Psoriasis? What is Psoriasis? What causes Psoriasis? Is Psoriasis curable? What are the signs and symptoms of Psoriasis? How can homeopathy help in treating Psoriasis? This post contains everything you need to know about Psoriasis.
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WHAT IS PSORIASIS?

Psoriasis is an auto-immune skin disease that most commonly manifests on the elbows, knees, scalp, lower back, or joints as red, itchy silvery scales. It can range from a few spots of dandruff-like scales to major silvery scales on the skin. It tends to relapse after a few weeks or months and is more likely to affect individuals with family history of similar skin conditions.

It is a common long-term disease that can be treated on the basis of the site and surface area of the skin, the thickness of plaques and scales and if there is involvement of arthritic joints or not.

HOW DOES PSORIASIS DEVELOP?

Basically, the cells of the skin are replaced by new cells at an interval of 25-30 days. But in psoriasis, the skin cell production is increased. And hence new cells pile up on each other layer by layer on the skin and accumulated in the form of flakes/plaques or erythematous patches.

IS PSORIASIS CONTAGIOUS?

“The Heartbreak of Psoriasis.’’Psoriasis for most patients is more emotionally than physically disabling. Psoriasis erodes the self image and forces the victim into a life of concealment and self- consciousness as there’s a lot of stigma around the disease.But actually it is not acquired by contact with an infected person. People cannot catch the condition by brushing up against someone who has psoriasis.It doesnot spread by kissing, swimming or having sex.
Thus due to the social stigma, patients may avoid activities , including sunbathing( which is the very activity that can clear the disease), for fear of being discovered . Thus it is not contagious and cannot spread from one person to another.

WHAT ARE ITS CAUSES?

Psoriasis stems from internal disharmony of the body in terms of disturbed immunity and genetic predisposition along with environmental triggers.

1. Internal factors :
   – Defective immune system
   – Genetics
2. External factors

• Physical trauma including skin conditions (boils ,dermatitis , lichen planus , skin parasites and vitiligo) and skin trauma ( acupuncture , shaving, adhesive taping , chemical irritation, bites , tattoos and vaccinations )
• Certain medications like hypertension medication etc.
• Food allergens
• Triggering Factors
  Many people who are predisposed may be free of any symptoms for many years until the disease is triggered by:-
  – Infections like streptococcus infection of throat
  – Climate (Cold dry weather conditions )
  – Smoking
  – Stress
  – Alcohol consumption

WHAT ARE THE SIGNS & SYMPTOMS?

It may present differently in affected individuals, some of the common symptoms include:

• Red eruptions with grey or white scales
• Itching and burning on the eruptions
• Brittle, thickened, pitted nails
• Dry cracked skin
• Swollen and stiff joints
• Bleeding from cracked skin
• Conjunctivitis

WHAT ARE THE COMMON LOCATIONS?

Psoriasis mainly shows up on the extensor surfaces of the body however, the common locations are:

• Lower
• Back
• Elbows
• Knees
• Legs
• Soles
• Scalp
• Face
• Palms

WHAT ARE THE STAGES OF PSORIASIS?

Psoriasis symptoms may range from :

• Mild: A few lesions, covering about 3% of your skin
• Moderate: Lesions covering between 3 to 10% of your skin
• Severe: Lesions covering 10% or more of your body, sometimes the entire body

WHAT ARE THE TYPES OF PSORIASIS?

