Abstract
Objectives
Atopic dermatitis (AD) is a chronic inflammatory skin disorder that has the immunoallergological characteristics of atopy and is characterised by itchy dermatitis with a recurrent-relapsing course and skin hyperreactivity. Official therapy involves topical anti-inflammatory and antimicrobial drugs for the skin but, as it is a recurrent and relapsing disease, the use of systemic anti-inflammatory and immunosuppressive drugs is eventually necessary to control the disease and prevent clinical exacerbation. However, systemic treatment may have a major impact on the patient, induce adverse reactions and not resolve the disease. The aim of the study is to establish whether the use of plant extracts may play a role in improving the quality of life of AD patients.
Case presentation
We describe the clinical case of a 27-year old Caucasian woman with dry, lichenified, slightly reddened and scaly skin lesions (EASI score 1.6), with anamnesis of atopy and multiple allergies, who was treated with an alternative therapeutic strategy to her previous ones, with three herbal-based parapharmaceuticals (Ribes nigrum L. buds, Piper longum L. fruits, Perilla frutescens L. Britton leaves and seeds in LUXFITOAL; Arctium lappa L. radix, Helychrisum italicum (Roth.) G. Don. flos, Viola tricolor L. herba cum floribus in LUXDERM; Trigonella foenum grecum seed extract, Hypericum perforatum extract in LUXTRIGONELLA cream). Two weeks after taking the drops and applying the cream the dry, lichenified skin lesions were no longer present and an eudermic state of the skin is restored (EASI score 0). Furthermore, six months after the beginning of the therapy, the good condition of the skin was maintained. The patient has never had such a long lapse of time without dermatitis reappearing on the anatomical sites observed at the first follow-up. After nine months, the patient was treated again for a dermatitis that had developed at another anatomical site, spreading frontally at the border between the lower margin of the neck and the upper margin of the thorax and at the chin (EASI value 3.2), achieving a marked improvement and a return of the eudermic state after two days (EASI value 0).
Conclusions
The patient was satisfied with the “clean hands” with no inflammation, with the resolution of the dermatitis in the other body sites and stated that the therapy has improved her perceived quality of life. These botanicals may be effective and play a role in improving the quality of life of a person with AD.
Acknowledgements
We would like to thank Dr. Eoghan O'Shaughnessy for his kind help in this study.
-
Research funding: None declared.
-
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: The patient involved in the case report is being treated by Dr. Katya Wulhfard, an Internal Medicine physician and expert in Integrative Medicine. The case management and review of the scientific literature relevant to the case was carried out by Dr. Andrea Maraschio, pharmacist, pharmacoepidemiologist and by Dr. Luigi Monsellato, Orthopaedic physician, psychologist and psychotherapist, responsible for the discovery of the Omeosinergetic medical principles underlying the formulation of these herbal products. Dr. Andrea Maraschio declares that he is the scientific manager of Olos System srl, the company that owns the formulations of LUXFITOAL, LUXDERM, LUXTRIGONELLA products. The other authors declare no conflict of interest.
-
Informed consent: Informed consent was obtained from all individuals included in this study.
-
Ethical approval: Not applicable.
References
1. Liang, Y, Chang, C, Lu, Q. The genetics and epigenetics of atopic dermatitis-filaggrin and other polymorphisms. Clin Rev Allergy Immunol 2016;51:315–28. https://doi.org/10.1007/s12016-015-8508-5.Search in Google Scholar PubMed
2. Weidinger, S, Beck, LA, Bieber, T, Kabashima, K, Irvine, AD. Atopic dermatitis. Nat Rev Dis Prim 2018;4:1. https://doi.org/10.1038/s41572-018-0001-z.Search in Google Scholar PubMed
3. Sanders, KM, Akiyama, T. The vicious cycle of itch and anxiety. Neurosci Biobehav Rev 2018;87:17–26. https://doi.org/10.1016/j.neubiorev.2018.01.009.Search in Google Scholar PubMed PubMed Central
