Cancer is still the second most common cause of death in the major industrial nations. Some people are particularly sensitive to oncogenic factors. External factors include; - Radiation and radioactive substances - Certain chemical products (food additives, contaminants, certain drugs) A cell that has undergone change is malignant. Unlike normal cells, cancerous cells multiply ceaselessly, and unless arrested, they will kill the host.

2. Malignant diseases
Cancer is still the second most common cause of death in the
major industrial nations.
Some people are particularly sensitive to oncogenic factors.
External factors include;
- Radiation and radioactive substances
- Certain chemical products (food additives, contaminants,
certain drugs)
A cell that has undergone change is malignant. Unlike normal
cells, cancerous cells multiply ceaselessly, and unless
arrested, they will kill the host.

3. Plants and cancer prevention
- Polyphenolic compounds containing herb:
Flavonoids (soybeans, citrus), Gingerols (ginger) and
Curcumins (turmeric)
-Carotenoids containing Herbs
carrots, tomatoes and peppers)
- Sulphur compounds containing herbs:
garlic, onions, brassicaceous vegetables (broccoli, cabbage
and cauliflower),
- Fiber and essential fatty acid containing herbs:
linseed (flaxseed), barley, cucumber, brown rice and whole
wheat.
- Diterpenes containing herbs:
Rosemary, sage and basil

5. Plants and cancer treatment
Plant Name Species Name Relevant Medicinal Compounds Action, uses and mechanism
Autumn
crocus
Colchicum
autumnale
Colchicine (toxic S.Eunsuitable
for clin. use)
Bind to tubulinblock mitosis
Camptotheca Camptotheca
acuminata
camptothecin,
topotecan (Hycamtin®),
irinotecan (CPT-11, Camptosar®)
9-aminocamptothecin (Synthetic
derivatives)
Head and neck cancers
Metastatic colon or rectal cancer
↓Topoisomerase I↓DNA replication
Nothapodytes
tree
Nothapodytes
foetida
camptothecin, acetylcamptothecin,
scopolectin
Lapacho tree
(pau d'arco)
Tabebuia spp. β lapachone, lapachol Immunostimulant, Anti-tumor
↑induction of cellular
immunitycytotoxic
mayapple Podophyllum
peltatum
podophyllotoxin (toxic
S.Eunsuitable for clin. use)
etoposide, teniposide (Synthetic
derivatives)
Lymphoma, lung, testicular cancer
Bind to tubulinblock mitosis
(teniposide↓Topoisomerase II↓DNA
rep.)
periwinkle
Vinca
Catharanthus
roseus
(Vinca rosea)
vinblastine (Velban®), vincristine
(leurocristine, Oncovin®), vindesine
(Eldisine®, Fildesin®), vinorelbine
(Navelbine®)
Leukemia, lymphoma, Hodgkin’s disease,
Wilms’ tumor, Ewing’s sarcoma and
Bronchogenic carcinoma
Bind to tubulinblock mitosis
yew Taxus baccata
Taxus brevifolia
Baccatin III Taxol
paclitaxel (Taxol®)
docetaxel (Taxotere®)
Overian, breast, lung, esophagus, and
head and neck cancers
Bind to tubulinblock mitosis
Bind to anti-apoptosis protein
apoptosis

9. Skin diseases
Specific phytotherapeutic strategies include the treatment of
eczema, contact and other allergic skin disease, superficial fungal
infections, and acne and furunculosis, and management of chronic
psoriatic diseases, and rosacea.
Herbal drugs used in skin diseases include
- Demulcents (Mucilage-containing herbs) have soothing and
emollient effect on dry or mildly inflamed skin. Such as flax,
fenugreek, mallow and marshmallow.
- Astringents are used in treating dermatitis topically by coagulating
surface proteins of cells which reduce permeability and secretion
and forming protective layer on the skin. Also its antimicrobial
activity is useful in the secondary infection in lesions. Such as Witch
hazel (Hamamelis virginiana), Oak bark (Quercus alba), Oats
(Avena sativa), Pansy flower, Heartsease (Viola tricolor).
- Immune-enhancing herbs topically: Echinacea (Echinacea spp.)
and Nigella sativa (Black cumin oil)

