Background
Methods
Structured interview and validation of the questionnaire
Statistical analysis
Ethical approval
Results
Characteristics of participants
Sociodemographic variable | Number of patients | Prevalence (%) |
---|---|---|
Age (years) | ||
< 40 | 79 | 53.0 |
≥ 40 | 70 | 47.0 |
Educational status | ||
No formal education or primary school | 35 | 23.5 |
Higher education | 114 | 76.5 |
Monthly household income | ||
Low | 57 | 38.3 |
High | 92 | 61.7 |
Marital status | ||
Single | 44 | 29.5 |
Married | 100 | 67.1 |
Other | 5 | 3.4 |
Place of residence | ||
City | 62 | 41.6 |
Village | 79 | 53.0 |
Camp | 8 | 5.4 |
Psoriasis stage | ||
Early | 51 | 34.2 |
Late | 98 | 65.8 |
Period relapsed since diagnosis (years) | ||
< 2 | 70 | 47.0 |
≥ 2 | 79 | 53.0 |
Sociodemographic variable | Number of patients | Percent | Users of medicinal plants | Nonuser of medicinal plants | χ2 or Fisher’s Exact Test | P value | Correlation | P value |
---|---|---|---|---|---|---|---|---|
Age (years) | ||||||||
< 40 | 79 | 53.0 | 26 | 53 | 31.2 | <0.001 | 0.458 | <0.01 |
≥ 40 | 70 | 47.0 | 55 | 15 | ||||
Educational level | ||||||||
No formal education or primary school | 35 | 23.5 | 20 | 15 | 0.14 | 0.85 | −0.031 | 0.7 |
Higher education | 114 | 76.5 | 61 | 53 | ||||
Monthly household income | ||||||||
Low | 57 | 38.3 | 49 | 8 | 37.2 | <0.001 | −0.499 | <0.001 |
High | 92 | 61.7 | 32 | 60 | ||||
Marital status | ||||||||
Single | 44 | 29.5 | 18 | 26 | 4.6 | 0.1 | 0.169 | 0.04 |
Married | 100 | 67.1 | 60 | 40 | ||||
Other (divorced/widowed) | 5 | 3.4 | 3 | 2 | ||||
Place of residence | ||||||||
City | 62 | 41.6 | 33 | 29 | 0.23 | 0.96 | 0.012 | 0.88 |
Village | 79 | 53.0 | 44 | 35 | ||||
Camp | 8 | 5.4 | 4 | 4 | ||||
Psoriasis stage | ||||||||
Early | 51 | 34.2 | 25 | 26 | 0.89 | 0.22 | 0.077 | 0.35 |
Late | 98 | 65.8 | 56 | 42 | ||||
Period relapsed since diagnosis (years) | ||||||||
< 2 | 70 | 47.0 | 37 | 33 | 0.12 | 0.73 | 0.028 | 0.73 |
≥ 2 | 79 | 53.0 | 44 | 35 |
Medicinal plants used
Scientific name/voucher number | English common name | Local name | Family | Number of users | Used part | Method of preparation | Application |
---|---|---|---|---|---|---|---|
Aloe vera (L.) Burm.f./Pharm-PCT-115 | Aloe | Sobar | Xanthorrhoeaceae | 35 | Leaves | Gel | Aloe leaves are grounded into gel which applied on the affected area once a day. |
Trigonella arabica Delile/Pharm-PCT-2511 | Fenugreek | Helba | Leguminosae | 27 | Seeds | Paste | Grounded seeds (about 5 table spoons) are mixed with 5 table spoons of Olive oil. This paste is applied on the affected area. |
Catharanthus roseus (L.) G. Don/Pharm-PCT-2728 | Vinca | Wanake | Apocynaceae | 25 | Entire plant | Paste | Smashed Vinca leaves with Aloe vera gel are mixed. This paste applied on the affected area once a day. |
Anthemis cotula L./Pharm-PCT-178 | Chamomile | Babonaj | Compositae | 24 | Flowers | Paste | About 50 mL of powdered Chamomile flowers are mixed with 15 mL Olive oil and this paste is applied 3–5 times daily on the affected area. |
Linum usitatissimum L./Pharm-PCT-2735 | Flax | Ketan | Linaceae | 15 | Seeds | Oil | Oil from Lin seeds is warmed and applied twice a day on the affected area. |
Simmondsia chinensis (Link) C.K. Schneid./Pharm-PCT-2744 | Jojoba | Jojoba | Simmondsiaceae | 13 | Seeds | Oil | Oil from seeds is applied with extensive massage on the affected area once a day. |
Capsicum annuum L./Pharm-PCT-2729 | Red Pepper | Shatta | Solanaceae | 11 | Fruits | Ointment | The smashed fruit is mixed with 20 g of Vaseline and rubbed twice a day on the affected area. |
