Palmoplantar Psoriasis Successfully Treated with Raw Natural Honey: A Case Report
DOI:
https://doi.org/10.17140/DRMTOJ-4-133Keywords:
Palmoplantar psoriasis, Raw natural honey, InflammationAbstract
Palmoplantar psoriasis is a disabling condition linked to significant reduction in quality-of-life. It is manifested by the development
of hyperkeratosis and/or recurrent batches of sterile pustules with associated erythema, scaling, and fissuring with symmetrical
distribution on the palm and soles. Many modalities of treatment exist including systemic therapies such as psoralen-UVA
(PUVA), retinoids, corticosteroids cyclosporine and methotrexate. Many of these systemic agents have un wanted and severe side
effects besides their high cost. Furthermore, new agents such as TNF-alfa blockers have been reported to cause paradoxical induction
of pustular psoriasis following their use or withdrawal. As a result safe, topical and effective alternatives are highly needed in
treating this chronic condition. We describe the clinical characteristics and evolution of a 68-years-old female with palmoplantar
psoriasis who was treated successfully with topical raw honey. This report provides preliminary evidence to support the use of
topical raw honey under occlusive dressing in the management of palmoplantar psoriasis.
References
Bolognia J, Jorizzo JL, Rapini RP. Dermatology. 2nd Eds. Maryland Heights, Missouri, US: Mosby Elsevier. 2008.
Pettey AA, Balkrishnan R, Rapp SR, Fleischer AB, Feldman SR. Patients with palmoplantar psoriasis have more physical disability and discomfort than patients with other forms of psoriasis: Impli-cations for clinical practice. J Am Acad Dermatol. 2003; 49: 271-275. doi: 10.1067/S0190-9622(03)01479-8
Lee E, Zarei M, LaSenna C, Villada G, Romanelli P. Psoriasis targeted therapy: Characterization of interleukin 17A expression in subtypes of psoriasis. J Drugs Dermatol. 2015; 14: 1133-1136.
Kumar B, Saraswat A, Kaur I. Palmoplantar lesions in psoriasis: A study of 3065 patients. Acta Derm Venereol. 2002; 82: 192-195. doi: 10.1080/00015550260132488
Jacobi A, Mayer A, Augustin M. Keratolytics and emollients and their role in the therapy of psoriasis: A systematic review. Dermatol Ther (Heidelb). 2015; 5: 1-18. doi: 10.1007/s13555-015-0068-3
Adişen E, Tekin O, Gülekon A, Gürer MA. A retrospective analysis of treatment responses of palmoplantar psoriasis in 114 patients. J Eur Acad Dermatol Venereol. 2009; 23: 814-819. doi: 10.1111/j.1468-3083.2009.03197.x
Khandpur S, Sharma VK. Comparison of clobetasol propio-nate cream plus coal tar vs. topical psoralen and solar ultraviolet a therapy in palmoplantar psoriasis. Clin Exp Dermatol. 2011; 36: 613-616. doi: 10.1111/j.1365-2230.2011.04061.x
Raposo I, Torres T. Palmoplantar psoriasis and palmoplantar pustulosis: Current treatment and future prospects. Am J Clin Der-matol. 2016; 17: 349-358. doi: 10.1007/s40257-016-0191-7
Mehta BH, Amladi ST. Evaluation of topical 0.1% tazarotene cream in the treatment of palmoplantar psoriasis: An observer-blinded randomized controlled study. Indian J Dermatol. 2011; 56: 40-43. doi: 10.4103/0019-5154.77550
