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1. The Use of Carica Papaya L. to Treat Psoriasis Vulgaris <br />Wilmarie Morales Soto<br />Abstract:<br />Purpose: To find a natural and less expensive option to treat psoriasis; to lower the possibility and severity of side effects of the treatments and; to evaluate the effect of the papaya (Carica Papaya L.) for the treatment of psoriasis.<br />Method: Two groups of twenty-five volunteers will be administered a treatment based on the Carica Papaya L. One will be applying the pulp and the other one will be applying the latex found in the leaf. The treatment will administered for a period of two weeks and observations will be made before, after and during the treatment. <br />Expected Results: After receiving the papaya treatment, at least, 60% of the participants will show a significant improvement in the condition of psoriasis. The participants treated with the latex compresses will show a significant improvement on the condition sooner than those that were treated with the pulp.<br />Introduction:<br />Psoriasis is a noncontagious skin condition that is thought to result from the rapid buildup of skin cells. It is very common and causes irritation, dry patches, scales and dry flakes on the skin in the areas of the arms, elbows, legs and scalp. Psoriasis is considered to be a long term, chronic, skin condition1. <br />Psoriasis is seen worldwide on people of all ages, but most common diagnostics are done in patients of ages twenty-five to forty. This skin condition affects about one to three percent of the United States population, which is an estimated seven to eight million people. Direct and indirect costs associated with the treatment of psoriasis are about 11.25 billion dollars per year2.<br />The exact cause of psoriasis is unknown. Some researchers believe that it may be a genetic condition. This is taken into consideration due to the fact that usually members of the same family tend to have this disease in common. Others consider it to be mainly linked to the environment or a combination of both. Even though there are many speculations and research efforts regard this disease, the true cause of psoriasis is still a mystery. <br />Types of psoriasis: <br />There are several types of psoriasis, the most common being psoriasis vulgaris. About eighty percent of people who have psoriasis have psoriasis vulgaris. Psoriasis vulgaris is characterized for defined patches of red raised skin that can appear on any area of skin, although the knees, elbows, and trunk are the most common locations. Other types of psoriasis include: guttate psoriasis (small, drop like spots), inverse psoriasis (in the folds like of the underarms, navel, and buttocks), pustular psoriasis (liquid-filled yellowish small blisters), and palmoplantar psoriasis (affecting primarily the palms and the soles). Psoriasis is also associated with joint problems in about 10%-35% of patients. The joint disease associated with psoriasis is referred to as psoriatic arthritis. Psoriatic arthritis is an inflammatory, destructive form of arthritis. In most cases, the skin symptoms occur before the onset of the arthritis3.<br />Treatments:<br />There are many treatments available for psoriasis. The type and dosage of the treatment are all determined based on the type and severity of the psoriasis in the person. There are skin applied treatments, which are known as topical medications. Topical medications include: corticosteroids, vitamin D analogue creams, topical retinoids, moisturizers, and others. Fairly new treatments for psoriasis are drugs called biologics. Biologics modulate and sometime suppress the immune system that is overactive in psoriasis4. <br />Existing treatments for psoriasis have had positive results. The problem with these treatments is that they are yet to be perfected and there side effects are fairly dangerous. Overuse or prolonged use of these medications may cause: atrophy, abnormal rises in body calcium levels, skin infections, and possible cancer development. Many biologics have been deemed unsafe, for it was believed to be involved in the development of a serious brain infection (progressive multifocal leukoencephalopathy) and thus was removed from the U.S market1, 7.