kava and Skin-Diseases

The burden of non-infectious skin disease in the Indigenous Australian population has not been previously examined. This study considers the published data on the epidemiology and clinical features of a number of non-infectious skin diseases in Indigenous Australians. It also outlines hypotheses for the possible differences in the prevalence of such diseases in this group compared with the general Australian population. There is a paucity of literature on the topic but, from the material available, Indigenous Australians appear to have a reduced prevalence of psoriasis, type 1 hypersensitivity reactions and skin cancer but increased rates of lupus erythematosus, kava dermopathy and vitamin D deficiency when compared to the non-Indigenous Australian population. This article profiles the prevalence and presentation of non-infectious skin diseases in the Indigenous Australian population to synthesise our limited knowledge and highlight deficiencies in our understanding.

Topics: Australia; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Eczema; Humans; Hypersensitivity, Immediate; Incidence; Kava; Lupus Erythematosus, Discoid; Lupus Erythematosus, Systemic; Melanoma; Native Hawaiian or Other Pacific Islander; Prevalence; Psoriasis; Skin Diseases; Skin Neoplasms

This paper systematically reviews the clinical evidence relating to the safety of extracts of the herbal anxiolytic kava (Piper methysticum). Literature searches were conducted in four electronic databases and the reference lists of all papers located were checked for further relevant publications. Information was also sought from the spontaneous reporting schemes of the WHO and national drug safety bodies and ten manufacturers of kava preparations were contacted. Data from short-term post-marketing surveillance studies and clinical trials suggest that adverse events are, in general, rare, mild and reversible. However, published case reports indicate that serious adverse events are possible including dermatological reactions, neurological complications and, of greatest concern, liver damage. Spontaneous reporting schemes also suggest that the most common adverse events are mild, but that serious ones occur. Controlled trials suggest that kava extracts do not impair cognitive performance and vigilance or potentiate the effects of central nervous system depressants. However, a possible interaction with benzodiazepines has been reported. It is concluded that when taken as a short-term monotherapy at recommended doses, kava extracts appear to be well tolerated by most users. Serious adverse events have been reported and further research is required to determine the nature and frequency of such events.

Topics: Anti-Anxiety Agents; Anxiety; Chemical and Drug Induced Liver Injury; Drug Interactions; Ethanol; Humans; Kava; Myoglobinuria; Nervous System Diseases; Neuropsychological Tests; Phytotherapy; Plant Extracts; Plants, Medicinal; Product Surveillance, Postmarketing; Psychomotor Performance; Randomized Controlled Trials as Topic; Skin Diseases; Sleep

Topics: Acute Disease; Aftercare; Anti-Inflammatory Agents; Biopsy; Diagnosis, Differential; Erythema; Exanthema; Female; Humans; Kava; Plants, Medicinal; Prednisolone; Pruritus; Skin Diseases; Systemic Inflammatory Response Syndrome; Treatment Outcome; Urticaria; Young Adult

Heavy kava use in Aboriginal communities has been linked to various health effects, including anecdotes of sudden cardiac deaths.. To examine associations between kava use and potential health effects.. A cross-sectional study was carried out within a kava-using east Arnhem Land Aboriginal community in tropical northern Australia. One-hundred-and-one adults who were current, recent or non-users of kava were enrolled in March 2000. Main outcome measures were physical, anthropometric, biochemical, haematological, immunological and neurocognitive assessments.. Kava users more frequently showed a characteristic dermopathy (P<0.001). They had increased levels of gamma-glutamyl transferase and alkaline phosphatase (P<0.001). Lymphocyte counts were significantly lower in kava users (P<0.001). Fibrinogen, plasminogen activator inhibitor-1 and neurocognitive tests were not different between kava use categories. IgE and IgG antibodies were elevated across the whole group, as were C-reactive protein and homocysteine.. Kava use was associated with dermopathy, liver function abnormalities and decreased lymphocytes. If kava continues to be used by Aboriginal populations, monitoring should focus on the health consequences of these findings, including a possible increase in serious infections. The interaction between kava, alcohol and other substances requires further study. Although markers of cardiovascular risk are increased across the population, these were not higher in kava users, and this increase may be linked to the large infectious pathogen burden reflective of the socioeconomic disadvantage seen in many remote Aboriginal communities.

Topics: Adult; Alkaline Phosphatase; Antibodies; C-Reactive Protein; Cognition; Cross-Sectional Studies; Fibrinogen; gamma-Glutamyltransferase; Humans; Immunoglobulin E; Immunoglobulin G; Kava; Lymphocyte Count; Male; Native Hawaiian or Other Pacific Islander; Northern Territory; Plasminogen Activator Inhibitor 1; Skin Diseases

Kava is a psychoactive beverage used ceremonially for thousands of years by Pacific Islanders. Kava is made from the root of the pepper plant, Piper methysticum, found in Polynesia, Melanesia, and Micronesia. The beverage is a nonfermented depressant with complex neuropharmacologic properties that causes a tranquil state of intoxication. Kava also affects the skin, causing a peculiar scaly eruption. The cutaneous effects were first reported by members of Captain James Cook's Pacific expeditions, but they have never been described in dermatologic literature. Heavy kava drinkers acquire a reversible ichthyosiform eruption, kava dermopathy. The cause is unknown but may relate to interference with cholesterol metabolism. Today kava is used across the Pacific in both traditional ceremonies and informal social events. In Western nations, kava is sold as a relaxant by health food stores. This article explores the history of kava dermopathy from Cook's early reports to its presence today.

Topics: Beverages; Ceremonial Behavior; Cultural Characteristics; Female; Humans; Kava; Male; Pacific Islands; Plant Extracts; Plants, Medicinal; Skin Diseases