ABSTRACT
Psoriasis is a common chronic, recurrent, immune mediated disease of the skin and joints. It can have a significant negative impact on the physical, emotional, and, psychosocial wellbeing of affected patients. Psoriasis is found worldwide but the prevalence varies among different ethnic groups. It has a strong genetic component but environmental factors such as infections can play an important role in the presentation of disease. There are several clinical cutaneous manifestations of psoriasis but most commonly the disease presents as chronic, symmetrical, erythematous, scaling papules and plaques.
INTRODUCTION
Psoriasis (sore-EYE-ah-sis) is a chronic (long-lasting) disease. Psoriasis is an autoimmune disease that causes raised, red, scaly patches to appear on the skin. It typically affects the outside of the elbows, knees or scalp, though it can appear on any location. Some people report that psoriasis is itchy, burns and stings. Psoriasis is associated with other serious health conditions, such as diabetes, heart disease and depression.
CAUSES
Many researches and scientists do not know what exactly causes psoriasis; we do know that the immune system and genetics play major roles in its development. Usually, something triggers psoriasis to flare. The skin cells in people with psoriasis grow at an abnormally fast rate, which causes the buildup of psoriasis lesions.
Men and women develop psoriasis at equal rates. Psoriasis also occurs in all racial groups, but at varying rates. Psoriasis often develops between the ages of 15 and 35, but it can develop at any age. About 10 to 15 percent of those with psoriasis get it before age 10. Some infants have psoriasis, although this is considered rare.
Psoriasis is not contagious. Psoriasis lesions are not infectious.
TRIGGERING FACTORS
Psoriasis typically starts or worsens because of a trigger, Factors that may trigger psoriasis include Infections, such as strep throat or skin infections, Injury to the skin, such as a cut or scrape, bug bite, or a severe sunburn, Stress, Cold weather, Smoking,
Heavy alcohol consumption, Certain medications — including lithium, which is prescribed for bipolar disorder, high blood pressure medications such as beta blockers; antimalarial drugs and iodides.
RISK FACTORS
Anyone can develop psoriasis, but these factors can increase risk of developing the disease
Family history. - Perhaps the most significant risk factor for psoriasis is having a family history of the disease. Having one parent with psoriasis increases risk of getting the disease, and having two parents with psoriasis increases risk even more.
Viral and bacterial infections - People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.
Stress - Because stress can impact immune system, high stress levels may increase risk of psoriasis.
Obesity - Excess weight increases the risk of psoriasis. Plaques associated with all types of psoriasis often develop in skin creases and folds.
Smoking - Smoking tobacco not only increases risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease.
CLINICAL MANIFESTATIONS
Psoriasis signs and symptoms can vary from person to person but may include one or more like Red patches of skin covered with silvery scales, Small scaling spots (commonly seen in children), Dry, cracked skin that may bleed, Itching, burning or soreness, Thickened, pitted or ridged nails, Swollen and stiff joints
Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.
Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission.
CLASSIFICATIONS
Several types of psoriasis exist. These include:
Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques itch or may be painful and can occur anywhere on body, including genitals and the soft tissue inside mouth, may have just a few plaques or many.
Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails may become loose and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.
Scalp psoriasis. Psoriasis on the scalp appears as red, itchy areas with silvery-white scales. The red or scaly areas often extend beyond the hairline. There may notice flakes of dead skin in hair or on shoulders, especially after scratching scalp.
Guttate psoriasis. This primarily affects young adults and children. It's usually triggered by a bacterial infection such as strep throat. It's marked by small, water-drop-shaped sores on your trunk, arms, legs and scalp. The sores are covered by a fine scale and aren't as thick as typical plaques are. There may have a single outbreak that goes away on its own, or may have repeated episodes.
Inverse psoriasis. Mainly affecting the skin in the armpits, in the groin, under the breasts and around the genitals, inverse psoriasis causes smooth patches of red, inflamed skin. It's worsened by friction and sweating. Fungal infections may trigger this type of psoriasis.
Pustular psoriasis. This uncommon form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters may come and go frequently. Generalized pustular psoriasis can also cause fever, chills, severe itching and diarrhea.
Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover entire body with a red, peeling rash that can itch or burn intensely.
Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes pitted, discolored nails and the swollen, painful joints that are typical of arthritis. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. Although the disease usually isn't as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.
DIAGNOSIS
In most cases, diagnosis of psoriasis is fairly straightforward.
Physical exam and medical history. Physician itself usually can diagnose psoriasis by taking medical history and examining skin, scalp and nails.
Skin biopsy. Rarely, physician may take a small sample of skin (biopsy) that's examined under a microscope to determine the exact type of psoriasis and to rule out other disorders.
Other conditions that may look like psoriasis or may occur at the same time as psoriasis include:
Seborrheic dermatitis. This type of dermatitis is characterized by greasy, scaly, itchy, red skin. It's often found on oily areas of the body, such as the face, upper chest and back. Seborrheic dermatitis can also appear on the scalp as stubborn, itchy dandruff.
Lichen planus. This is an inflammatory, itchy skin condition that appears as rows of itchy, flat-topped bumps (lesions) on the arms and legs.
Ringworm of the body (tinea corporis). Ringworm is caused by a fungal infection on the top layer of your skin. The infection often causes a red, scaly ring or circle of rash.
Pityriasis rosea. This common skin condition usually begins as one large spot (herald patch) on your chest, abdomen or back, which then spreads. The rash of pityriasis rosea often extends from the middle of the body, and its shape resembles drooping pine tree branches.
MANAGEMENT
Lifestyle Remedies
Although self-help measures won't cure psoriasis, they may help improve the appearance and feel of damaged skin. These measures may benefit you:
Take daily baths. Bathing daily helps remove scales and calm inflamed skin. Add bath oil, colloidal oatmeal, Epsom salts or Dead Sea salts to the water and soak. Avoid hot water and harsh soaps, which can worsen symptoms; use lukewarm water and mild soaps that have added oils and fats.
Use moisturizer. Blot your skin after bathing, then immediately apply a heavy, ointment-based moisturizer while your skin is still moist. For very dry skin, oils may be preferable — they have more staying power than creams or lotions do and are more effective at preventing water from evaporating from your skin. During cold, dry weather, you may need to apply a moisturizer several times a day.
Expose your skin to small amounts of sunlight. A controlled amount of sunlight can significantly improve lesions, but too much sun can trigger or worsen outbreaks and increase the risk of skin cancer.
Avoid psoriasis triggers. Find out what triggers, if any, worsen your psoriasis and take steps to prevent or avoid them. Infections, injuries to your skin, stress, smoking and intense sun exposure can all worsen psoriasis.
Avoid drinking alcohol. Alcohol consumption may decrease the effectiveness of some psoriasis treatments.
Natural home remedies
Aloe vera: Applying aloevera gel to the affected area will reduce the rashes and scaling of skin. It has been tested by many dermatologists. Aloevera gel needs to be applied 3 times everyday to reduce the lesions. If you do this for three to four weeks, you will notice a major change on your skin.
Banana peel is the vital ingredient to cure skin ailments. You can use a banana peel and rub the inner area of the peel to your lesions. It will soothe your skin and remove the rashes.
Cayenne pepper also holds anti-inflammatory properties, that help in healing the skin. It reduces the redness and scaling. Try to get a Capsaicin cream, that is available in medical stores. It is made from hot peppers and is simply great to reduce the lesions. Make sure you do not apply it on broken skin.
Castor Oil - Applying Castrol oil to small, thick and wellcircumscribed lesions will help to improve your skin. Mix coldpressed castor oil with 1 teaspoon of baking soda. Apply this mixture on the lesions before going to bed. You will notice a complete healing of that area after a few weeks. Do not apply this on open skin.
Chamomile contain anti-inflammatory flavonoid compounds. This will help to treat psoriasis and is widely used in Europe for this purpose.
Turmeric - This herb is being frequently studied for its powerful anti-inflammatory and antioxidant properties. Curcumin, the active ingredient in turmeric also has the ability to alter gene expression.
Coconut Oil - Applying tepidly warm coconut oil on the affected areas for half an hour will prevent dryness and reduces the chances of aggravation.
Fish Oil - The fatty acids present in Omega 3 have proved to cure the problem of scaly and patchy skin. Creams based with fish oil can be applied to the affected area to reduce the problem.