Lozinski A, Barzilai A, Pavlotsky F. Broad-band UVB versus paint PUVA for palmoplantar psoriasis treatment. J Dermatolog Treat. 2016; 27: 221-223. doi: 10.3109/09546634.2015.1093588
Hawk JL, Grice PL. The efficacy of localized PUVA therapy for chronic hand and foot dermatoses. Clin Exp Dermatol. 1994; 19: 479-482. doi: 10.1111/j.1365-2230.1994.tb01251.x
Carrascosa JM, Plana A, Ferrándiz C. Effectiveness and safety of psoralen-UVA (PUVA) topical therapy in palmoplantar psoria-sis: A report on 48 patients. Actas Dermosifiliogr. 2013; 104: 418-425. doi: 10.1016/j.adengl.2013.04.005
Abel EA, Goldberg LH, Farber EM. Treatment of palmoplan-tar psoriasis with topical methoxsalen plus long-wave ultraviolet light. Arch Dermatol. 1980; 116: 1257-1261. doi: 10.1001/arch-derm.116.11.1257
Neumann NJ, Mahnke N, Korpusik D, Stege H, Ruzicka T. Treatment of palmoplantar psoriasis with monochromatic excimer light (308-nm) versus cream PUVA. Acta Derm Venereol. 2006; 86: 22-24. doi: 10.2340/00015555-0002
Coleman WR, Lowe NJ, David M, Halder RM. Palmoplan-tar psoriasis: Experience with 8-methoxypsoralen soaks plus ultraviolet A with the use of a high-output metal halide device. J Am Acad Dermatol. 1989; 20: 1078-1082. doi: 10.1016/S0190- 9622(89)70136-5
Schiener R, Gottlöber P, Müller B, et al. PUVA-gel vs. PU-VA-bath therapy for severe recalcitrant palmoplantar derma-toses. Photodermatol Photoimmunol Photomed. 2005; 21: 62-67. doi: 10.1111/j.1600-0781.2005.00134.x
Gupta S, Singh K, Lalit M. Comparative therapeutic evaluation of different topicals and narrow band ultraviolet B therapy com-bined with systemic methotrexate in the treatment of palmoplantar psoriasis. Indian J Dermatol. 2011; 56: 165-170. doi: 10.4103/0019- 5154.80410
Goldberg DJ, Chwalek J, Hussain M. 308-nm Excimer laser treatment of palmoplantar psoriasis. J Cosmet Laser Ther. 2011; 13: 47-49. doi: 10.3109/14764172.2011.564769
Furuhashi T, Torii K, Kato H, Nishida E, Saito C, Morita A. Efficacy of excimer light therapy (308 nm) for palmoplantar pustu-losis with the induction of circulating regulatory T cells. Exp Der-matol. 2011; 20: 768-770. doi: 10.1111/j.1600-0625.2011.01316.x
Nisticò SP, Saraceno R, Chiricozzi A, Giunta A, Di Stefani A, Zerbinati N. UVA-1 laser in the treatment of palmoplantar pustu-lar psoriasis. Photomed Laser Surg. 2013; 31: 434-438. doi: 10.1089/ pho.2013.3545
Kim YC, Lee ES, Chung PS, Rhee CK. Recalcitrant palmoplan-tar pustular psoriasis successfully treated with topical 5-aminolae-vulinic acid photodynamic therapy. Clin Exp Dermatol. 2005; 30: 723-724. doi: 10.1111/j.1365-2230.2005.01905.x
Yamamoto T. Extra-palmoplantar lesions associated with pal-moplantar pustulosis. J Eur Acad Dermatol Venereol. 2009; 23: 1227- 1232. doi: 10.1111/j.1468-3083.2009.03296.x
Kumar B, Sandhu K, Kaur I. Topical 0.25% methotrexate gel in a hydrogel base for palmoplantar psoriasis. J Dermatol. 2004; 31: 798-801. doi: 10.1111/j.1346-8138.2004.tb00602.x
Ravi Kumar BC, Kaur I, Kumar B. Topical methotrexate thera-py in palmoplantar psoriasis. Indian J Dermatol Venereol Leprol. 1999; 65: 270-272.