4. Weidinger, S, Novak, N. Atopic dermatitis. Lancet 2016;387:1109–22. https://doi.org/10.1016/S0140-6736(15)00149-X.Search in Google Scholar PubMed
5. Bylund, S, Kobyletzki, LB, Svalstedt, M, Svensson, Å. Prevalence and incidence of atopic dermatitis: a systematic review. Acta Derm Venereol 2020;100:adv00160. https://doi.org/10.2340/00015555-3510.Search in Google Scholar PubMed PubMed Central
6. Barbarot, S, Auziere, S, Gadkari, A, Girolomoni, G, Puig, L, Simpson, EL, et al.. Epidemiology of atopic dermatitis in adults: results from an international survey. Allergy 2018;73:1284–93. https://doi.org/10.1111/all.13401 [Epub 2018 Feb 13].Search in Google Scholar PubMed
7. Pesce, G, Marcon, A, Carosso, A, Antonicelli, L, Cazzoletti, L, Ferrari, M, et al.. Adult eczema in Italy: prevalence and associations with environmental factors. J Eur Acad Dermatol Venereol 2015;29:1180–7. https://doi.org/10.1111/jdv.12784 [Epub 2014 Nov 2].Search in Google Scholar PubMed
8. American Academy of Dermatology Association. Atopic dermatitis clinical guideline, published in 2014. Available from: https://www.aad.org/member/clinical-quality/guidelines/atopic-dermatitis.Search in Google Scholar
9. Megna, M, Napolitano, M, Patruno, C, Villani, A, Balato, A, Monfrecola, G, et al.. Systemic treatment of adult atopic dermatitis: a review. Dermatol Ther 2017;7:1–23. https://doi.org/10.1007/s13555-016-0170-1 [Epub 2016 Dec 26].Search in Google Scholar PubMed PubMed Central
10. Hanifin, JM, Thurston, M, Omoto, M, Cherill, R, Tofte, SJ, Graeber, M, et al.. The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. EASI Evaluator Group. Exp Dermatol 2001;10:11–8. https://doi.org/10.1034/j.1600-0625.2001.100102.x.Search in Google Scholar PubMed
11. Russo, E, Scicchitano, F, Whalley, BJ, Mazzitello, C, Ciriaco, M, Esposito, S, et al.. Hypericum perforatum: pharmacokinetic, mechanism of action, tolerability, and clinical drug-drug interactions. Phytother Res 2014;28:643–55. https://doi.org/10.1002/ptr.5050 [Epub 2013 Jul 30].Search in Google Scholar PubMed
12. Aarland, RC, Bañuelos-Hernández, AE, Fragoso-Serrano, M, Sierra-Palacios, ED, Díaz de León-Sánchez, F, Pérez-Flores, LJ, et al.. Studies on phytochemical, antioxidant, anti-inflammatory, hypoglycaemic and antiproliferative activities of Echinacea purpurea and Echinacea angustifolia extracts. Pharm Biol 2017;55:649–56. https://doi.org/10.1080/13880209.2016.1265989.Search in Google Scholar PubMed PubMed Central
13. Matthias, A, Blanchfield, JT, Penman, KG, Bone, KM, Toth, I, Lehmann, RP. Permeability studies of Kavalactones using a Caco-2 cell monolayer model. J Clin Pharm Therapeut 2007;32:233–9. https://doi.org/10.1111/j.1365-2710.2007.00810.x.Search in Google Scholar PubMed
14. Shara, M, Stohs, SJ. Efficacy and safety of white willow bark (salix alba) extracts. Phytother Res 2015;29:1112–6. https://doi.org/10.1002/ptr.5377 [Epub 2015 May 22].Search in Google Scholar PubMed
15. European Medicines Agency. Overview of available toxicological data regarding the herbal substance(s)/herbal preparation(s) and constituents thereof. In: Assessment report on Salix [various species including S. purpurea L., S. daphnoides Vill., S. fragilis L.], cortex Final, EMA/HMPC/80628/2016. Avaiable from: https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-salix-various-species-including-s-purpurea-l-s-daphnoides-vill-s-fragilis-l_en.pdf.Search in Google Scholar
16. Kumar, S, Kamboj, J, Suman, SS. Overview for various aspects of the health benefits of Piper longum linn. fruit. J Acupunct Meridian Stud 2011;4:134–40. https://doi.org/10.1016/S2005-2901(11)60020-4.Search in Google Scholar PubMed
17. Kumar, S, Arya, P, Mukherjee, C, Singh, BK, Singh, N, Parmar, VS, et al.. Novel aromatic ester from Piper longumand its analogues inhibit expression of cell adhesion molecules on endothelial cells. Biochemistry 2005;44:15944–52. https://doi.org/10.1021/bi050941u.Search in Google Scholar PubMed
18. Christina, AJ, Saraswathy, GR, Robert, SJ, Kothai, R, Chidambaranathan, N, Nalini, G, et al.. Inhibition of CCl4-induced liver fibrosis by Piper longum Linn. Phytomedicine 2006;13:196–8. https://doi.org/10.1016/j.phymed.2004.01.009 [Epub 2005 Jun 24].Search in Google Scholar PubMed
