The Efficacy and Safety of Topically Applied Indigo Naturalis Ointment in Patients with Plaque-Type Psoriasis

Abstract

Background: It has been reported in the Chinese literature that indigo naturalis exhibits potential antipsoriatic effects in systemic therapy. Objective: To evaluate the efficacy and safety of topically applied indigo naturalis on treating plaque-type psoriasis and to analyze the histological change in skin tissues. Methods: Fourteen patients with chronic plaque psoriasis were enrolled. The patients were topically applied with either indigo naturalis ointment or vehicle ointment on contralateral skin lesions daily for 8 weeks. Efficacy was evaluated on the basis of the clinical scores, including induration, scaling, erythema and clearing percentage. At the end of treatment, skin punch biopsies were taken and prepared for the immunohistochemical analysis. Results: A significant reduction in clinical scores was achieved with topically applied indigo naturalis ointment. Analysis of biopsies showed a marked improvement of skin histology. The expressions of proliferating marker Ki-67 and inflammatory marker CD3 were decreased, but the differentiation marker such as filaggrin was increased in the epidermis after indigo naturalis ointment treatment. Conclusions: The results suggest that topical application of indigo naturalis ointment may be a novel, safe and effective therapy for psoriasis that is mediated, at least in part, by modulating the proliferation and differentiation of keratinocytes in epidermis, as well as by inhibiting the infiltration of T lymphocytes and therefore the subsequent inflammatory reactions in psoriatic lesions.

Clinical Efficacy and Safety of Oral Qing-Dai in Patients with Ulcerative Colitis: A Single-Center Open-Label Prospective Study

“…Topical and oral Qing-Dai are used to treat various inflammatory diseases and dermatosis, such as psoriasis [16][17][18] . Traditionally, Qing-Dai has been used in Chinese medicine to treat UC patients; however, published data on the safety and efficacy of Qing-Dai for UC patients are lacking in the English literature.…”

Traditional Chinese medicine herbs — are they safe for psoriatic patients?

“…The patients' blood parameters as well as liver and renal function tests were within the normal range. The same authors' molecular study revealed decreased expressions of Ki-67 proliferating marker as well as CD3 inflammatory marker, whereas filaggrin, the differentiation marker, was increased in the epidermis [11].…”

“…Its major active components are indirubin, indigo, and tryptanthrin. According to the literature reports, Indigo naturalis exhibits antiviral, antibacterial and anti-tumor properties [9,11]. TCM uses this herb in the treatment of various inflammatory and infectious diseases e.g.…”

“…eczema, aphthae, skin eruptions, mumps, erysipelas, herpes zoster, carbuncles and furuncles. Yet, because of its poor solubility in water and poor absorption, its use is limited [9,11,12]. Indigo naturalis' ability to modify the proliferation and differentiation of keratinocytes explains its application in the treatment of psoriatic patients.…”

Treatment of Psoriatic Nails with Indigo Naturalis Oil Extract: A Non-Controlled Pilot Study

“…Over the past 8 years, we have treated more than 10,000 patients with skin psoriasis using indigo naturalis, and our previous clinical trial results attracted much attention from mainstream newspapers and magazines. Our evidence-based research results showed that topical application of indigo naturalis ointment can significantly improve psoriatic symptoms [2,3]. …”