Psoriasis and Homoeopathy

PSORIASIS:

- Psoriasis is a disease which affects the skin and also joints. 
- It commonly causes red scaly patches to appear on the skin. 
- The scaly patches caused by psoriasis, called psoriatic plaques, are areas of inflammation and excessive skin production. 
- Skin rapidly accumulates at these sites and takes a silvery-white appearance.
- Plaques frequently occur on the skin of the elbows and knees, but can affect any area including the scalp and genitals. 

- Psoriasis is an inflammatory skin disease in which skin cells replicate at an extremely rapid rate. 

- New skin cells are produced about eight times faster than normal--over several days instead of a month--but the rate at which old cells slough off is unchanged. 

- This causes cells to build up on the skin's surface, forming thick patches, or plaques, of red sores (lesions) covered with flaky, silvery-white dead skin cells (scales).

- The disorder is a chronic recurring condition which varies in severity from minor localized patches to complete body coverage. 
- Fingernails and toenails are frequently affected (psoriatic nail dystrophy) - and can be seen as an isolated finding. 
- Psoriasis can also cause inflammation of the joints, which is known as PSORIATIC ARTHRITIS. 

- The cause of psoriasis is not known, but it is believed to have a genetic component.
- Several factors are thought to aggravate psoriasis. These include stress, excessive alcohol consumption, and smoking.
- Individuals with psoriasis may suffer from depression and loss of self-esteem. 
- As such, quality of life is an important factor in evaluating the severity of the disease. 

- Certain medicines, including lithium salt and beta blockers, have been reported to trigger or aggravate the disease. 

- There are two main hypotheses about the process that occurs in the development of the disease. 

- The first considers psoriasis as primarily a disorder of excessive growth and reproduction of skin cells. The problem is simply seen as a fault of the epidermis and its keratinocytes.

- The second hypothesis sees the disease as being an immune-mediated disorder in which the excessive reproduction of skin cells is secondary to factors produced by the immune system. T cells (which normally help protect the body against infection) become active, migrate to the dermis and trigger the release of cytokines (tumor necrosis factor-alpha TNFα, in particular) which cause inflammation and the rapid production of skin cells. It is not known what initiates the activation of the T cells.

- The immune-mediated model of psoriasis has been supported by the observation that immuno-suppressant medications can clear psoriasis plaques.

TYPES OF PSORIASIS:

Plaque Psoriasis: (psoriasis vulgaris) 

PLAQUE PSORIASIS

is the most common form of psoriasis. It affects 80 to 90% of people with psoriasis. 
-Plaque psoriasis typically appears as raised areas of inflamed skin covered with silvery white scaly skin. These areas are called plaques.




Flexural Psoriasis:

 (inverse psoriasis) appears as smooth inflamed patches of skin. It occurs in skin folds, particularly around the genitals (between the thigh and groin), the armpits, under an overweight stomach (pannus), and under the breasts (infra-mammary fold). It is aggravated by friction and sweat, and is vulnerable to fungal infections.

 Guttate Psoriasis: 
is characterized by numerous small oval (teardrop-shaped) spots. These numerous spots of psoriasis appear over large areas of the body, such as the trunk, limbs, and scalp. Guttate psoriasis is associated with streptococcal throat infection

Pustular Psoriasis: 

appears as raised bumps that are filled with non-infectious pus (pustules). The skin under and surrounding pustules is red and tender. Pustular psoriasis can be localized, commonly to the hands and feet , or generalised with widespread patches occurring randomly on any part of the body.

Nail Psoriasis: 

produces a variety of changes in the appearance of finger and toe nails. These changes include discolouring under the nail plate, pitting of the nails, lines going across the nails, thickening of the skin under the nail, and the loosening (onycholysis) and crumbling of the nail.

Psoriatic arthritis involves joint and connective tissue inflammation. 

- Psoriatic arthritis can affect any joint but is most common in the joints of the fingers and toes. 

- This can result in a sausage-shaped swelling of the fingers and toes known as dactylitis. Psoriatic arthritis can also affect the hips, knees and spine (spondylitis). - About 10-15% of people who have psoriasis also have psoriatic arthritis.