10. - Healing, anti-inflammatory and antimicrobial herbs topically:
a) Herbs containing volatile oil: Lavender, chamomile (Matricaria
recutita) (topically and internally), yarrow (Achillea millefolium) and
marigold (calendula) (Calendula officinalis), tea tree (Melaleuca
alternifolia), Basil (Ocimum spp.), Artimisia (A.vulgaris and A. absinthium)
b) Herbs containing saponines and alkaloids:
Licorice root (Glycyrrhiza glabra), bittersweet nightshade (Solanum
dulcamara syn: Dulcamarae stipites) and Neem (Azadirachta indica)
c) Herbs containing phenolics
St. John’s wort (Hypericum perforatum), Aloe vera gel, Red clover
(Trifolium pretense) and turmeric (Curcuma longa),
d) Herbs containing sulphur compounds
Radish (Raphanus spp.), Onion (red onion) (Allium cepa),
-Antihistaminic:
Coleus (Coleus forskohlii) contains forskolin diterpene which has inhibitory
effect on immunological histamine release and leukotriens metabolism
- Psoralens plus ultraviolet light (PUVA)
- Topical venous and connective tissue herbs:
Hawthorn (Crataegus laevigata) Biberry fruits (Vaccinium myrtillus), Grap
seed (Vitis vinifera)

11. Psoriasis
- Externally linseed oil with 1-2% of hypericum oil added.
- Saponin containing herb:
Primula (cowslip), glycyrrhiza (licorice), quillaia (quillaia),
senega (snakeroot), trigonella (fenugreek).

12. Eczema
Eczema (Dermatitis) is mostly acute, less frequently chronic,
recurrent, non-contagious inflammatory condition of the skin, it
represents an allergic response to a variety of agents that react
on the skin from either the outside or the inside. It is
characterized by redness, itching, blistering, oozing, weeping;
scaling , thickening of skin .
Eczema can be classified to morpho-etiologic types as;
1- Atopic eczema (atopic dermatitis)
2- Nummular eczema (discoid eczema)
3- Irritant contact eczema (dermatitis)
4- Allergic contact eczema
5- Hand eczema 6- Seborrheic dermatitis
7- Neurodermatitis (lichen simplex chronicus)
8- Asteatotic eczema (xerotic eczema, eczema craquele)
9- Stasis eczema

13. Irritant
contact eczemaAtopic eczema Nummular eczema Allergic
contact eczema
Sebrrheic dermatitis Hand
eczema
Neurodermatitis Stasis
eczema

14. Typical sites of eczema in adults and infants

15. European standard screening series and examples of common sources
Allergen Examples of Common Sources
Potassium dichromate Cement and leather shoes
Neomycin sulphate Topical medicaments
Thiuram mix Rubber products (shoes, balloons), pesticides
Paraphenylenediamine Hair dyes, azo dyes, fur dyes, leather dyes & photodeveloper
Benzocaine Topical anaesthetics
Formaldehyde Glues, paper, clothing, cosmetic e.g. shampoo
Colophony Adhesive plasters, paper, plaster, polishes and waxes
Quinoline mix Antiseptics in topical therapeutics
Balsam of Peru Cosmetics (perfumes, flavors)
Black rubber mix Rubber products
Wool alcohols Lanolin, vehicles
Mercapto mix Shoes, rubber products
Epoxy resin Glues, pastes, insulator, building material
Paraben mix Preservatives and vehicles in medicine and cosmetics
P-tertiarybutyl phenol formaldehyde resin
Leather, adhesive and rubber systems
Quaternium 15 Cosmetics
Nickel sulphate Ear-rings, metal tools, clothing accessories

16. Treatment of eczema
Due to the diversity of causes of eczema and types of reaction,
treatment should be planned to suit each case individually. It is
important to try to find the possible cause and to tell the patient how
to avoid it. The following are the measures that may be applied in a
case of eczema.
1. Systemic therapy:
1. Antihistamines 2. Antibiotics for secondary infection
3. Systemic corticosteroids 4- Sodium cromoglycate
II. Topical therapy:
1- Potassium permanganate solution 1/8000
2- Lead subacetate solution
3- Topical corticosteroids 4- Tar preparations
5- Doxpin 6- Pramoxine
Ш- Psoralens plus ultraviolet light (PUVA)
IV Immunosuppressives

17. Phytotherapy of eczema
- Essential fatty acids: Internally and topically.
- Demulcents (Mucilage-containing herbs) flax, fenugreek
and marshmallow.
- Astringents Such as Witch hazel, Oak bark, Oats, Pansy
flower
- Immune-enhancing herbs topically: Echinacea
- Healing, anti-inflammatory and antimicrobial herbs
topically;
a) Herbs containing volatile oil:
Lavender, chamomile (topically and internally), yarrow,
calendula, Tea tree, Basil ,Artimisia
b) Herbs containing saponines and alkaloids:
Licorice root and bittersweet
c) Herbs containing phenolics
St. John’s wort, Aloe vera gel, Red clover and turmeric.
- Antihistaminic: Coleus
- Psoralens plus ultraviolet light (PUVA)