Kumar U, Kaur I, Dogra S, De D, Kumar B. Topical tazarotene vs. coal tar in stable plaque psoriasis. Clin Exp Dermatol. 2010; 35: 482-486. doi: 10.1111/j.1365-2230.2009.03610.x
Umezawa Y, Nakagawa H, Tamaki K. Phase III clinical study of maxacalcitol ointment in patients with palmoplantar pustulosis: A randomized, double-blind, placebo-controlled trial. J Dermatol. 2016; 43: 288-293. doi: 10.1111/1346-8138.13064
Duweb GA, Abuzariba O, Rahim M, al-Taweel M, al-Alem S, Abdulla SA. Occlusive versus nonocclusive calcipotriol ointment treatment for palmoplantar psoriasis. Int J Tissue React. 2001; 23: 59-62.
Fluhr JW, Cavallotti C, Berardesca E. Emollients, moisturizers, and keratolytic agents in psoriasis. Clin Dermatol. 2008; 26: 380-386. doi: 10.1016/j.clindermatol.2008.01.015
Schäcke H, Döcke WD, Asadullah K. Mechanisms involved in the side effects of glucocorticoids. Pharmacology and Therapeutics. 2002; 96(1): 23-43. doi.org/10.1016/S0163-7258(02)00297-8 Case Report | Volume 3 | Number 1| Mohamed H, et al
Arenas R, Moreno-Coutiño G, Vera L, Welsh O. Tinea incog-nito. Clinics in Dermatology. 2010; 28(2): 137-139. doi: 10.1016/j. clindermatol.2009.12.011
Al Sayed Mohammed H, Al-Lenjawi B, Mendoza D. Seborrheic dermatitis treatment with natural honey .Wounds International. 2018; 9: 36-38.
Kherallah B, Gouda Z, Mohamed H. Efficacy of natural hon-ey Versus fluticasone propionate in mild psoriasis: A case study. Wounds. 2017; 29: E78-E83.
Al-Lenjawi B, Mohamed H, Abu Salma M, Abo Gouda Z. Natural honey in the management of thermal burn of the foot in a type 2 diabetic patient: A case report. Dermatol Open J. 2016; 1: 14-18. doi: 10.17140/DRMTOJ1-105
Mohamed H, Abo Salma M, Al-Lenjawi B, et al. The efficacy of natural honey in the management of second degree burn com-plicated by acute dermatitis in a diabetic patient. J Diabetes Metab. 2014; 5: doi: 10.4172/2155-6156.1000373
Mohamed H. Successful healing of diabetic foot ulcers and various etiology ulcers with natural honey: An alternative paradigm in wound healing. J Diab Rel Dis. 2016; 1(1): 107.
Mohamed H, Abu Salma M, Al-Lenjawi B, et al. The efficacy and safety of natural honey on the healing of foot ulcers: A case series. Wounds. 2015; 27(4): 103-114.
Mohamed H. Natural honey as an adjunctive alternative in the management of diabetic foot ulcers. J Diabetes Metab . 2012; 20(4): 212-216. doi: 10.4172/2155-6156.S1.028
Mohamed H, Al-Lenjawi B, Abu Salma M, Abdi S. Honey based therapy for the management of a recalcitrant diabetic foot ulcer. J Tissue Viability. 2014; 23(1): 29-33. doi: 10.1016/j.jtv.2013.06.001
Mohamed H, Salma MA, Al-Lenjawi B, et al. Enhancing pri-mary healing post ray amputation in a diabetic patient: Efficacy of natural honey. Journal of Diabetic Foot Complications. 2014; 6(1): 13-18.
Al-Lenjawi B, Mohamed H, Al-Ali A, Kherallah B. Are all wound products created equally? The re-emergence of natural honey. The Journal of Diabetic Foot Complications. 2015; 7(2): 26-41.