Erythrodermic Psoriasis: 
- involves the widespread inflammation and exfoliation of the skin over most of the body surface. 
- It may be accompanied by severe itching, swelling and pain. 
- It is often the result of an exacerbation of unstable plaque psoriasis, particularly following the abrupt withdrawal of systemic treatment. 
- This form of psoriasis can be fatal, as the extreme inflammation and exfoliation disrupt the body's ability to regulate temperature and for the skin to perform barrier functions.

 Types of PSORIASIS from its LOCATION: 

DIAGNOSIS:

- A diagnosis of psoriasis is usually based on the appearance of the skin. There are no special blood tests or diagnostic procedures for psoriasis. 

- Sometimes a skin biopsy, or scraping, may be needed to rule out other disorders and to confirm the diagnosis. Skin from a biopsy will show clubbed  pegs if positive for psoriasis. 

- Another sign of psoriasis is that when the plaques are scraped, one can see pinpoint bleeding from the skin below (Auspitz's sign).

Differential Diagnosis:

1. Diaper dermatitis

2. Onychomycosis

3. Squamous cell carcinoma

4. Nummular eczema

5. Lichen planus

6. Lichen simplex chronicus

7. Mycosis fungoides

8. Subcorneal pustulosis

HOMOEOPATHIC MEDICINES for PSORIASIS:

ARSENICUM ALBUM:

- It is indicated when the skin is covered with rough, dry patches with scales.

- The person feels intense itching and burning on the skin patches.

- Psoriasis with itching and burning < cold & scratching

- Skin – dry , rough & scaly

- The burning sensation gets worse with scratching.

- It also gets worse on applying something cold.

- Extreme anxiety along with Restlessness.

- Patient is thirsty only for small quantity at a time with often thirst.

ARSENICUM IODATUM:

- Psoriasis with large scales.

- After falling of scales, the skin appears red, raw and inflamed.

- Dry, scaly, itchy skin.

- Scales peel off easily, leaving a raw surface exposed.

- Psoriasis that often occurs in emaciated and elderly women.

- Intense itching is felt in the raw skin.

PETROLEUM:

- Psoriasis that gets triggered in winters.

- Dry, very sensitive, rough, constricted and thickened skin which may crack easily.

- Psoriasis of the hands, Finger nails and toe nails are also affected.

- Thick crusts appear on dry skin patches.

- The skin often shows rawness and redness. It is accompanied by itching and burning. Scratching makes the skin prone to pus formation.

- Petroleum is also of great help in treating skin which gets dry and cracked. Also indicated when it bleeds easily.

HYDROCOTYLE ASIATICA:

- Dry erruptions, Great thickening of outer skin layer and exfoliation of scales.

- Psoriasis appears on trunk, extremities, palms, soles.

- Usual circular spots with scaly edges.

- Psoriasis when associated with uterine complaints.

PSORINUM:

- This is psoriasis nosode, it works when skin looks dirty

- Much itching < warmth of bed.

- Crusts disappear  in summer and reappear in winter.

- PSORINUM PATIENT IS SO DIRTY AND FOUL THAT WE CAN HAVE SMELL OF HIM IF HE IS SITTING IN NEXT ROOM.

SULPHUR:

- Patient is dirty, has aversion to bathing.

- Dry, scaly unhealthy skin.

- Disease worse in spring time and in damp weather.

- The warmth of bed worsens the itching.

- The skin also looks dirty and unhealthy.

- Sulphur is also of great help for treating Guttate Psoriasis that has been suppressed with the use of ointments.

GRAPTHITIS:

- If the crusts are sticky and glutenous, and patient is constipated and cautious.

- It is more indicated in the groin, bends of limbs and the area behind the ears.

SKOOKUM CHUCK AQUA:

- Has strong affinity for skin and mucous membrane- an anti-psoric medicines

- Dry skin, profuse, ichorous, cadaverously smelling discharge.

"PSORIASIS IS TREATED WITH CONSTITUTIONAL REMEDY, THESE INDICATED REMEDIES ARE ONLY CAN USE WHEN NO OTHER SYMPTOMS OR CAN NOT GET CONSTITUTION."