IMPACTO TERAPÊUTICO E MECANISMOS NEUROIMUNOMODULADORES DO CANABIDIOL NO PRURIDO REFRATÁRIO DE DERMATOSES CRÔNICAS

Abstract

THERAPEUTIC IMPACT AND NEUROIMMUNOMODULATORY MECHANISMS OF CANNABIDIOL IN REFRACTORY PRURITUS ASSOCIATED WITH CHRONIC DERMATOSES

ABSTRACT

Introduction: Chronic refractory pruritus, defined in this review as pruritus lasting more than six weeks with an unsatisfactory response to usual therapeutic measures, represents a significant challenge in dermatological practice. The cutaneous endocannabinoid system contributes to epidermal homeostasis and communication among keratinocytes, immune cells, and sensory nerve fibers. Objective: To critically review the available evidence regarding the therapeutic potential of cannabidiol (CBD) for refractory pruritus in chronic dermatoses, correlating its neuroimmunomodulatory mechanisms with cutaneous pathophysiology. Materials and methods: A literature review was conducted in PubMed, MEDLINE, and the Cochrane Library, considering publications from 2020 to 2026, in addition to established dermatology reference textbooks. Clinical trials, phase II/III studies, and mechanistic reviews addressing CBD, the endocannabinoid system, and cutaneous diseases were prioritized. Results: The identified studies suggest that CBD may modulate pathways involved in pruritic signaling and neurogenic inflammation, including TRPV1 and cannabinoid receptors, and may exert anti-inflammatory, antiproliferative, and sebostatic effects in specific dermatoses. Formulation strategies, including nanoencapsulation, have also been investigated to optimize cutaneous delivery. However, heterogeneity of the available evidence and the need for greater standardization of products and clinical studies limit definitive conclusions regarding efficacy and safety. Conclusion: CBD shows potential as an adjunctive approach for the management of pruritus and cutaneous inflammatory processes; however, its routine incorporation into dermatological practice requires more robust clinical evidence and careful safety assessment.

Keywords: Cannabidiol, refractory pruritus, endocannabinoid system, atopic dermatitis, neuroinflammation.