kava and Ichthyosis

The stories of kava and chaulmoogra demonstrate the importance of herbal products in ancient and recent Hawaiian medicine. Kava is a psychoactive beverage that has been used ceremonially for millennia throughout the Pacific. It is a nonfermented depressant that causes tranquil intoxication in which thoughts and memory remain clear. Its broad pharmacologic activity led to use in Hawaii to treat skin disorders and later in Germany to treat gonorrhea. Kava is now available outside the Pacific basin as a relaxant, emerging as a popular, albeit deritualized, natural product. In the late 19th century, the main treatment for leprosy was chaulmoogra, extracted from Hydnocarpus seeds. Chaulmoogra had been a traditional treatment for skin diseases in Ayurvedic and Chinese medicine. Chaulmoogra from Asian markets was expensive and usually adulterated so the USDA decided to plant Hydnocarpus in Hawaii. Joseph Rock, a botanist at University of Hawaii, trekked through southeast Asia collecting fresh seeds to plant on Oahu. Rock's trees provided chaulmoogra for leprosy patients on Molokai and elsewhere until it was replaced by dapsone. Chaulmoogra, once the treatment for leprosy worldwide, is now nearly forgotten; kava, once poorly known outside the Pacific, is now a widely-used alternative medicine. Hawaii will probably continue its role in the transition of plants from traditional use to conventional use.

Topics: Anti-Anxiety Agents; Gonorrhea; Hawaii; Humans; Ichthyosis; Kava; Leprosy; Military Medicine; Phytotherapy; Plant Extracts; Plants, Medicinal

Kava dermopathy is a common cutaneous effect of regular or heavy use of Kava, a psychoactive beverage consumed widely throughout the Pacific. In Fiji in 2012, over 1000 study participants underwent full skin examination, and kava dermopathy was a common cutaneous finding. The clinical manifestations of kava dermopathy share similarities with the spectrum of autosomal recessive congenital ichthyoses, predominantly lamellar ichthyosis. The pathogenesis of Kava dermopathy may be associated with a functional defect in one or more cytochrome P450 enzymes implicated in epidermal integrity, thus mimicking the genetic defect as seen in lamellar ichthyosis type 3.

Topics: Beverages; Cytochrome P-450 Enzyme System; Epidermis; Fiji; Humans; Ichthyosis; Kava; Lactones; Phytotherapy