18. Essential fatty acids
The essential fatty acids are those that are not synthesized
or poorly synthesized by human. Such as eicosapentanoic
(EPA), docosahexanoic acid (DHA) from fish oils, g linoleic
acid (GLA), evening primrose (Oenothera biennis) , borage
(Borago officinalis) and black currant (Ribes nigrum) oils.
Safflower, sunflower and pumpkin seed oils are rich in linoleic
acid
Action and uses:
Internally: reduce erythema and pruritus (for 2-3 months to
provide marked effect)
Topically: reduce erythema, pruritus and oozing.
Mechanism of action: They interfere with arachidonic acid
metabolism

19. Oak bark (Quercus alba)
Constituents: Large amounts of tannin
Action and uses: - Eczema and contact dermatitis - Eye conditions
- Inflamed hemorrhoids
Methods of application: One or two tablespoons of the chopped
bark are boiled for fifteen minutes in ½ liter of water, the liquid is
strained off, left to cool, and used undiluted.

20. Wild pansy (Viola tricolor)
Constituents: Tannins and saponin.
Action and uses:
chronic eczema and chronic skin complaints

21. Mallow (Malva sylvestris)
Constituents: mucilage.
Action and uses: A decoction is made in much the same way as
with oak bark used for treatment of eczematoid dermatitis and also
for acute bronchial catarrh.

22. Bittersweet nightshade
)Solanum dulcamara(
Constituents:
- Steroidal alkaloid glycosides (solasodine, solanosine and others),
- Steroidal saponins (Tigogenin, tiogenin and yamogenin) - Tannins
Action and uses: chronic eczema and chronic skin complaints as
cream

23. Ammi majus )Ammi majus(
Constituents: 5-methoxypsoralen and 8- methoxypsoralen
Mechanism of action: Psoralens plus ultraviolet light (PUVA) therapy
to slow skin-cell overproduction (antiproliferative activity) (Psoralens
have no effect unless combined with ultraviolet light therapy)

24. Acne vulgaris
Acne is an acute or chronic inflammatory process of sebaceous
glands
Pathogenesis:
The main factors in development of acne are:
1- Abnormal keratinization process 2- Increasing sebum
productin
3- Proliferation of Propionibacterium acnes (P. acnes)
4- Inflammation and immune responses.
Classification
Non-inflammatory (Comedonal) and inflammatory acnes
(papulopustular or cystic)
Factors affecting acne:
1- Drugs and hormones 2- Psychological conditions 3- Diet:
4- Physical trauma or irritation 5- Cosmetics. 6-
Menstrual cycle

25. Normal
sebaceouse gland Blackhead acne
Whitehead acne
Papulopustular
acne )papules(

26. Comedonal acne (Black head)
Papulopustular acne
(papules)
Papulopustular acne
(pustules)
Cystic acne

27. Treatment of acne
- Avoid anything that seems to worsen the condition
- Decreasing the amount of sebum that is secreted
- Unblocking the sebaceous duct so that the contents can be easily
- Changing the composition of the sebum to make it less irritating by
decreasing the pop-ulation of P. acnes.
- Control of inflammation.
- Hormonal therapy is indicated for women with acne especially for
those with features of androgen excess like hirsutism and
androgenic alopecia.
Phytotherapy of acne
- Essential fatty acids: Internally and topically.
- Demulcents )Mucilage-containing herbs( flax, fenugreek and
marshmallow.
- Astringents Witch hazel, Oak bark , Oats and Pansy flower
- Immune-enhancing herbs topically: Echinacea and Black seed

28. - Healing, anti-inflammatory and antimicrobial herbs topically:
a( Herbs containing volatile oil: Lavender, chamomile (topically and
internally), yarrow, marigold (calendula), Tea tree, Basil, Artimisia and
eugenol from (Eugenia aromatica)
b( Herbs containing saponines and alkaloids: Licorice root , Neem and
bittersweet
c( Herbs containing phenolics
St. John’s wort, turmeric, Aloe vera gel and Red clover
d) Herbs containing sulphur compounds
Radish (Raphanus spp.), Onion (red onion) (Allium cepa),
- Antihistaminic: Coleus
- Hormonal regulating herbs: Chaste berry, vitex (Vitex agnus–castus)
- Comedolytic, exfoliative agents: Fruit acids such as citric, gluconic,
gluconolactone, glycolic, malic and tartaric acids, have been used topically
and have shown promise in treating acne because of their exfoliative
properties. In a study, glucolactone was as effective in clearing inflamed
and non-inflamed acne lesions as 5% benzoyl peroxide.
- Topical venous and connective tissue herbs: Hawthorn (Crataegus
laevigata) Biberry fruits (Vaccinium myrtillus), Grap seed (Vitis vinifera)

