Psoriasis is a chronic inflammatory disease, which primarily engages the skin and affects approximately 2-4% of the general population; the pathogenesis of psoriasis involves interplay between environmental and genetic risk factors. 1,2 About 6% to 42% of people with psoriasis develop an inflammatory form of osteoarthritis called psoriatic arthritis (PsA). 3 This condition causes the joints to become swollen, painful and tender to the touch, but, disorders of the peripheral joint inflammation, axial skeleton, enthesitis, tenosynovitis, nail changes and dactylitis are also common in this disease. [4][5][6] It has been theorised that psoriatic/PsA may be associated with osteopenia that may lead to bone loss ending up with osteoporosis (OP). 7,8

Uremic pruritus is a frequent and prominent symptom in patients with advanced or end-stage renal disease. Lack of an effective treatment for kidney disease-associated pruritus often leads to many problems for these patients and makes it difficult to choose an appropriate treatment. The purpose of this evidence-based hypothesis is to share the scientific reasons and related mechanisms in order to claim that lettuce could be useful in the treatment of uremic pruritus. This hypothesis is based on studies related to lettuce and its anti-inflammatory, antioxidant, antidiabetic, sedative, hypnotic, nephroprotective, potassium balancing, and blood purification properties. As a result, we suggest that lettuce could be a good choice for improving and reducing uremic pruritus due to its certain characteristics. Although proof of this hypothesis requires further clinical trial studies, this hypothesis can nevertheless lead to formulating an appropriate therapy for uremic-induced pruritus. By conducting a molecular docking study, we investigated the interactions between nineteen natural bioactive components of lettuce (Lactuca sativa L.) and human kappa opioid receptors. The in silico docking studies revealed that most of the ligands showed better antipruritic efficacy than gabapentin. Gamma-tocopherol, delta-tocopherol, and campesterol demonstrated the highest binding affinities toward the target protein.