A double-blind randomized controlled trial of topical Curcuma xanthorrhiza Roxb. on mild psoriasis: clinical manifestations, histopathological features, and K6 expressions

Githa Rahmayunita, Tjut N.A. Jacoeb, Endi Novianto, Wresti Indriatmi, Rahadi Rihatmadja, Erdina H.D. Pusponegoro



DOI: https://doi.org/10.13181/mji.v27i3.2511

Abstract


Background: Curcuma xanthorrhiza Roxb. exerts its anti-inflammatory effects by reducing the concentration of IL-6, IL-8, and phosphorylase kinase, which has role in keratinocyte proliferation. Our study aimed to evaluate the efficacy of C. xanthorrhiza in psoriasis.

Methods: From 18 to 59 year-old patients with mild psoriasis, 2 similar lesions were selected. The severity assessment was based on the psoriasis area severity index (PASI), Trozak score, and K6 expression. Using a double-blinded randomized method, lesion was treated with 1% C. xanthorrhiza ointment vs placebo for 4 weeks. The results were analyzed by the chi-square test using STATATM V.12 software (Stata Corp.).

Results: The study was conducted in 2010 to 2012 with 17 subjects participated. The median of PASI score were reduced significantly in both lesions, either treated with 1% C. xanthorrhiza ointment vs placebo; however when compared between the group, it was not significant (p=0.520). The Trozak score were reduced in lesions treated with 1% C. xanthorrhiza ointment; but it was not significant (p = 0.306). In lesions treated with placebo, the Trozak score was increased significantly. The difference of Trozak score between lesions treated with C. xanthorrhiza and placebo was significant (p=0.024). There was no significant difference of K6 expression in lesions treated with 1% C. xanthorrhiza ointments or placebo as well as on the difference of mean values of K6 expression between the group (p=0.827).

Conclusion: Based on the results, 1% C. xanthorrhiza ointment is effective treatment option for mild psoriasis, but longer follow-up period is suggested to confirm this results. C. xanthorrhiza ointment is safe for topical administration as there were no side effects reported in this study.


Keywords


topical Curcuma xanthorrhiza, psoriasis, PASI, Trozak score, K6 expressions

Full Text:

PDF

References


  1. Gudjonsson JE, Elder JT. Psoriasis. In: Wolf K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffel DJ, editors. Fitzpatrick's Dermatology in General Medicine. 8th Edition. New York: McGraw-Hill; 2012. p.197-231
  2. Grove T. The pathogenesis of psoriasis: Biochemical aspects. [cited February 25, 2007]. Available from: http://www.jyi.org/issue-4/groove.html
  3. Ghosh A, Panda S. Recent understanding of the etiopathogenesis of psoriasis. Indian J Paediatr Dermatol. 2017;18(1):1–8. https://doi.org/10.4103/2319-7250.195569
  4. Capon F. The genetic basis of psoriasis. Int J Mol Sci. 2017;18(2):2526. https://doi.org/10.3390/ijms18122526
  5. Mustafa AA, Al-Hoqail IA. Biologic systemic therapy for moderate-to-severe psoriasis: a review. J Taibah Univ Sci. 2013;8(3):142–50. https://doi.org/10.1016/j.jtumed.2013.09.001
  6. Menter A. Recent advances in psoriasis therapy and the work of international psoriasis council. US Derm Rev. 2006;1:23–7. https://doi.org/10.1016/j.det.2014.10.001
  7. Sastroamidjoyo S. Daftar tumbuh-tumbuhan yang dapat dipergunakan sebagai bahan-bahan obat asli Indonesia. In: Tjokronegoro A, editor. Obat asli Indonesia. Jakarta: Dian Rakyat;1997. p.254-5
  8. Maria Laksmi Parahita. Curcuma xanthorrhiza (temulawak) morfologi, anatomi, dan fisiologi. [cited 20 Februari 2007]. Available from: http://toiusd.multiply.com/journal/item/240.
  9. Suyono Hadi. Manfaat temulawak ditinjau dari segi kedokteran. Naskah lengkap Simposium Nasional Temulawak, Bandung: UNPAD, 1985.
  10. Miquel J, Bernd A, Sempere JM, Díaz-Alperi J, Ramírez A. The curcuma antioxidants: pharmacological effects and prospects for future clinical use. a review. Arch Gerontol Geriatr. 2002;34(1):37–46. https://doi.org/10.1016/S0167-4943(01)00194-7
  11. Sarafian G, Afshar M, Mansouri P, Asgarpanah J, Raoufinejad K, Rajabi M. Topical turmeric microemulgel in the management of plaque psoriasis; a clinical evaluation. Iran J Pharm Res. 2015;14(3):865–76.
  12. Heng MC, Song MK, Harker J, Heng MK. Drug- induced suppression of phosphorylase kinase activity correlates with resolution of psoriasis as assessed by clinical, histological and immunohistochemical parameters. Br J Dermatol. 2000;143(5):937–49. https://doi.org/10.1046/j.1365-2133.2000.03767.x
  13. Trozak DJ. Histologic grading system for psoriasis vulgaris. Int J Dermatol. 1994;33(5):380–1. https://doi.org/10.1111/j.1365-4362.1994.tb01073.x
  14. Jacob A, Wu R, Zhou M, Wang P. Mechanism of the anti-inflammatory effect of curcumin: PPAR-γ activation. PPAR Res. 2007;2007:89369. https://doi.org/10.1155/2007/89369
  15. Kang D, Li B, Luo L, Jiang W, Lu Q, Rong M, Lai R. Curcumin shows excellent therapeutic effect on psoriasis in mouse model. Biochimie.2016 Apr;123:73-80. https://doi.org/10.1016/j.biochi.2016.01.013
  16. Liu M, Li X, Chen XY, Xue F, Zheng J. Topical application of linoleic acid-ceramide containing moisturizer exhibit therapeutic and preventive benefits for psoriasis vulgaris: a randomized controlled trial. Dermatol Ther. 2015;28(6):373–82. https://doi.org/10.1111/dth.12259
  17. Körver JE, Visser WH, van Rens DW, Pasch MC, van Erp PE, Boezeman JB, et al. A double blind, randomized quantitative comparison of calcitriol ointment and calcipotriol ointment on epidermal cell population, proliferation and differentiation. Br J Dermatol. 2007;156(1):130–7. https://doi.org/10.1111/j.1365-2133.2006.07561.x





Copyright (c) 2018 Githa Rahmayunita, Tjut N.A. Jacoeb, Endi Novianto, Wresti Indriatmi, Rahadi Rihatmadja, Erdina H.D. Pusponegoro

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

All articles and issues in Medical Journal of Indonesia have unique DOI number registered in Crossref.
 
Romeo
 
http://mji.ui.ac.id/journal/index.php/mji/pages/view/stat 
Unique Visitors