Effectiveness of a Traditional Thai Hemorrhoid and Skin Disease Formula in a Patient with Severe Psoriasis at the Thai Traditional and Alternative Medicine Center: A Case Report

Abstract

A 29-year-old Thai female patient presented with a history of thick, erythematous plaques with scaling and silvery scales accompanied by pruritus on both arms and legs, the abdomen, the back, and the forehead. The patient received treatment from a Thai traditional medicine practitioner using a traditional hemorrhoid and skin disease topical formulation in cream form (50 g per tube). The formulation contained three herbal ingredients: cottonseed oil (Gossypium spp.), turmeric (Curcuma longa L.), and cannabis leaves (Cannabis sativa L.). The cream was applied to the affected areas at a dosage of three fingertip units for a lesion approximately equivalent to two palm areas, twice daily after morning and evening bathing. The patient was followed up every 30 days for three consecutive months at the Thai Traditional and Alternative Medicine Center, Nonthaburi Province. Treatment outcomes were evaluated using the Psoriasis Area and Severity Index (PASI), and safety was assessed through laboratory investigations. Before treatment, the patient’s PASI score was 22.4, indicating very severe psoriasis (PASI > 12). Laboratory results showed elevated levels of albumin/globulin ratio, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) above the normal range. After 30, 60, and 90 days of treatment, the PASI scores decreased to 22.0, 19.2, and 13.6, respectively. However, the albumin/globulin ratio and erythrocyte sedimentation rate (ESR) remained higher than the normal range. Quality of life was assessed using the Dermatology Life Quality Index (DLQI). The results showed improvement after treatment, with the DLQI score decreasing from 24 points at baseline (Day 0), indicating a very large impact on the patient’s life, to 8 points at Day 90, indicating a moderate impact on quality of life. These findings suggest that the traditional hemorrhoid and skin disease herbal formulation may have potential in reducing the severity of psoriasis and improving quality of life among patients with severe psoriasis.