Cannabinoids: Potential Role in Inflammatory and Neoplastic Skin Diseases

Rose Milando; Adam Friedman

Disclosures

Am J Clin Dermatol. 2019;20(2):167-180. 

In This Article

Limitations

One of the biggest limitations of these studies is that endogenous and exogenous cannabinoids behave differently, and their modes of action in vivo and in vitro are difficult to correlate. It has also become apparent that the effects of cannabinoids vary in a dose-dependent manner. It is important to keep these factors in mind when trying to reconcile inconsistent results between studies. Large systematic reviews and meta-analyses would be helpful to sift through these studies, their methods, and their results, to reach conclusions about treatment efficacy.

One large systematic review by Whiting et al.[123] investigated the therapeutic use and adverse effects of cannabinoid administration for a variety of tissues and pathologies. The authors noted that the use of cannabinoids in the treatment of a variety of conditions such as multiple sclerosis, glaucoma, and chronic pain were associated with adverse effects such as disorientation, gastrointestinal upset, emesis, and fatigue.[123] However, this review did not address cannabinoid use in inflammatory skin conditions, nor did it supply data about adverse effects of topical cannabinoid administration. A few studies mentioned cases of ACD in response to Cannabis sativa derivatives, so it would be beneficial for future research to include large systematic reviews investigating the dermatological use and adverse effects of topical cannabinoids.[124,125]

While the political and social environment is becoming more tolerant of medicinal cannabinoids, the stigma surrounding marijuana and its derivatives still represents a barrier to research. Although the tides seem to be changing, there is a dearth of available FDA-regulated cannabinoid compounds, and, as such, many patients look to the internet and find unregulated and untested topical products.[68,126] Without proper regulation and testing, there is no way to know what exactly these products contain and whether they could be harmful to patients. Increasing research on cannabinoid treatments could potentially expand the number and variety of therapies available to patients and limit the need for unregulated products.

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