Improvement of sulphur mustard-induced chronic pruritus, quality of life and antioxidant status by Curcumin: results of a randomised, doubleblind, placebo-controlled trial
Br J Nutr. 2012; 108(7):1272-9.
Sulfur Mustard [Bis (2-chloroethyl) sulphide] or SM has been used as chemical warfare agent for almost 100 years. SM is a compound with potent alkylating, vesicant, blister-forming, cytotoxic, mutagenic and carcinogenic properties. Skin due to higher surface area is most vulnerable for SM exposure leading to chronic skin complications, such as Pruritus. Chemically injured victim of that era still suffer from SM complications and therefore have decreased Quality of life (QOL).
Treatment of SM induced chronic Pruritus includes antihistamines, local moisturizers and topical corticosteroids; out of which corticosteroids on long term application produce many side effects. Curcumin, the bioactive ingredient of turmeric, has numerous promising therapeutic benefits including anti-oxidant and anti-inflammatory activity. Regarding the role of oxidative stress and inflammation in the pathogenesis of SM-induced chronic skin complications, Curcumin could present a potential medication for alleviation of symptoms.
To investigate the therapeutic efficacy of supplementation with Curcumin in the attenuation of SM-induced pruritus.
A randomized, double-blind, double-centre and placebo-controlled trial with 96 male Iranian veterans of Iran-Iraq war (age range 37-59 years) was planned. Out of 96, 80 patients completed the study. Patients were randomized to receive either Curcumin (1 g /day, n=46) or matched placebo (n=50) for a period of 4 weeks. Patients were visited by a board-certified dermatologist at baseline and at the end of the study. Serum concentrations of substance P and activities of antioxidant enzymes were measured. Assessment of pruritus severity was done on pruritus score, visual analogue scale (VAS), and scoring atopic dermatitis (SCORAD INDEX). Quality of life (QOL) was evaluated using Dermatology Life Quality Index (DLQI) questionnaire.
Results and Discussion:
- Serum substance P concentrations (P<0.001) were reduced in the Curcumin group, while no significant change was observed in the placebo group.
- Activities of superoxide dismutase (P=0.02), glutathione peroxidase (P=0.006) and catalase(P<0.001) were significantly increased after supplementation with Curcumin whereas there was no significant change for placebo.
- There was also reduction in measures of pruritus severity including the pruritus score (P<0.001), VAS score (P<0.001), overall SCORAD (P<0.001) and objective SCORAD (P<0.009), and DLQI’s first question (P<0.001). None of these measures were significantly changed in the placebo group.
- As for the assessment of QOL, DLQI scores decreased in both Curcumin and placebo groups, however this reduction was significantly greater in the Curcumin group (P<0.001).
Based on the findings of current study Curcumin can be considered as an effective, safe, widely available and inexpensive treatment for the management of the SM-induced chronic pruritic skin lesions.