29. Tea tree )Melaleuca alternifolia(
Constituents: volatile oil
Action and uses: Topical anti-allergic and anti-inflammatory
and antimicrobial activity (effective in acne treatment)
Formulation: 5% tea tree oil gel

30. Basil )Ocimum spp.(
Ocimum basilicum and O. gratissimum
Constituents: volatile oil
Action and uses: Topical anti-allergic and anti-inflammatory and
antimicrobial activity (effective in acne treatment)
Formulation: 5% volatile oil gel

31. Radish (Raphanus spp.(
Raphanus sativus and R. raphanistrum
Constituents: glucosinolates, flavonoids and anthocyanins.
Action and uses: anti-acne agent (astringent and antiseptic)
Formulation: powdered radish seed levigated in honey to get uniform
preparation, and used as anti-acne preparation.

32. Onion, red onion (Allium cepa(
Constituents: Sulfur containing compounds such as cystein and
sulfoxides
Flavonoids (quercetin and kaempferol),
Action and uses: Topical anti-allergic and anti-inflammatory and
antimicrobial activity (effective in acne treatment)
Formulation: Onion is used externally as a poultice

33. Aloe vera gel (Aloe vera)
Constituents: Anthraquinone
Polysaccharides (pectins, hemicelluloses, glucomannan, acemannan,
and mannose derivatives) composed of several monosaccharides,
predominantly mannose 6-phosphate

34. Action and uses:
Topical anti-allergic and anti-inflammatory and antimicrobial activity
(effective in acne treatment and minor wounds and inflammatory
skin disorders)
Aloe gel alone show minimal activity against acne but have
synergistic effect with Ocimum oil as anti-acne agent.
Mechanism of action
- It improves the healing of wound through
1-Stimulation the activity of macrophages and fibroblasts by
Binding of Mannose 6-phosphate and acemannan to the growth
factor receptors on the surface of the fibroblasts ↑their
activity↑granulation tissue ↑wound healing
Stimulation of Acemannan to macrophage ↑release of fibrogenic
cytokines
2- Increasing collagen and content of the granulation (Increasing
glycosaminoglycans especially hyaluronic acid of extracellular
matrix)

35. Chaste berry , vitex (Vitex agnus-castus(
Mechanism of action: ↑relase of (FSH) and ↓(LH) ↑progestrone
level and ↓estogen ttt acne.

36. Wound healing
The grand scenario of wound healing combines three processes:
hemostasis (because vessels are open), inflammation (because
there has been injury) and regeneration (because structures have
been severed or destroyed)
Factors affecting wound healing:
1- The presence or absence of bacteria.
2- The nature of the wound (open or closed).
3- The blood supply (tissue perfusion).
4- The amount of dead tissue to be eliminated
5- The type of wounded tissue
6- Age (wounds in older persons close more slowly).
7- Diabets makes the wound more prone to infection, prolong
inflammation, impair neovasculization, decrease collagen synthesis,
and impairs the macrophage functions.
8- Nutrition 9- Steroid therapy: delays the wound healing
10- Cancer and chemotherapy.
11- Stress: Psychological stress delays wound healing and
decreases immune 12- Smoking: may delay wound healing.

37. Phases of wound healing

38. Phytotherapy of wounds
- Immune-enhancing herbs topically: Echinacea and Black seed oil
- Healing, anti-inflammatory and antimicrobial herbs topically:
a( Herbs containing volatile oil: Lavender, chamomile (topically and
internally), yarrow and marigold (calendula), Tea tree, Basil, Artimisia
b( Herbs containing saponines and alkaloids Licorice root, bittersweet
and Neem
c( Herbs containing phenolics St. John’s wort, turmeric, Aloe vera gel,
red clover
- Proteolytic enzymes Bromelain from pineapple (Ananas comosus),
Papain from (Carica papaya). It is used topically as enzymatic debridement
agent. It is used internally as anti-edematous and anti-inflammatory
- Topical of venous and connective tissue herbs: hawthorn, biberry,
grap seed
- Glucosamine stimulates the synthesis of glycosaminoglycans and
collagen.
- Chitin and chitosan promotes wound healing, activates macrophages,
and bacteriostatic.
- Comfrey (Symphytum officinalis(: contains allantoin which is reported
to promote cell division and the growth of connective tissue topically.
- Chlorophyl promotes wound healing.