Topical cannabidiol (CBD) oil was associated with a dramatic reduction in severe, treatment-resistant keloids and a full restoration of function in a patient with chronic graft-versus-host disease, according to a new case report from researchers with the National Institutes of Health.
The report, accepted September 2 for publication in JAAD Case Reports, was authored by researchers with the National Heart, Lung, and Blood Institute and the NIH Clinical Center. The authors note that CBD has demonstrated anti-inflammatory and anti-fibrotic effects in preclinical models, but clinical evidence involving keloids remains extremely limited.
The case involved a 37-year-old man with relapsed severe aplastic anemia who underwent a hematopoietic stem cell transplant and subsequently developed chronic graft-versus-host disease (cGVHD), including severe skin and muscle-related symptoms.
The patient developed large lesions on his ankles and the tops of his feet, along with joint stiffness. The condition was resistant to corticosteroids and multiple other treatments, including ibrutinib, ruxolitinib, extracorporeal photopheresis, mycophenolate mofetil and rituximab. He was eventually diagnosed with keloids on both feet.
Belumosudil improved some of his underlying cGVHD symptoms but produced no meaningful improvement in the skin lesions. Standard treatments for the keloids, including steroid injections and laser therapy, also provided minimal benefit.
Because the keloids continued to interfere with the patient’s ability to work, clinicians initiated a trial of topical CBD oil. The patient applied the CBD product to the affected areas three times daily during the first six months, followed by one to two applications per day. Treatment continued for a total of 24 months.
Researchers said the keloids underwent “near complete flattening” after approximately 12 months. The patient experienced restoration of function and a marked improvement in quality of life soon after beginning treatment, while reporting no side effects.
Photographs included in the report show extensive raised lesions across the feet and ankles before treatment, followed by substantial flattening after CBD therapy. The authors described the post-treatment result as a full resolution of symptoms.
Following regression of the keloids, the patient was also able to taper his use of mycophenolate mofetil and corticosteroids, which researchers said reduced his risk of opportunistic infection.
The researchers cautioned that the case cannot establish that CBD alone caused the improvement because the patient was receiving other treatments. However, they said the timing and magnitude of the response, combined with existing preclinical evidence showing anti-inflammatory and anti-fibrotic effects of CBD, warrant further study.
The authors said the findings support prospective, controlled clinical trials to more rigorously evaluate CBD’s potential effectiveness and mechanisms in treating keloids.
