Original Article

Efficacy of Pumpkin Ointment in Treatment of Chronic Hand Eczema: A Randomized, Active-Controlled, Double Blind Clinical Trial

Abstract

Background: Hand Eczema (HE) is chronic skin disease with a high prevalence in population. It has negative impact on the quality of life. Due to the public interest in herbal remedies, we attempt to assess the efficacy of pumpkin ointment in treatment of chronic HE in this research.

Methods:  This study was conducted in an outpatient clinic at Imam-Khomeini Hospital in Tehran (Iran) from May 2015 to Nov 2016. We performed a double-blind trial on 60 patients with chronic HE randomized to four groups included pumpkin, betamethasone, eucerin and almond ointment (n=15 for each group) for 28 days. Patients were ordered to apply ointments twice a day. Hand Eczema Severity Index (HECSI) and Dermatology Life Quality Index (DLQI) of the patients were evaluated by a dermatologist on the 1st, 14th and 28th d after the start of treatment.

Results: Patients’ DLQI scores in pumpkin and betamethasone group was significant and pumpkin group showed a better response in quality of life (P=0.001). Betamethasone and pumpkin ointment were effective and showed significant improvement compared with almond and eucerin and reduce HECSI scores (P=0.002 and P=0.012 respectively). Betamethasone ointment outcome on HECSI scores in comparison with topical pumpkin was significant (P<0.001). No clinically adverse effects were observed.

Conclusion: Although pumpkin ointment showed a better response in patients’ DLQI in HE but it was less effective than betamethasone in decreasing HECSI.

Diepgen TL, Agner T, Aberer W, Berth-Jones J, Cambazard F, Elsner P, et al. Management of chronic hand eczema. Contact dermatitis. 2007; 57:203-10.

de Leon FJ, Berbegal L, Silvestre JF. Management of Chronic Hand Eczema. Actas dermo-sifiliograficas. 2015; 106:533-44.

Diepgen TL. Occupational skin-disease data in Europe. International archives of occupational and environmental health. 2003; 76:331-8.

De León F, Berbegal L, Silvestre J. Management of chronic hand eczema. Actas Dermo-Sifiliográficas (English Edition). 2015; 106:533-44.

Skoet R, Zachariae R, Agner T. Contact dermatitis and quality of life: a structured review of the literature. British Journal of Dermatology. 2003; 149:452-6.

Ghasri P, Scheinfeld N. Update on the use of alitretinoin in treating chronic hand eczema. Clinical, cosmetic and investigational dermatology. 2010; 3:59-65.

Jowkar F, Jamshidzadeh A, Mirzadeh Yazdi A, Pasalar M. The effects of fumaria parviflora L extract on chronic hand eczema: a randomized double-blind placebo controlled clinical trial. Iranian Red Crescent medical journal. 2011; 13:824-8.

Yang M, Chang JM. Successful treatment of refractory chronic hand eczema with calcipotriol/betamethasone ointment: A report of three cases. Experimental and therapeutic medicine. 2015; 10:1943-6.

Hashempur MH, Ghasemi MS, Daneshfard B, Ghoreishi PS, Lari ZN, Homayouni K, et al. Efficacy of topical chamomile oil for mild and moderate carpal tunnel syndrome: A randomized double-blind placebo-controlled clinical trial. Complementary Therapies in Clinical Practice. 2017; 26:61-7.

Niazi M, Hashempur MH, Taghizadeh M, Heydari M, Shariat A. Efficacy of topical Rose (Rosa damascena Mill.) oil for migraine headache: A randomized double-blinded placebo-controlled cross-over trial. Complementary Therapies in Medicine. 2017; 34:35-41.

King T, McKenna J, Alexandroff AB. Alitretinoin for the treatment of severe chronic hand eczema. Patient preference and adherence. 2014; 8:1629-34.

Agarwal US, Besarwal RK, Gupta R, Agarwal P, Napalia S. Hand eczema. Indian J Dermatol. 2014; 59:213-24.

Boelsma E, Hendriks HF, Roza L. Nutritional skin care: health effects of micronutrients and fatty acids. The American journal of clinical nutrition. 2001; 73:853-64.

Zhou T, Kong Q, Huang J, Dai R, Li Q. Characterization of nutritional components and utilization of pumpkin. Food. 2007; 1:313-21.

Aghili MH. Gharabadin Kabir (Republished by Institute of Medical History, Islamic and Complementary Medicine). Tehran,Iran: Iran University of Medical Sciences; 2008:1179.

Neter J, Kutner MH, Nachtsheim CJ, Wasserman W. Applied linear statistical models: Irwin Chicago; 1996.

Yousefi M, Barikbin B, Kamalinejad M, Abolhasani E, Ebadi A, Younespour S, et al. Comparison of therapeutic effect of topical Nigella with Betamethasone and Eucerin in hand eczema. Journal of the European Academy of Dermatology and Venereology. 2013; 27:1498-504.

Held E, Skoet R, Johansen JD, Agner T. The hand eczema severity index (HECSI): a scoring system for clinical assessment of hand eczema. A study of inter- and intraobserver reliability. The British journal of dermatology. 2005; 152:302-7.

Feizy V, Ghazi P, Dolatshahi M, Hatmi Z. Quality of life in vitiligo patients: a report from Razi referral University Hospital in Tehran. Tehran University Medical Journal (TUMJ). 2007; 65:50-4.

Goddard AL, Lio PA. Alternative, Complementary, and Forgotten Remedies for Atopic Dermatitis. Evidence-Based Complementary and Alternative Medicine. 2015; 2015.

Pal SK, Shukla Y. Herbal medicine: current status and the future. Asian pacific journal of cancer prevention. 2003; 4:281-8.

