Psoriasis
Overview
Psoriasis patches develops on knees, elbows, scalp and lower back.
Flare ups keeps on appearing. Disappearing of symptoms does not mean that disease has been cured, it may have entered into remission stage.
Causes
Immune system
Defect in immune system plays vital role in developing psoriasis.
An autoimmune mediated inflammatory cells, T- lymphocytes attacks its own cells causing inflammation and damage to the skin. Skin tends to multiplies five times more than usual.
As the new cells keeps on building up on skin, it gradually develops ass white patches.
Genetic disorder
If your first relative have psoriasis, your chance of developing the disease doubles up.
Environmental factors
You may develop the disease after certain period of time; which may be due to triggering environmental condition such as,
- Infection
- Weather effect
- Injury to skin
- Stress and anxiety
- Smoking
- Excessive consumption of alcohol
- Certain medication
Signs and Symptoms
Signs and symptoms differs from different types of psoriasis. Some common representations are as below:
- Red, thick, inflamed skin patches
- Itchy skin, may be painful and sometimes even bleeds
- Dry and cracked skin
- Thick and pitted nails
- Painful joints
Types
Plaque psoriasis
About 80 percentage of psoriasis patient is found to have plaque psoriasis.
Red, inflamed patches present on elbows, knees and scalp.
Guttate psoriasis
Often child shows this type of psoriasis.
Small pink on skin are developed.
Patches are found on torso, arms and legs.
Inverse psoriasis
Mainly found on skin folds like; on armpits, buttocks, groin and breasts.
Represents as red, shiny, and inflamed skin. This condition is worsen by friction and sweating.
Fungal infection is the triggering cause.
Erythrodermic psoriasis
Erythrodermic is very rare type of psoriasis.
It covers major portion of the skin. Peeling and burning in large sections of skin are appeared. Skin appears as sunburned.
Fever is common symptom in this type. This is found to be life-threatening condition, if not taken care properly. So without delay visit your doctor.
Nail psoriasis
Common in patient who have psoriatic arthritis.
Affects fingernails and toenails. Represents as pitting of nails, abnormal nail growth and discoloration.
Pustular psoriasis
Rare type of psoriasis. Pus filled lesions and red skin surrounding it. Fever, chills, nausea, rapid heart beat and muscular weakness are common symptoms.
Diagnosis
For diagnosis you will asked questions about medical history by your doctor. With the aid of physical examination of nails, scalp and skin generally final diagnosis is done.
Biopsy
If in any confusion, your doctor will take tissues of your skin and the sample will be send for biopsy study, to confirm probable diagnosis.
Biopsy shows parkeratosis, micro abscess, absence of granular lesions, regular elongation of ridges in form of camel foot appearance, spongiform pustules of Kogoj with dilated and tortuous capillaries in dermal papilla.
Laboratory tests
- Complete blood count
- Renal function test
- Liver function test
- ESR (Erythrocyte sedimentation rate), is raised in erythrodermic and pustular psoriasis
- Uric acid levels are at higher side
Differential Diagnosis
- Eczema
- Seborrheic dermatitis
- Pityriasis rosea
- Mycosis fugoides
- Secondary syphilis
Complications
Some common complication related to psoriasis are:
- Inflammatory bowel disease
- Diabetes mellitus
- Cardiovascular diseases
- Psoriatic arthritis
- Anxiety
- Depression
Homeopathic treatment for psoriasis
Graphitis
- Indicated for all sorts of skin conditions.
- There is moist scaly eruptions on scalp, face, bends of joints, between fingers and behind the ears.
- The sides of mouth and eyes are cracked, bleeds and oozes gluey nectar like thick, tenacious discharge.
- Great itching accompanies the eruption. Dry and horny skin. Hair falls out.
Arsenic alb
- Indicated for chronic thickened skin.
- For psoriasis, eczema and chronic urticaria.
- Itching and burning sensation, swelling with papules, nettle rash and pimple formation.
- Burning sensitive ulcers with offensive discharge.
- Pustular forms into scabs.
Sulfur
- Indicated when skin is rough, coarse and soreness in the folds of skin. There is tendency to pustular eruption.
- Great aggravation from washing and scratching, makes the parts burn.
