found to be able to inhibit HaCa human T cell expression of IL-17 and also secretion of relevant cytokines such as IL-23. Zi cao is the chief herb used in formulas and topical ointments to treat psoriasis in TCM: http://www.ncbi.nlm.nih.gov/pubmed/26087561
26. The National Psoriasis Foundation in 2010 confirms that Complementary and Integrative Medicine (acupuncture, herbal medicine etc.) is proven effective and that acceptable scientific studies are now rapidly providing new guidelines for expanded use with standard medicine: http://www.psoriasis.org/netcommunity/sublearn03_comp_approach
27. A 2008 study of Chinese herbs that treat allergic diseases, performed at Konkuk University School of Medicine in Korea, found numerous herbs that were effective, and one herb, Sophorae Flos (Huai hua mi) that exerted the most significant inhibition of mast cell allergic responses: http://www.ebmonline.org/cgi/content/abstract/233/10/1271
28. A 2007 study in China found that an ointment with Indigo naturalis, or Qing dai leaves, was effective in controlling and inhibiting psoriasis, both by modulating proliferation and differentiation of keratinocytes in the epidermal skin, and by inhibiting T lymphocyte chemokine attraction to the keratinocytes, which stimulates that abnormal growth cycle: http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract&ProduktNr=224164&Ausgabe=232802&ArtikelNr=98576
29. A 2012 meta-review of published randomized controlled human trial with topical Chinese herbal medicine, by the Beijing University of Chinese Medicine, Beijing, China, found that only 10 such controlled trials were found in all of the literature, but that 6 of these human clinical trials showed that use of the topical Chinese herbal medicine with UVB therapy produced better results than UVB alone, and decreased the severity of adverse side effects. One study reported similar results in therapy between the topical Chinese herbal medicine and standard Western Medicine, or modern pharmaceutical treatment: http://www.ncbi.nlm.nih.gov/pubmed/22466949
30. A 2014 review of the evidence for Chinese Herbal Medicine (CHM) in the treatment of psoriasis, by experts at Capital Medical University, the Beijing University of Chinese Medicine, and various Chinese and Japanese hospitals, shows that there is now quality evidence for CHM to be used alone or combined with standard therapies in the treatment of psoriasis. A number of formulas studied and proven to work are presented, with a list of the herbal ingredients, and typed to subgroups of patients according to the standard practice in Traditional Chinese Medicine: http://www.sciencedirect.com/science/article/pii/S1876382014000110
31. Medscape Today lists the top 10 herbal remedies currently utilized by medical doctors in the United States: http://www.medscape.com/viewarticle/567028_2
32. The role of melatonin in the pathogenesis of psoriasis has long been noted in modern medicine: http://cat.inist.fr/?aModele=afficheN&cpsidt=18763047
33. The role of sulfur compounds and the natural cell detoxification of these compounds, such as glutathione and methionine are well documented in the normalization of skin cell disease mechanisms. Therapy may utilize sulfur containing herbs in ointment as well as nutrient medicines to boost glutathione metabolism: http://archderm.highwire.org/cgi/content/summary/34/4/568
34. The role of superantigens in psoriasis has been the subject of much of the research to find cures in the last decade. This research summary is from Duke University Medical Center, Durham, North Carolina, in 2001: http://ebm.rsmjournals.com/cgi/content/abstract/226/3/164
35. Herbal research has proven in a double-blind placebo human trial that Mahonia aquifolium produces significant benefit in the treatment of psoriasis with 12 weeks of use. This herb is analogous to the most common herb studied in China, Berberis vulgaris, or, the active ingredient berberis is found in Coptis chinensis, or Huang lian: http://journals.lww.com/americantherapeutics/pages/articleviewer.aspx?year=2006&issue=03000&article=00007&type=abstract
36. A 2009 study at Harvard Medical School and Immune Disease Institute found that a chemical derived from the Chinese herb Chang Shan, or Dichroa febrifuga, halofuginone, selectively inhibits a driver of autoimmune T-cell responses, Th-17, by activating a natural chemokine protective response, the amino acid starvation response. This activity would potentially inhibit the root autoimmune response that causes psoriasis. Unfortunately, the synthesized chemical derivative is highly toxic. Once again, use of the traditional Chinese herbs has been proven safe for thousands of years, but attempts to synthetically create chemical derivatives for patented use often proves to be risky: http://www.ncbi.nlm.nih.gov/pubmed/19498172 describes birth defect risks
37. A 2010 study at the University of Kansas found that resveratrol, a chemical found in the Chinese herb Polygonum cuspidatum (Hu zhang) and others (e.g. Rheum) regulated genetic expression of FOXO to inhibit angiogenesis in diseased tissues, such as psoriasis:http://www.ncbi.nlm.nih.gov/pubmed/20012470
38. A 2005 study at the University of Freiburg, Germany, found that a number of chemicals in medicinal herbs and foods have application in the treatment of psoriasis, acting as potent inhibitors of enzymes that drive the disease process, such as the serine protease Human neutrophil elastase (HNE). Genistein (soy and Sophora japonica, or Huai hua mi), agrimonilin (Agrimonia pilosa, or Xian he cao), and pedunculagin (pomegranates) were 3 herbal and nutrient chemicals these researchers found that were potent in this regard, that could exert effects to resolve psoriatic lesions:http://www.ncbi.nlm.nih.gov/pubmed/17024589
39. Bass and Boney Pharmaceuticals website www.rosacea-ltd.com/pregnant-rosaceans.php.3describes birth defect risks
40. About.com, accredited by Health on the Net http://ibdcrohns.about.com/cs/prescriptiondrugs/p/medprednisone.htm
41. British Medical Journal: http://adc.bmj.com/cgi/content/full/90/5/500
42. Lymphomation.org: www.lymphomation.org/side-effect-prednisone.htm
43. Respiratory Medicine vol.100, issue 8; 1307017 (Aug 06): www.resmedjournal.com/article/PIISO9546110500510X/abstract

"long-term use of high-dose inhaled corticosteroid therapy has potential to cause systemic side effects – impaired growth in children, decreased bone mineral density, skin thinning and bruising, and cataracts. Hypothalamic-pituitiary-adrenal-axis suppression, measured by serum or urine cortisol decrease correlates with the occurrence of systemic side effects of high-dose inhaled corticosteroids."