Epsom Salt Bath - Fill your bath tub with luke warm water. You can add a cup of milk & Epsom salt. This soothing shower will help you to get rid of the itchiness and it will gradually reduce the plaques and scales on your body.
Baking Soda & Water - Take 1 teaspoon of baking soda and 4 teaspoons of water. Mix them together and apply it to the affected area. Apply this with a sterilized cotton or cloth, to prevent bacteria. Leave it on till it dries and fall off. this mixture will help to reduce the itchiness of these areas.
HOMOEOPATHIC MANAGEMENT
From the homoeopathic point of view physician can approach treatment in different ways. Homoeopathic medicines for Psoriasis act on the body at the level of immunity and restore the deviated function. They also help to control the symptoms of Psoriasis without any side-effects. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. Please consult a qualified homoeopath before taking any homoeopathic remedy.
Indicated Remedies | Indications |
Graphites:
| Skin becomes rough, hard and persistent dryness. Psoriasis especially at the bend of joints, groins, neck, behind ears, and even nails. The skin gets cracked. Along with psoriasis joints get involved. Psoriasis with lot of burning and stinging. Psoriasis along with eczema. This remedy executes positive influence over digestive system, female reproductive system, etc. This remedy is suited more to obese individuals who are sensitive to cold and are usually constipated. |
Kali arsenicum
| The patient complains of intolerable itching that aggravates on undressing. Itching more in warm room or warm season. Cuts and fissures in bends of elbow and knee joint. Psoriasis associated with arthritis. The remedy is more suitable to individuals who are restless, nervous, and anemic. |
Arsenic Album | Excellent psoriasis remedy in which psoriasis, worse by cold application and wetness, better by warmth. |
Kali Brom | remarkable psoriasis remedy in which there is syphilitic psoriasis. Skin cold, blue, spotted corrugated, large, indolent, painful pustules. |
Thyrodinum | one of the best psoriasis remedy for chilly and anemic subjects. Dry impoverished skin; cold hands and feet. |
Radium Brom | psoriasis of penis, itching eruptions on face oozing, Patchy erythema on forehead. |
Apis melliaca | for skin rashes that feel hot and dry and are sensitive to touch. Symptoms improve with cool baths and worsen with heat. This remedy is most appropriate for individuals who often feel sad, disappointed, or evendepressed. They tend to cry easily but may also be irritable and envious by nature. |
Calendula | used topically, particularly if the affected area becomes inflamed. This remedy will soothe but not cure the skin condition. |
Rhus toxicodendron | used for psoriatic arthritis and for skin disorders accompanied by intense itching that worsens at night and improves with the application of heat. This remedy is most appropriate for individuals who are generally restless and unable to get comfortable at night. |
Sulphur | for skin disorders that are accompanied by intense itching. This remedy is most appropriate for individuals who are thirsty, irritable when not feeling well, uninspired and messy under ordinary circumstances, and who describe a sensation of internal heat and burning. Symptoms tend to improve with open, cold air and worsen with warmth |
Kali Arsenicosum | It has marked action on skin disorders like eczema, psoriasis and ulcers. There are dry, scaly eruptions with itching worse from warmth, walking and undressing. It is also useful in chronic eczema. There are ãssures in bends of arms and knees. There are numerous small nodules under the skin. Intolerable itching worse while undressing in psoriasis. |
Kali Sulphuricum | It has marked action on psoriasis. There are burning, itching, papular eruptions. Skin is dry, hot and burning. Itchy eruptions in nettle rash in children. Kali Sulph also helps in seborrhoea or dandruff and ringworm of scalp or beard with abundant scales. Sores on skin with thick, profuse, yellow watery secretion. |
Conclusion
Homoeopathy treats the person as a whole and tries to find a constitutional remedy with the aim of strengthening the organism generally. This means looking at not only the patient’s psoriasis symptoms, but also his or her general health and way of reacting to the environment, as well as what drives him or her on an emotional level. But homoeopaths can also treat symptomatically, meaning treating the psoriasis symptoms specifically. Usually aim for constitutional treatment but sometimes combine the two approaches, giving a more symptomatic skin remedy for flare ups, while treating the person as a whole with a constitutional remedy.
