Topical application of Cassia fistula L. fruit gel in management of cutaneous lesions of pemphigus vulgaris: A double-blind, placebo-controlled clinical trial

Abstract

<strong><span style="font-size: medium;">Objective:</span></strong><span style="font-size: medium;"> <em>Cassia fistula</em></span><span style="font-size: medium;"> L. fruit extract has been traditionally used in the treatment of pemphigus vulgaris (PV) lesions in Iran. The aim of this study was to determine the efficacy of </span><em><span style="font-size: medium;">C. fistula</span></em><span style="font-size: medium;"> fruit gel on healing time of PV lesions in a clinical setting.<br /></span><strong><span style="font-size: medium;">Materials and Methods:</span></strong><span style="font-size: medium;"> This was a randomized, double-blind placebo-controlled clinical trial that was performed in dermatology ward at Saadi hospital, affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Right- or left- sided lesions of PV patients on standard systemic treatment were randomized for treatment with either </span><em><span style="font-size: medium;">C. fistula</span></em><span style="font-size: medium;"> fruit gel or placebo prescribed twice daily. The largest diameter of each lesion was measured at the baseline (day 0) and on days 10 and 20. Epithelialization Index (EI), as outcome measure was calculated and compared between the two groups.<br /></span><strong><span style="font-size: medium;">Results:</span></strong><span style="font-size: medium;"> The present study comprised 20 patients, with overall 82 cutaneous lesions including 41 lesions in the </span><em><span style="font-size: medium;">C. fistula</span></em><span style="font-size: medium;"> fruit gel group and 41 lesions in the placebo group. The EI in the </span><em><span style="font-size: medium;">C. fistula</span></em><span style="font-size: medium;"> fruit gel group was significantly higher than that of the placebo group both on day 10 (65±28vs 30±34; p=0.001) and at the end of the study (91±22 vs 69±49; p=0.003). <br /></span><strong><span style="font-size: medium;">Conclusion:</span></strong><span style="font-size: medium;"> Topical application of </span><em><span style="font-size: medium;">C. fistula</span></em><span style="font-size: medium;"> fruit gel can be considered as an effective adjuvant therapy in treatment of PV.</span>