PSORIASIS

Introduction:

It is a greek language meaning “itching condition”(psora-itch, sis-action).

Definition:

Psoriasis is a chronic recurring skin disease characterized by red, flaky, crusty, patches of the skin covered with silvery scales.

It is an immune mediated diseases that affects the skin and it is not contagious disease.

Causes and triggering factors:

  1. Stress.
  2. Skin injury and infections (mostly streptococcal infection).
  3. Changes in season or climates.
  4. Certain medicine including lithium salt, beta blockers, antimalarial drugs.
  5. Excessive alcohol consumption.
  6. Smoking.
  7. Some hair spray, face creams, hand infections.
  8. Genetic cause- leucocyte antigen alleles.
  9. Idiopathic.

10. Advanced effects of human immune deficiency virus.

11. Family history of psoriasis.

Mechanism:

It has two hypothesis, they are as follows:

  • The first considers the psoriasis are 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 is 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.
  • Tcells become active and migrate to the dermis and trigger the release of cytokines, which cause inflammation and rapid production of skin cells.

General symptoms and stages:

Psoriasis can appear anywhere on the skin but its favourite location are the knee, elbow bends, arms, legs, scalp, genetial areas, and nails.

It is often symmetrical lesions have similar shapes.

Plagues may be surrounded by a rim.

There are four stages are as follows:

  1. Early stage.
  2. Progressive stage.
  3. Stationary stage.
  4. Regressive stage.

Early stage:

It begins with small pink papules with are covered with fine white scales.these papules become plagues with itching.

Progressive stage:

Here the plaques grow in to larger ones and merge with one another with itching. many patients experience the koebner phenomena.

Stationary stage:

It begins few weeks after the progressive stage. The old lesions are covered with thick white scales, be new lesions do not appear.

Regressive stage:

The plaque stops growing they flatten and turn pale. When scaling decreases the lesions decrease in size and disappear leaving the discoloration on the skin.

Classification:

There are different varities of psoriasis:

  1. Psoriasis vulgaris.
  2. Psoriatic erythroderma.
  3. Pustular psoriasis.
  4. Guttate psoriasis.
  5. Nail psoriasis.
  6. Psoriatic arthritis.
  7. Inverse psoriasis.
  8. Drug induced psoriasis.

Psoriasis vulgaris:

It is the most common form of psoriasis. It affects 80-90% of the people with psoriasis.

Plague psoriasis is typically appears as raised areas of inflamed skin covered with silvery white scaly skin.

Psoriatic erythroderma:

It involves the widespread inflammation and exfoliation of skin over most of the body surface.

It accompanied by severe itching, swelling and pain.

It is often the result of an excaberation unstable plagues psoriasis, particularly following the abrupt withdrawl of systemic treatment.

Pustular psoriasis:

It appears as raised bumps that are filled with non infections pus(pustules). The skin under and surrounding the pustules is red and tender. Pustular psoriasis can be localized, commonly to the hands and feet (palmoplantar pustulosis), or generalized with widespread patches.

Guttate psoriasis:

It is characterized by numerous small, scaly, red, pink, tear drop-shaped lesions. These numerous spots of psoriasis appear over large areas of the body, primarily the trunk, but also the limbs and scalp.

Nail psoriasis:

It produces a variety of changes in the appearance of fingers 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 arthiritis:

It involves joint and connective tissues inflammation. Psoriatic arthritis can affect any joint, but is most common in the joints of the fingers and toes. This can result in a sauage-shaped swelling of the fingers and toes known as dacylitis.

Psoriatic arthritis can also affect the hips, knees and spine (spondylitis). Between 10-30% of people who have psoriasis also have psoriatic arthritis.

Drug induced psoriasis:

There are some drugs which can induce lithium salt, beta blockers, antimalarial drugs.

 Diagnosis:

  1. 1.    Auspitz’s sign:

On peeling of the lesions of the skin, it can produce the haemorrhagic spots.

  1. 2.    Koebner’s phenomena:

This type of phenomena is first discovered by heinrich koebner in 1872. The skin injury ( tattoo pricking, cuts etc)can causes new psoriatic lesions.

  1. PSAI:

Psoriasis area severity index(PSAI) is the most widely used measurement tool for psoriasis. PSAI combines the assessment of the severity of lesions and the area affected in to a single score in the range 0 (no disease) to range72 (maximal).

Homoeopathic treatment:

Arsenicum album:

Dry rough scaly eruption, itching, burning, swelling, papular eruptions. Malignant pustules, ulcers and offensive discharge.

cold, wet, scratching.

Warmth.

Kali arsenicum:

Patches on back, arms and spreading from elbows. Scaly itching. Scaling off leaves behind red skin.

Kali bromatum:

Syphilitic psoriasis, skin is cold, blue, spotted, corrugated, large indolent painful pustules.

Thyroidinum:

It is one of the best psoriatic remedy for the chilly and anameic subjects, dry impoverished skin, cold hands  and feet.

Radium bromide:

Psoriasis of penis, itching eruption on face oozing, patch erythema on forehead

Graphitis:

Rough hard persistent dryness of skin with eruption oozing out a sticky exudation occurs in bends of limbs, groins, neck, and behind ears.

Other remedies:

There are many other remedies which includes aur.met, psorinum, selenium, hydrocotyle, mezerium, petroleum, iodum, pulsatilla, sepia, silicea, rhustox, thuja, Tuberculinum, cal carb, lyopodium,merc sol.

Conclusion:

In positive homoeopathy we are following the method of homoeopathy by          Dr. Prafull G. vijayakar.

Homoeopathic medicines act best on the genetic background, that it acts on the seven layers from them ectoderm to inner organs.  so that psoriasis is permanently eradicated by our positive homoeopathy.

 

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N. Chamundeswari

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