Acute hepatitis induced by traditional Chinese herbs used in the treatment of psoriasis [1]

Herbal remedies are increasingly being employed in developed countries for the treatment of several disorders, such as gastrointestinal, hepatic, renal, and skin diseases. However, several reports have implicated traditional herbs in different types of liver damage, including abnormal liver tests, acute hepatitis, steatosis, chronic hepatitis, hepatic fibrosis, bile-duct injury, veno-occlusive disease, and massive hepatic necrosis with acute liver failure. Particularly, several cases of Chinese herbal medicine-induced liver disease have been reported to date in the literatureAdministration of herbal derivatives for many clinical uses has a long tradition in eastern medicine, and has gained widespread popularity all over the world in the last few years. However, any scientific evaluation of herbal products presents considerable problems, because they contain a large mixture of ingredients, and there have not been randomized, placebo-controlled clinical trials to support their efficacy and safety. Particularly, Chinese herbal products have been employed for more than 1000 years in the treatment of various ailments, such as asthenia, insomnia, dyspepsia, gallstone disease, acute and chronic hepatitis, renal failure, prostate disorders, obesity, and skin disorders. In contrast, their ability to induce several hepatotoxic effects has already been described; as far as we know, 30 cases of liver damage have been reported to date, as summarized in Table 1. Chinese herbal medicine-associated liver injury is usually represented by acute hepatitis, but chronic hepatitis, hepatic fibrosis, or massive hepatic necrosis with acute liver failure have been also described.