Frequency of immunostimulatory herbal supplement use among patients with autoimmune skin disease

To the Editor: Complementary and alternative medicine (CAM) use is common in the United States.1,2 However, certain herbal supplements, including Spirulina platensis, Aphanizomenon flos-aquae, Chlorella, Echinacea, and alfalfa, have immunostimulatory effects.1 Patients may consume immunostimulatory CAM for their purported health effects.3,4 However, this poses a potential risk for patients with autoimmune skin disease.1 To characterize the frequency of immunostimulatory CAM use in such patients, we performed a single-center case-control study of herbal supplement use (Spirulina, Echinacea, Chlorella, Aphanizomenon, and alfalfa) among adults with dermatomyositis (DM), cutaneous lupus erythematosus (CLE), and autoimmune blistering disease (AIBD) and healthy controls without autoimmune disease.