Tonks AJ, Cooper RA, Jones KP, Blair S, Parton J, Tonks A. Honey stimulates inflammatory cytokine production from monocytes. Cytokine. 2003; 21(5): 242–347. doi: 10.1016/S1043- 4666(03)00092-9
Tomblin V, Ferguson LR, Han DY, Murray P, Schlothauer R. Potential pathway of anti-inflammatory effect by New Zealand honeys. Int J Gen Med. 2014; 7: 149-158. doi: 10.2147/IJGM. S45839
Jull AB, Cullum N, Dumville JC, Westby MJ, Deshpande S, Walker N. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2015, (3): CD005083. doi: 10.1002/14651858. CD005083.pub4
Lindberg T, Andersson O, Palm M, Fagerström C. A systematic review and meta-analysis of dressings used for wound healing: The efficiency of honey compared to silver on burns. Contemp Nurse. 2015; 51: 121-134. doi: 10.1080/10376178.2016.1171727
Borsato DM, Prudente AS, Döll-Boscardin PM, et al. Topi-cal anti-inflammatory activity of a monofloral honey of Mimo-sa scabrella provided by Melipona marginata during winter in southern Brazil.. J Med Food. 2014; 17(7): 817-825. doi: 10.1089/ jmf.2013.0024
Candiracci M, Piatti E, Dominguez-Barragán M, et al. Anti-inflammatory activity of a honey flavonoid extract on lipopolysac-charide-activated N13 microglial cells. J Agric Food Chem. 2012; 60: 12304-12311. doi: 10.1021/jf302468h
Leong AG, Herst PM, Harper JL. Indigenous New Zea-land honeys exhibit multiple anti-inflammatory activities. Innate Immun. 2012; 18: 459-466. doi: 10.1177/1753425911422263
Zare A, Ahmadi M, Hedayat A. Study on anti-inflam-matory effect of subcutaneous honey bee venom injection and dermal application of cream containing honey bee venom in adjuvant-induced arthritic rats. Arch Razi Inst. 2007; 62: 223–227. doi: 10.22092/ARI.2007.103758
Hussein SZ, Mohd Yusoff K, Makpol S, Mohd Yusof YA. Submit your article to this journal | https://openventio.org/submit-manuscript/ Gelam honey inhibits the production of proinflammatory, medi-ators NO, PGE(2), TNF-α, and IL-6 in carrageenan-induced acute paw edema in rats. Evid Based Compl Alt Med. 2012; 2012: 1-12. doi: 10.1155/2012/109636
Ahmad A, Khan RA, Mesaik MA. Anti-inflammatory effect of natural honey on bovine thrombin-induced oxidative burst in phagocytes. Phytother Res. 2009; 23: 801-808. doi: 10.1002/ptr.2648
Kassim M, Achoui M, Mustafa MR, Mohd MA, Yusoff KM. Ellagic acid, phenolic acids, and flavonoids in Malaysian honey extracts demonstrate in vitro anti–inflammatory activity. Nutr Res. 2010; 30: 650-659. doi: 10.1016/j.nutres.2010.08.008
Yang H, Liu Q, Ahn JH, et al. Luteolin down regulates IL-1b-in-duced MMP-9 and -3 expressions in osteoblasts via inhibi-tion of ERK signaling pathway. J Enzyme Inhib Med Chem. 2012; 27: 261- 226.
Majtan J, Bohova J, Garcia-Villalba R, et al. Fir hon-eydew hon-ey flavonoids inhibit TNF-a-induced MMP-9 expression in human keratinocytes: A new action of honey in wound healing. Arch Der-matol Res. 2013; 305: 619-627. doi: 10.1007/s00403-013-1385-y
Woo KJ, Jeong YJ, Inoue H, Park JW, Kwon TK. Chrysin sup-presses lipopolysaccharide-induced cycloooxy-genase-2 expression through the inhibition of nuclear fac-tor for IL-6 (NF-IL-6) DNA-binding activity. FEBS Lett. 2005; 579: 705-711. doi: 10.1016/j.feb-slet.2004.12.048
Palmieri D, Perego P, Palombo D. Apigenin inhibits the TNFα-induced expression of eNOS and MMP-9 via modulating Akt sig-nalling through oestrogen receptor engagement. Mol Cell Biochem. 2012; 371(1-2): 129-136. doi: 10.1007/s11010-012-1429-1
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Dermatology (DER) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.