- Dryness and heat of scalp with extreme and severe itching especially at evening time.
- Eruption of yellow crusts. Eruption at margin of hair. It is great anti septic remedy.
Rhus tox
- Indicated for psoriatic arthritis.
- The skin is covered with various vesicles, person feels great itching and tingling sensation. Skin is swollen and edematous. Vesicles have red areola around them.
- Symptoms are worst at night, in damp weather and in winter. Rapid vesication and angry looking skin are main characteristics of sulfur.
Mezerum
- There is great itching, which is worse when patient is warm or wrapped up. There is small vesicles with terrible itching.
- Secretions dries up quickly, producing scabs from beneath, from which acrid thick pus oozes out, it is the main characteristic of this drug.
Petroleum
- Petroleum has main indication, when there is great dryness at folds, scalp, face and genitals.
- Every little injury suppurates. Cracks and fissures are common.
- Discharge oozing out which is thin and watery. Symptoms are worse in winter.
- Skin is dry, cracked, constricted, very sensitive, rough, fissure and leathery.
- Thick greenish crusts, burning and itching, redness raw, cracks and bleeds easily.
- Severe and violent itching. Cannot rest until scratched. Scratches till skin starts to peel off and becomes moist, raw and inflamed.
- Tips of fingers are rough, cracked, fissured every winter. Deep cracks in palms.
- Skin symptoms appears if diarrhea is suppressed.
- Foul smelling sweat all over the skin especially foot sweat, intense heat and burning on soles of feet and palms of hands.
Treatment with modern medicine
According to modern medicine, there is no permanent cure for psoriasis. Mostly symptomatic treatment is prescribed and medicine mainly works on decreasing cell division.
To measure the severity of condition. Psoriasis Area Severity Index (PSAI) is generally taken into consideration.
Topical therapy
Corticosteroid are recommended. Hydrocortisone ointments are commonly prescribed for face, skin folds and for widespread patches.
Strong corticosteroids like triamcinolone, clobetasol are prescribed for areas which are tough to treat.
Long term use makes the skin thin and you many develop resistance to that particular steroid.
Vitamin D
Calcipotriene and calciterol decreases the skin cell growth.
Retanoids
Synthetic form of Vitamin A, helps to improve skin. Side effects are dryness and irritation of skin. The prescription should be followed as per doctor only. Contraindicates during pregnancy, breast feeding and if you are trying to conceive.
Calcineurin inhibitors
Tacrolinus and pimercolinus reduces inflammation and plaque formation.
Avoid long term use as it may increases the risk of developing skin cancer.
Contraindicated during pregnancy, breast feeding and during trial of conceiving.
Salicylic acid
Shampoo containing salicylic acid is helpful in reducing scaling of scalp during posrisis.
Coal tar shampoo and ointments
Coal tar reduces rapid growth of skin cell. Side effects are seen in sensitive person, folliculitis and pimple like rashes are observed.
Phototherapy
Phototherapy is the first line of treatment for psoriasis. Exposure to sunlight or UVB are benificial.
Combination of psoralene with exposure to narrowbased UVB (NBUVB) is recommended. NBUVB has no side effects and is useful for all age group, in case of pregnancy and breast feeding also it is safe.
Oral or inject able drugs
Methotrexate decreases skin build up and is helpful to clear psoriatic patches. Some common side effects are gastrointestinal disturbance, loss of appetite and fatigue.
Oral retinoid
Cyclosporin which suppresses the immune system.
Fumarates
Biologicals
Biologicals auch as infliximab, adalimumab, interleukin antagonist and etanercept are given.
There are chances of suppressing immunity causing risk of serious infection. Before prescribing ypur doctor will suggest you for tuberculosis of hepatitis work up.
Psoriasis patient should avoid beta blockers, chloroquine and NSADIs group of drugs.
Apart from medication some alternative therapy helps to reduce your itchy and dry skin,
Aloe extract cream
Fish oil supplements
Oregon grapes/ Barberry
Essential oils
Diet- obese person should loose weight and avoid gluten containing diet.
References
3. https://www.healthline.com/health/homeopathic-remedies-for-psoriasis#side-effects-and-precautions
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