Akrami R, Hashempur MH, Tavakoli A, Nimrouzi M, Sayadi M, Roodaki M, et al. Effects of Fumaria parviflora L on Uremic Pruritus in Hemodialysis Patients: A Randomized, Double-Blind, Placebo-Controlled Trial. Jundishapur journal of natural pharmaceutical products. inpress:e39744.

Hashempur MH, Khademi F, Rahmanifard M, Zarshenas MM. An Evidence-Based Study on Medicinal Plants for Hemorrhoids in Medieval Persia. Journal of evidence-based complementary & alternative medicine. 2017:2156587216688597.

Kim MY, Kim EJ, Kim Y-N, Choi C, Lee B-H. Comparison of the chemical compositions and nutritive values of various pumpkin (Cucurbitaceae) species and parts. Nutrition research and practice. 2012; 6:21-7.

Zhou T, Kong Q, Huang J, Dai R, Li Q. Characterization of Nutritional Components and Utilization of Pumpkin.

Badr SE, Shaaban M, Elkholy YM, Helal MH, Hamza AS, Masoud MS, et al. Chemical composition and biological activity of ripe pumpkin fruits (Cucurbita pepo L.) cultivated in Egyptian habitats. Natural product research. 2011; 25:1524-39.

Habib MR, Iqbal A. Processing of Mixed Vegetable Juice from Tomato, Cucumber and Pumpkin. Food Science and Technology. 2014; 2:83-91.

McCusker MM, Grant-Kels JM. Healing fats of the skin: the structural and immunologic roles of the ω-6 and ω-3 fatty acids. Clinics in Dermatology. 2010; 28:440-51.

Shrivastava A, Roy S. Cucurbitaceae: A ethnomedicinally important vegetable family. Journal of Medicinal Plants. 2013; 1.

Marandi S, Parvin N. Effect of herbal topical cream AJMT in comparison with fluocinolone acetonide on hand eczema. Journal of Shahrekord Uuniversity of Medical Sciences. 2008; 10.

Jowkar F, Jamshidzadeh A, Yazdi AM, Pasalar M. The effects of fumaria parviflora L extract on chronic hand eczema: a randomized double-blind placebo controlled clinical trial. Iranian Red Crescent medical journal. 2011; 13:824.

Nawab M, Mannan A, Siddiqui M. Evaluation of the clinical efficacy of Unani formulation on eczema. 2008.

Charman C, Morris A, Williams H. Topical corticosteroid phobia in patients with atopic eczema. British journal of dermatology. 2000; 142:931-6.

Dhar S, Seth J, Parikh D. Systemic side-effects of topical corticosteroids. Indian journal of dermatology. 2014; 59:460.

Lau MYZ, Burgess JA, Nixon R, Dharmage SC, Matheson MC. A review of the impact of occupational contact dermatitis on quality of life. Journal of allergy. 2011; 2011.

Yadav M, Jain S, Tomar R, Prasad GB, Yadav H. Medicinal and biological potential of pumpkin: an updated review. Nutrition research reviews. 2010; 23:184-90.

Kim MY, Kim EJ, Kim YN, Choi C, Lee BH. Comparison of the chemical compositions and nutritive values of various pumpkin (Cucurbitaceae) species and parts. Nutrition research and practice. 2012; 6:21-7.

Oliveira M, Nunes-Pinheiro DCS, Bezerra BMO, Leite LO, Tomé AR, Girão VCC. Topical anti-infl ammatory potential of pumpkin (cucurbita pepo l.) seed oil on acute and chronic skin infl ammation in mice. Acta Scientiae Veterinariae. 2013; 41:1168.

Rawat I, Sharma D, Goel HC. Antioxidant and anti-inflammatory potential of some dietary cucurbits. Oxidants and Antioxidants in Medical Science. 2014; 3:65-72.

Sarkar S, Buha D. Effect of ripe fruit pulp extract of Cucurbita pepo Linn. in aspirin induced gastric and duodenal ulcer in rats. Indian journal of experimental biology. 2008; 46:639-45.

Marzocchella L, Fantini M, Benvenuto M, Masuelli L, Tresoldi I, Modesti A, et al. Dietary flavonoids: molecular mechanisms of action as anti-inflammatory agents. Recent patents on inflammation & allergy drug discovery. 2011; 5:200-20.

Kucharekova M, Van De Kerkhof P, Van Der Valk P. A randomized comparison of an emollient containing skin‐related lipids with a petrolatum‐based emollient as adjunct in the treatment of chronic hand dermatitis. Contact dermatitis. 2003; 48:293-9.

Hon K-LE, Wang SS, Pong NH, Leung TF. The ideal moisturizer: a survey of parental expectations and practice in childhood-onset eczema. Journal of Dermatological Treatment. 2013; 24:7-12.

Bikowski JB. Hand eczema: diagnosis and management. Cutis. 2008; 82:9-15.

Karanja JK, Mugendi BJ, Khamis FM, Muchugi AN. Nutritional Evaluation of Some Kenyan Pumpkins (Cucurbita spp.). 2014.

Held E, Agner T. Effect of moisturizers on skin susceptibility to irritants. ACTA DERMATOVENEREOLOGICA-STOCKHOLM-. 2001; 81:104-7.

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IssueVol 49 No 7 (2020) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v49i7.3588
PMCIDPMC7548497
PMID33083301
Keywords
Hand Eczema Traditional medicine Pumpkin Almond Betamethasone

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How to Cite
1.
KHADEMI A, MANSURI P, PAHLEVAN D, BOZORGI M, NASIRI M, HEJAZI S, AZIZIAN Z, SHIRBEIGI L. Efficacy of Pumpkin Ointment in Treatment of Chronic Hand Eczema: A Randomized, Active-Controlled, Double Blind Clinical Trial. Iran J Public Health. 2020;49(7):1339-1347.