Psoriasis successfully treated with topical Cannabinoids: Case report

The case has been published in the Journal of Drugs in Dermatology.

Psoriasis is a common skin disorder characterized by hyperproliferation of keratinocytes. Although the exact pathophysiology of psoriasis is not entirely understood, the immune system and its interaction with the nervous system have been postulated and investigated as the underlying mechanism. The interaction between these two systems through the cholinergic anti-inflammatory pathway and also the endocannabinoid system may suggest cannabinoids as a potential addition to the antipsoriatic armamentarium.

Activation of the endocannabinoid system in the skin reduces inflammation through shifting the pro-inflammatory Th1 response to an anti-inflammatory Th2 response via cannabinoid receptor type 2 (CBr2) activation. he endocannabinoid system also plays a role in regulating keratinocyte proliferation and differentiation, which are pathologically increased in psoriasis.

Globally there has been an exponential rise in the use of medical cannabis for chronic dermatologic conditions such as psoriasis, eczema, and acne has been growing mostly owing to rapidly emerging decriminalization across the country and impressive commercially driven popularization of a variety of cannabinoid preparations including topical forms such as creams, salves, lotions, lubricants, and many others.

A 33-year-old male patient, presented with a one-year history of psoriasis, with erythematous, scaly plaques in sebaceous areas, which progressively worsened. He also reported a strong family history of psoriasis with his sister and his father. On trying over-the-counter topical hydrocortisone steroid cream which had failed to control his symptoms, he was initially prescribed triamcinolone acetonide cream 0.1%. Though erythema reduced on the patient's face, for only a short time and the disease spread to his trunk and other areas of his body.

After assessing the pros and cons, chain triglyceride (MCT) oil, beeswax, and sunflower lecithin, THC soap infused with a scent-free hemp soap, 5 mg/ml, and hair oil with THC distillate dissolved into jojoba oil, 5 mg/mL was prescribed to him with advice to apply the cream and oil to patches on body skin and to use the oil on the hair-baring areas daily as well as to use the soap when showering.

Improvement was noted within two days of initiating this regimen. Following 2 weeks of use, the patient reported continued improvement and clearance.No adverse side effects and flare-ups were noted until the complete resolution of symptoms.

"Through the literature supporting the use of cannabis for the treatment and management of psoriasis is still in its infancy, there is evidence showing that cannabis may be an effective treatment through multiple potential mechanisms. More research, investment, and acceptance are needed to fully capitalize on the potential of cannabinoids in dermatology." concluded the research team.

For the full article follow the link: Topical Cannabinoids for the Management of Psoriasis Vulgaris: Report of a Case and Review of the Literature

J Drugs Dermatol 2020 Aug 01;19(8)795, AJ Friedman, K Momeni, M Kogan

Primary source: Journal of Drugs in Dermatology