19. Koul, IB, Kapil, A. Evaluation of the liver protective potential of piperine, an active principle of black and long peppers. Planta Med 1993;59:413–7. https://doi.org/10.1055/s-2006-959721.Search in Google Scholar PubMed
20. Heo, JC, Nam, DY, Seo, MS, Lee, SH. Alleviation of atopic dermatitis-related symptoms by Perilla frutescens Britton. Int J Mol Med 2011;28:733–7. https://doi.org/10.3892/ijmm.2011.763.[Epub 2011 Aug 2].Search in Google Scholar PubMed
21. Szabo, SJ, Kim, ST, Costa, GL, Zhang, X, Fathman, CG, Glimcher, LH. A novel transcription factor, T-bet, directs Th1 lineage commitment. Cell 2000;100:655–69. https://doi.org/10.1016/s0092-8674(00)80702-3.Search in Google Scholar PubMed
22. Chen, ML, Wu, CH, Hung, LS, Lin, BF. Ethanol extract of perilla frutescens suppresses allergen-specific Th2 responses and alleviates airway inflammation and hyperreactivity in ovalbumin-sensitized murine model of asthma. Evid Based Complement Alternat Med 2015;2015:324265. https://doi.org/10.1155/2015/324265 [Epub 2015 Apr 20].Search in Google Scholar PubMed PubMed Central
23. Sanbongi, C, Takano, H, Osakabe, N, Sasa, N, Natsume, M, Yanagisawa, R, et al.. Rosmarinic acid in perilla extract inhibits allergic inflammation induced by mite allergen, in a mouse model. Clin Exp Allergy 2004;34:971–7. https://doi.org/10.1111/j.1365-2222.2004.01979.x.Search in Google Scholar PubMed
24. Takano, H, Osakabe, N, Sanbongi, C, Yanagisawa, R, Inoue, K, Yasuda, A, et al.. Extract of Perilla frutescens enriched for rosmarinic acid, a polyphenolic phytochemical, inhibits seasonal allergic rhinoconjunctivitis in humans. Exp Biol Med 2004;229:247–54. https://doi.org/10.1177/153537020422900305.Search in Google Scholar PubMed
25. European Medicines Agency. Antioxidative effects and anti-inflammatory effects. In:Assessment report on Arctium lappa L., radix EMA/HMPC/246764/2009: EMA, Committee on Herbal Medicinal Products (HPMC); 2010. Avaiable from: https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-arctium-lappa-l-radix_en.pdf.Search in Google Scholar
26. Viegas, DA, Palmeira-de-Oliveira, A, Salgueiro, L, Martinez-de-Oliveira, J, Palmeira-de-Oliveira, R. Helichrysum italicum: from traditional use to scientific data. J Ethnopharmacol 2014;151:54–65. https://doi.org/10.1016/j.jep.2013.11.005.Search in Google Scholar PubMed
27. Piana, M, Silva, MA, Trevisan, G, de Brum, TF, Silva, RC, Boligon, AA, et al.. Antiinflammatory effects of Viola tricolor gel in a model of sunburn in rats and the gel stability study. J Ethnopharmacol 2013;150:458–65. https://doi.org/10.1016/j.jep.2013.08.040.Search in Google Scholar PubMed
28. Bae, MJ, Shin, HS, Choi, DW, Shon, DH. Antiallergic effect of Trigonella foenum-graecum L. extracts on allergic skin inflammation induced by trimellitic anhydride in BALB/c mice. J Ethnopharmacol 2012;144:514–22. https://doi.org/10.1016/j.jep.2012.09.030 [Epub 2012 Oct 2].Search in Google Scholar PubMed
29. Schempp, CM, Windeck, T, Hezel, S, Simon, JC. Topical treatment of atopic dermatitis with St. John’s wort cream-a randomized, placebo controlled, double blind half-side comparison. Phytomedicine 2003;10:31–7. https://doi.org/10.1078/1433-187x-00306.Search in Google Scholar PubMed
30. Schempp, CM, Winghofer, B, Lüdtke, R, Simon-Haarhaus, B, Schöpf, E, Simon, JC. Topical application of St John’s wort (Hypericum perforatum L.) and of its metabolite hyperforin inhibits the allostimulatory capacity of epidermal cells. Br J Dermatol 2000;142:979–84. https://doi.org/10.1046/j.1365-2133.2000.03482.x.Search in Google Scholar PubMed
31. Penazzi, G. Emulsioni. In: Come sono fatti i cosmetici Guida pratica alla lettura dell’INCI. Milano: Edra; 2015:57–60 pp.Search in Google Scholar
32. Monsellato, LM. Cos’è la Medicina omeosinergetica (O.Medi.Sine)? In: L’infiammazione: il calore dell’evoluzione: Lettura Alternativa Edizioni; 2021:270–7 pp.Search in Google Scholar
33. Monsellato, LM. La Medicina omeosinergetica: la medicina della consapevolezza. In: I virus figli di un Dio minore Dai virus ancestrali alle moderne malattie infettive, tra genetica ed epigenetica: Uno Editori; 2022:311–5 pp.Search in Google Scholar
34. Monsellato, LM. La medicina omeosinergetica (O.Medi.Sine®). In: Epigenetica relazionale Guarire senza medicine; 2022:203–44 pp.Search in Google Scholar
© 2023 Walter de Gruyter GmbH, Berlin/Boston
