Honey and bee venom in dermatology: A novel possible alternative or complimentary therapy for psoriasis vulgaris.

Sir,

In this communication, we propose a hypothesis of honey and bee venom which has been used in the Ayurvedic treatments of arthritis, wounds, eczemas, and dermatitis to be a possible treatment option for psoriasis.

Honey is a carbohydrate-rich compound derived from floral and other plants nectars modified by honeybee, Apis mellifera. Bee honey has anti-inflammatory, anti-bacterial, anti-viral, and anti-oxidant properties due to its osmotic effect, hydrogen peroxide content, and high acidity. Treatment options of the venom components of this order have been widely studied in the literature.[1] It has been well-documented that undiluted honey inhibits the growth of organisms such as Staphylococcus aureus and Candida albicans.[23] Jeddar et al. reported that honey at 40% concentration was bactericidal to certain Gram-positive and Gram-negative bacteria.[2] Honey improves wound-healing, and it can be used as a wound-dressing.[4] It has been also reported that bee honey and venom regimens had been used in the Ayurvedic and folkloric treatments of arthritis, eczemas, and dermatitis.[5] Recent reports confirm that the honey is efficient in the treatment of venous and pressure ulcers.[67]

Bee venom acupuncture (BVA) method is a kind of herbal acupuncture performed with diluted honey bee venom and used efficiently in the treatment of various diseases.[8] BVA can be used into acupoints or ashi points on the body.[9] It has been reported that BVA had analgesic, anti-inflammatory, anti-cancer, and anti-arthritic effects Rheumatoid arthritis (RA) is a chronic, autoimmune, and inflammatory disorder of unknown etiology characterized by the progressive destruction of synovial membranes and articular surfaces. CD4 + T cells have a major role in the inflammation of the disease with release of the various inflammatory cytokine productions such as tumor necrosis factor-alpha and interleukin-1 (IL-1). The major aims of treatment in RA are relief of the pain, prevention of disability, and reduction of inflammation.[10] Recent studies reported that BVA is an effective therapeutic option in the treatment of RA.[1011121314] Kwon et al. reported that BVA is a clinically effective and safe method for relieving pain in the patients with knee arthritis.[11] Suh et al. stated that BVA decreased the proteolytic enzyme activity and free-radical induced protein damage in the synovial fluid in an animal model.[14] Bee venom has been reported to inhibit macrophages and lymphocytes and to decrease the infiltration of the leukocytes and fibroblast to synovium. It causes a reduction of the amount of the cytokines such as CD54, CD56, IL-1, and IL-2.[12] Psoriasis is a common, chronic, and recurrent inflammatory disease of the skin characterized by erythematous and scaling plaques. The etiopathogenesis of the disease has not been clarified yet, but it has been showed that Th2 cell activity and IL-2 production are reduced in the disease.[15] Elevated levels IL-1 α- and β-mRNA were found to be expressed in the keratinocytes cultured from the psoriatic lesions.[16] We propose that bee venom therapy may be an alternative therapeutic option in the treatment of psoriasis vulgaris that shares the similar pathway with RA. Multicenter and controlled studies may be considered out to clarify this hypothesis.