## 5 Antioxidants from Natural Products as Alternative Treatment
### Curcumin  
Curcumin, a bioactive compound found in turmeric (_Curcuma longa_), has garnered significant attention for its potent antioxidant properties and numerous health benefits. Its ability to scavenge free radicals, modulate oxidative stress, and protect cells from damage makes it particularly relevant in the context of psoriasis pathogenesis. Studies have shown that combination therapy of curcumin and Ustekinumab (CUC) in psoriasis rats exhibits superior efficacy in alleviating psoriatic symptoms and restoring antioxidant levels compared to Ustekinumab alone [8]. Moreover, curcumin demonstrates potent antiinflammatory properties and has shown effectiveness in treating psoriasis. According to a meta-analysis of 26 studies, CUR, either by itself or in combination therapy, significantly improved patients' Psoriasis Area and Severity Index (PASI) scores [77]. Preclinical studies also showed that CUR performed better in improving the psoriatic dermatitis phenotype, indicating that it may be a useful treatment for psoriasis [77].  
Notably, curcumin has been found to elevate levels of crucial antioxidants such as SOD, glutathione peroxidase (GPx), and CAT, highlighting its distinctive antioxidant effects [8]. A study presents a water-responsive gel (WRG) formulation specifically developed to improve the distribution of topical drugs to the skin for the treatment of psoriasis, using curcumin as a model drug. The findings demonstrated that the application of curcumin-loaded WRG (CUR-WRG) showed a notable decrease in oxidative stress indicators, such as MDA, and an increase in antioxidant enzyme activity, including SOD, in both skin tissue and serum. These results emphasize the capacity of CUR-WRG to rectify oxidative imbalance in psoriatic skin, indicating it as a promising method for controlling psoriasis by improving topical antioxidant treatment [78]. An investigation also shows that the administration of curcumin greatly reduced the concentrations of ROS and MDA in skin tissues while simultaneously improving antioxidant defenses, including SOD and CAT [79].  
These findings indicate that curcumin has the ability to effectively reduce oxidative damage in psoriasis.  
Research indicates that topical application or oral supplementation of curcumin can effectively alleviate psoriaticity symptoms such as scaling, itching, and redness, making it a viable adjuvant treatment option for psoriasis management. A study conducted by [PERSON] et al. was performed by instructing the patient to apply 2 g of cream (EP2311454) three times a day, spreading it evenly over the afflicted regions and rubbing them in until completely absorbed. Curcumin is one of the antioxidant compounds in EP2311454 therapy, which has been shown to have anti-inflammatory properties in vitro and to be effective in treating patients with mild to severe psoriasis [80]. According to [PERSON] et al. (2020), clinical outcomes included 80% significant decreases in Dermatology Life Quality Index (DLOI) ratings, a reduction in Body Surface Area (BSA) after 15 days of therapy, and severe patients reaching a PASI of 75. The evidence supports the use of curcumin as a helpful adjuvant therapy for psoriasis symptoms, whether it is used topically or as a supplement.  
In summary, curcumin shows promise as a therapeutic agent for the management of psoriasis due to its strong anti-inflammatory and antioxidant qualities. Research has demonstrated its effectiveness in preclinical models and clinical settings, with improvements observed in BSA, DLQI ratings, and PASI scores. Adding curcumin to therapy regimens, either as an oral supplement or as a topical application, offers a beneficial adjuvant approach to the overall management of psoriasis, potentially relieving symptoms and enhancing the quality of life for patients. Further research is warranted to elucidate its mechanisms of action and optimize its therapeutic use in psoriasis treatment.