<br />Herbal Medicine/ Papaya<br />Throughout the ages plants have been used as natural remedies to treat several diseases. Even with all the advances of medicine and pharmacology, the use of herbal remedies is still a common practice in many countries. One of the most commonly used plants in traditional medicine is the papaya. Throughout the course of history the papaya has been used to cure several common diseases including digestive conditions, infections, parasites, and conditions related to fertility4, 6. These home remedies include the use of the fruit, the leaves, the root, and the seeds of the plant. In traditional medicine the papaya is used to treat several skin conditions such as: warts, scars, wounds, acne, burns, and psoriasis. <br />Scientific and medical research has been conducted in regards to the use of papaya for several health conditions, including the use of the papaya enzymes to treat digestive disorders. Other investigations are researching the effectiveness of the papaya seed extract to eliminate parasites. Recently, research has been done to explore the effect of papaya on the modulation of the immune system5. <br />In spite of the use of carica papaya in traditional medicine to cure psoriasis, scientific studies have not been made to determine if the treatment is effective. Thus, the objectives of this study are: 1) to find a natural and less expensive option to treat psoriasis; 2) to lower the possibility and severity of side effects of the treatments available; and 3) to evaluate the effect of the papaya (Carica Papaya L.) for the treatment of psoriasis.<br />Materials and Methodology <br />Materials:<br />Plant: Carica papaya L. The parts of the plant that will be used will be the pulp and the latex of the leaf. The papayas will be organically grown (without fertilizers, pesticides and preservatives) to avoid chemical substances from intervening with the results of the treatment and the possible curative effect of the plant. <br />Humans: The treatment will be applied on 50 volunteers with psoriasis vulgaris, from the ages of 30-40.<br />Methodology:<br />Before the tests commence, all volunteers will be tested for possible allergies to the Carica Papaya L. The volunteers will be divided into two groups (25 each). One group will be administered the pulp treatment. The other group will be given the latex treatment. Each participant will have a record which will contain observations done before, after, and during the treatment.<br />Before the treatment begins observations will be done taking in consideration the level of inflammation, the redness of the area, the amount and severity of eruptions, and the size of the infected area. Each person will apply compresses that contain the substance of each corresponding group over the affected area for ten minutes twice a day during a period of two weeks. The area will be washed with distilled water only.<br />While the treatment is being administered, annotations will be made of the progression of the disease or the reduction of symptoms. After treatment is complete final observations will be made considering the state of the skin of each individual compared with the condition before the treatment on each participant of both groups. Also, the collected data will be compared between both groups. <br />Expected Results and Discussion <br />After receiving the papaya treatment at least 60% of the participants will show a significant improvement in the condition of psoriasis. Due to a mayor concentration of lubricants, sodium, amino acids and enzymes the participants treated with the latex compresses will show a significant improvement on the condition sooner than those that were treated with the pulp.<br />It is recommended for future investigations to study the content of the different substances that are active in the latex of the leaf in order to determine the possibility of developing a medication that contains the curative agents in the latex. <br />References<br />1Psoriasis. MedlinePlus Medical Encyclopedia. Retrieve on June 20, 2011 from: http://www.nlm.nih.gov/medlineplus/psoriasis.html<br />2National Psoriasis Foundation. Statistics about psoriasis. Retrieve on of June 20, 2011 from: http://www.psoriasis.org/learn_statistics<br />3Psoriasis. Retrieved on June 23, 2011from: http://www.medicinenet.com/psoriasis/article.htm#<br />4Dawson, E. (1998). The medicinal properties of the papaya, Carica papaya L. Retrieved on June 23, 2011 from: http://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1366&context=ebl&sei-redir=1#search=%22carica%20papaya%20psoriasis%22<br />5Mojica-Henshaw, M.P., Francisco, A.D., Guzman, F., and Tigno, X.T. (2003). Possible immunomodulatory actions of Carica Papaya seed extract. Clinical Hemorheology and Microcirculation. Vol.29, Num. 3-4, pp. 219-229. <br />6Papaya. Retrieved on June 24, 2011 from: http://www.drugs.com/npp/papaya.html<br />7Psoriasis: treatments and drugs. Mayo Clinic Staff. Retrieved on une 20, 2011 from: http://www.mayoclinic.com/health/psoriasis/DS00193/DSECTION=treatments-and-drugs<br />