A double-blind evaluation of topical capsaicin in pruritic psoriasis

Ellis, Charles N.; Berberian, Brenda J.; Sulica, Virginia I.; Dodd, W. Alan; Jarratt, Michael; Katz, H. Irving; Prawer, Steven E.; Krueger, Gerald G.; Rex, Ira H.; Wolf, John E.

doi:10.1016/0190-9622(93)70208-b

Cited by 166 publications

(94 citation statements)

References 18 publications

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“…In the field of herbal medicine, statistically significant results were obtained in 2 RCTs evaluating the efficacy of topical Aloe vera cream [8, 9]and topical capsaicin in patients with pruritic psoriasis [10, 11]. Two other RCTs examined the topical application of oleum horwathiensis (Psoricur) [12]and Mahonia aquifolium [13], and found beneficial but statistically insignificant results.…”

Section: Introductionmentioning

confidence: 99%

Complementary Medicine and Psoriasis: Linking the Patient’s Outlook with Evidence-Based Medicine

Ben‐Arye

Frenkel

et al. 2003

Dermatology

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Background: There is increasing evidence for the extensive use of complementary and alternative medicine (CAM) by patients with psoriasis. Clinical research in the arena of CAM and psoriasis treatment is evolving and includes some randomized controlled trials. Objective: To study CAM use among patients with psoriasis attending a dermatology clinic in a major university hospital in northern Israel. Prevalence, reasons for CAM use and its relevance to doctor-patient communication were emphasized. Methods: Semistructured interviews were conducted with psoriasis patients in a dermatology clinic. Consent was obtained for 78 patients. Post-visit questionnaires were given to 5 physicians. Results: Seventy-eight patients with psoriasis were interviewed and 77 were studied. Sixty-two percent used CAM. Fifty-eight percent of users had seen a CAM practitioner. The study found a trend of CAM use among patients with psoriasis from Arab compared to Jewish descent (p = 0.087). CAM users reported on average 2 different CAM modalities. Herbal medicine and nutritional treatments ranked first, followed by homeopathy, traditional Chinese medicine and nutritional supplements. The main reason for CAM use was stated to be to do everything to heal the disease, followed by a quest for improved quality of life. Others mentioned an interest in a less toxic treatment, disappointment with conventional treatment and stress reduction. Well over half of the study participants and their dermatologists did not initiate a discussion about CAM use. The dermatologists’ ability to predict CAM use in their patients was relatively low. Conclusion: There is growing evidence of extensive CAM use among patients with psoriasis. Most patients use CAM as a complementary treatment, rather than an alternative to conventional treatment. Teaching CAM should be integrated into the dermatology residency curriculum. Dermatologists need to increase their awareness of CAM use by their patients in order to improve therapeutic communication.

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Section: Introductionmentioning

confidence: 99%

Complementary Medicine and Psoriasis: Linking the Patient’s Outlook with Evidence-Based Medicine

Ben‐Arye

Frenkel

et al. 2003

Dermatology

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“…As we have presented above, prolonged application of capsaicin (and other exogenous vanilloid substances) results in depletion of neuropeptides in the C-type neurons causing desensitization of TRPV1-coupled responses which can lead to disruption of the pruritogenic crosstalk of sensory neurons and other skin cells [2,5,8,41,45,46,244]. Although very few studies, investigating the therapeutic effect of topical capsaicin, fulfill the criteria of a well-designed, correctly controlled human clinical trial [245], numerous publications report on the beneficial effects of its topical application in different pruritic syndroms such as notalgia paresthetica, psoriasis, prurigo nodularis, aquagenic pruritus, uremic pruritus, cholestasis, pruritus ani or allergic rhinitis [244,[246][247][248][249][250][251][252][253][254][255]. Likewise, the anti-pruritic effect of capsaicin was also reported in animal experiments [256,257].…”

Section: Potential Itch Therapies Targeting Trpv1mentioning

confidence: 99%

TRP Channels and Pruritus

Tóth¹,

Bı́ró²

2013

TOPAINJ

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Itch (pruritus) is one of the most often seen sensory phenomena in clinical practice. Recent neurophysiological findings proposed the existence of a novel pruriceptive system which includes a multitude of pruritogenic (itch-inducing) peripheral mediators, itch-selective pruriceptors, sensory afferent networks, spinal cord neurons, and certain central nervous system regions. In this review, we first introduce major features of the pruriceptive system. We then focus on defining the roles of transient receptor potential (TRP) ion channels in skin-coupled itch and provide compelling evidence that certain thermosensitive TRP channels (especially TRPV1, TRPV3, TRPV4, and TRPA1) are indeed key players in pruritus pathogenesis. Finally, we propose TRP-centered future experimental directions towards the therapeutic targeting of TRP channels in the clinical management of itch.

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“…Interestingly, capsaicin is effective in treating systemic itch occurring in chronic kidney patients undergoing hemodialysis [100,101]. In a double-blind, placebocontrolled, crossover study, 19 hemodialysis patients with moderate to severe pruritus were examined.…”

Section: Systemic Itchmentioning

confidence: 99%

“…Topical capsaicin reduces not only the severity of pruritus in psoriasis but also reduced scaling and erythema, possibly improving the overall progression of this disease [100,101], presumably due to its synergistic anti-inflammatory effects. We have also documented cases where capsaicin was effective in the treatment of refractory, painful lipodermatosclerosis and lobular panniculitis, in which other treatments failed [102].…”

Section: Other Dermatological Indicationsmentioning

confidence: 99%