Glycyrrhiza glabra L./Pharm-PCT-1128 | Licorice | Arek alsoos | Leguminosae | 10 | Roots | Ointment | About 100 g of licorice powder is mixed with 100 mL of Vaseline and applied on the affected area twice a day. |
Persea americana Mill./Pharm-PCT-2740 | Avocado | Avokado | Lauraceae | 9 | Fruits | Paste | The smashed fruit is mixed with Olive oil and applied on the affected area. |
Ficus carica L./Pharm-PCT-1028 | Fig | Tenn | Moraceae | 9 | Fruits | Latex | The latex from the fruit is rubbed on the affected area once a day. |
Olea europaea L./Pharm-PCT-1664 | Olive | Zayton | Oleaceae | 7 | Fruits oil | Oil | Olive oil is applied on the affected area twice a day. |
Nigella arvensis L./Pharm-PCT-1640 | Black Cumin | Kezha | Ranunculaceae | 6 | Seeds | Oil | Oil from seeds is applied on the affected area twice a day. |
Ammi visnaga (L.) Lam./Pharm-PCT-139 | Khella | Khella masrye | Apiaceae | 6 | Fruits | Paste | Khella powder is mixed with Olive oil, this paste rubbed on the affected area twice a day. |
Curcuma longa L./Pharm-PCT-2709 | Turmeric | Korkom | Zingiberaceae | 6 | Rhizomes | Paste | About 250 g of the powdered rhizomes are boiled in 100 mL of Olive oil and the mixture is applied to the affected area once a day. |
Pinus halepensis Mill./Pharm-PCT-1863 | Pine | Sonobar | Pinaceae | 5 | Wood | Tar | Tar from Pine woods is applied on the affected area twice a day. |
Avena barbata Pott ex Link/Pharm-PCT-346 | Oat | Shofan | Poaceae | 5 | Seeds | Paste | About 50 g of seed powder is mixed with 25 mL of water and this paste is rubbed on the affected area daily at bed time. |
Juglans regia L./Pharm-PCT-2714 | Walnut | Joz | Juglandaceae | 4 | Fruits (peels) | Decoction | About 50 g of the leaves are boiled in 100 mL of water and the affected area is washed with this decoction twice a day. |
Prunus amygdalus var. amara (DC.) Focke/Pharm-PCT-2743 | Bitter Almond | Loz mor | Rosaceae | 4 | Seeds | Oil | About 20 mL of the oil are mixed with black cumin oil and applied on the affecting area once a day along with chamomile tea. |
Malva sylvestris L./Pharm-PCT-1507 | Common mallow | Khobeza | Malvaceae | 4 | Leaves | Decoction | About 10 g of the leaves are boiled in 100 mL of water. The affected is rubbed with this decoction twice a day. |
Salvia fruticosa Mill./Pharm-PCT-2117 | Sage | Maramya | Lamiaceae | 3 | Leaves | Decoction | About 20 g of the leaves are boiled in 100 mL of water and the affected is washed with this decoction twice a day. |
Paronychia argentea Lam./Pharm-PCT-1793 | Algerian tea | Rejl alhamama | Caryophyllaceae | 3 | Entire plant | Paste | About 50 g of the powdered plant are mixed with 100 mL of Olive oil and the affected area is rubbed with this paste once a day. |
Lawsonia inermis L./Pharm-PCT-2736 | Henna | Hena | Lythraceae | 3 | Leaves | Paste | About 100 g of dried Henna leaves are mixed with 30 mL of water, this paste applied on the affected area once a day. |
Urtica urens L./Pharm-PCT-2562 | Stinging Nettles | Kores | Urticaceae | 3 | Leaves | Decoction | About 100 g of the leaves are boiled in 100 mL of water and the affected area is washed with this decoction three times a day. |
Senna alexandrina Mill./Pharm-PCT-2224 | Senna | Senamake | Leguminosae | 3 | Leaves | Paste | About 50 g of dried Senna leaves are mixed with 10 mL of water and this paste is applied topically on the affected area once a day. |
Inula viscosa (L.) Aiton/Pharm-PCT-2713 | Inula | Altayon | Compositae | 2 | Leaves | Infusion | About 100 g of the leaves are steeped in 100 mL of water for 12 h. The affected area is washed with this infusion twice a day. |
Origanum jordanicum Danin & Kunne/Pharm-PCT-1729 | Thyme | Zaatar | Lamiaceae | 2 | Leaves | Decoction | About 30 g of the leaves are boiled in 100 mL of water. The affected area is washed with this decoction twice a day. |
Allium sativum L./Pharm-PCT-2704 | Garlic | Thom | Amaryllidaceae | 2 | Bulb | Vinegar | Garlic bulb vinegar is applied with massage to the affected area twice a day. |
Citrus limon (L.) Osbeck/Pharm-PCT-2741 | Lemon | laemon | Rutaceae | 2 | Fruits | Juice | About 50 mL of Lemon juice are mixed with 5 mL of concentrated iodine solution. This mixture is applied on the affected area three times a day. |
Zingiber officinale Roscoe/Pharm-PCT-2724 | Ginger | Zangabel | Zingiberaceae | 2 | Rhizomes | Ointment | About 50 g of the powdered rhizomes are mixed with 50 g of Vaseline and this ointment is rubbed on the affecting area once a day. |
Musa paradisiaca L./Pharm-PCT-2715 | Banana | Moz | Musaceae | 2 | Fruits | Paste | The smashed fruit peels are rubbed on the affected area twice a day. |
Ricinus communis L./Pharm-PCT-2742 | Castor | Kharwaa | Euphorbiaceae | 2 | Seeds | Oil | Oil from the seeds are applied on the affected area twice daily. |
Vitis vinifera L./Pharm-PCT-2665 | Grape | A’nab | Vitaceae | 2 | Fruits | Vinegar | The affected area is washed three times a day with Grape vinegar. |
Teucrium capitatum L./Pharm-PCT-2407 | Germander | Ja’ade | Lamiaceae | 2 | Leaves | Decoction | About 50 g of the leaves are boiled in 100 mL of water and the affected area is bathed with this decoction once a day. |
Item | Percent |
---|---|
Sources from where patients obtained their medicinal plants | |
Wild life | 47.9 |
Herbalists | 20.5 |
Friends | 12.3 |
Pharmacists | 1.4 |
Undeclared | 17.8 |
Sources from where patients obtained knowledge about medicinal plants | |
Family friend | 8.33 |
Other patients | 31.5 |
Herbalist | 25.9 |
Public media | 16.7 |
Pharmacists | 0.93 |
Doctors | 1.85 |
Internet | 14.8 |
Reason reported by patients for using medicinal plants | |
Medicinal plants enhance my immune system | 16.7 |
I was advised to use medicinal plants | 15.8 |
Medicinal plants are available and affordable | 5 |
Using medicinal plants is safe | 27.5 |
Medicinal plants are effective | 11.7 |
I have sufficient experience and information about medicinal plants | 6.67 |
Medicinal plants improve conventional therapy and reduce their side effects | 16.7 |
Reason reported by patients for not using medicinal plants | |
I don’t have enough information on medicinal plants | 28 |
I am not convinced that medicinal plants are better than conventional therapies | 16 |
Medicinal plants might have serious side effects | 56 |
Reasons for using or not using medicinal plants
Discussion
Plant species | Reported ethnopharmacological use with reference source | In vivo and in vitro activity against psoriasis with reference source | Side effects and toxicity with reference source |
---|---|---|---|
Aloe vera
| Hydrophilic cream and gel of Aloe vera were tried and showed significant improvement against psoriasis in a randomized clinical trial [24, 25]. In another study, topical Aloe vera with 0.1% triamcinolone acetonide was used in mild to moderate plaque psoriasis. Aloe showed its ability to reduce the clinical symptoms of psoriasis [41]. Aloe extract showed anti-psoriatic activity of 81.95%, compared with 87.94 for tazarotene in the mouse tail model of psoriasis [42]. | ||
Trigonella arabica
| No reference | No reference | |
Catharanthus roseus
| No reference | C. roseus reduced the expression of psoriatic marker, keratin 17 (K17) in human keratinocytes [47]. | No reference |
Anthemis cotula
| No reference | No reference | Contact sensitization [48]. |