1. Plaque Psoriasis – It is the most common type of psoriasis also known as Psoriasis Vulgaris. It causes dry, raised, red skin patches which are irregular covered with silvery scales that may itch or burn. Plaques tend to be symmetrically distributed and thus enlarge and then tend to remain stable for months or years. Smaller plaques or papules may coalesce into larger lesions. Numerous lesions cover almost the entire body surface. A temporary brown, white, or red macule remains when the plaque subsides.
   It often pops up in these areas like Elbows, knees, scalp, and lower back.
2. Guttate Psoriasis – Often starts in children or young adults as small, pink-red spots on your skin and happens in less than 2% of cases. They are often triggered by a streptococcal infection, typically streptococcal pharyngitis. They often appear on your:
   – Trunk
   – Upper arms
   – Thighs
   – Scalp
3. Inverse Psoriasis – Inverse psoriasis also known as hidden psoriasis , intertriginous psoriasis or flexural psoriasis is a type of psoriasis that affects skin folds. Patches of skin in this type are bright red, smooth, and shiny, but don’t have scales and thus get worse with sweating and rubbing .Heat, trauma, and infection are thought to play a role in the development of this atypical form of psoriasis.
4. Pustular Psoriasis – Mostly appears in adults and causes pus-filled bumps (pustules) surrounded by red skin whch may look infectious . Sometimes it covers most of your body, which is called “generalized” pustular psoriasis.
   Triggers include topical medicine, suddenly stopping systemic drugs or strong topical steroids that you used over a large area of your body ,getting too much ultraviolet (UV) light without using sunscreen, pregnancy, infection, stress and exposure to certain chemicals.
   Symptoms include:
   – Fever
   – Chills
   – Nausea
   – Fast heart rate
   – Muscle weakness
5. Erythrodermic Psoriasis – Affects most of your body and causes widespread patches. Skin looks fiery that appears to be burned.
   Other symptoms include:
   – Severe itching, burning, or peeling
   – Faster heart rate
   – Changes in body temperature
   – Can cause severe illness from protein and fluid loss
   – May also get an infection, pneumonia, or congestive heart failure.
   It can be fatal as the inflammation and exfoliation can disrupt the body’s ability to regulate temperature and perform barrier functions.
6. Nail Psoriasis – Up to half of those with psoriasis have nail changes
   Symptoms include:
   – Pitting of your nails
   – Tender, painful nails
   – Separation of the nail from the bed
   – Color changes (yellow-brown)
   – Chalk-like material under your nails
7. Mouth Psoriasis – Psoriasis in the mouth is very rare. In contrast to lichen planus, this is another common papulosquamous disorder that commonly involves both the skin and mouth
   May appear as white or grey-yellow plaques
   Fissured tongue is the most common finding
8. Scalp psoriasis – Can pop up as a single patch or several, and can even affect your entire scalp.
   It can also spread to your forehead, the back of your neck, or behind and inside your ears. Also it can be mild and almost unnoticeable
   Symptoms include:
   – Scaly, red, bumpy patches
   – Silvery-white scales
   – Dandruff-like flaking
   – Dry scalp
   – Itching
   – Burning or soreness
   – Hair loss

HOW IS PSORIASIS DIAGNOSED?

Psoriasis can be diagnosed through a Physical Exam Or Lab tests
Physical exam
The physician usually takes a look at the scales and eruption on your body to diagnose psoriasis, commonly on:-

• Scalp
• Ears
• Elbows
• Nails
• Belly button
• KneesFamily history is also determined as psoriasis is generally hereditary
  Lab tests
  Biopsy – Small Piece of skin is removed and tested to make sure it isn’t any other severe medical condition. No other test confirms Psoriasis.

OTHER COMORBIDITIES ASSOCIATED WITH PSORIASIS

• Autoimmune diseases like ulcerative colitis
• Atherosclerosis
• Hypertension
• Psoriatic Arthritis
• Deficiency of vitamin D( 25- hydroxyvitamin D)
• Dyschromia
• Inflammation of eyes
• Diabetes & Obesity
• Mental health conditions like depression & anxiety

DIFFERENTIAL DIAGNOSIS

• Adult blepharitis
• Eczema
• Diaper dermatitis
• Allergic contact dermatitis
• Lichen planus

WHAT IF YOU DON’T TREAT PSORIASIS?

If psoriasis is not treated timely it can lead to plaques that build and spread. These plaques are painful and itchy, and thus become infected and become scars along with :

1. Psoriatic arthritis ( with joint pain , stiffness and swelling ) which if left untreated might cause permanent joint damage.
2. Nail psoriasis which may damage your nails and even lead to loss of nails.
3. Scalp psoriasis which can cause hair loss which can be permanent.

DOES PSORIASIS REOCCUR?

Psoriasis can reoccur and flare up with much greater tendency than before . There’s no permanent cure for psoriasis. But treatment can help you feel better. Treatments aim to stop skin cells from growing so quickly and thus it is a lifelong disease.

ALLOPATHIC TREATMENT OF PSORIASIS

Treatment for Psoriasis by tropical creams that come as creams, foams and ointments that are to be applied directly on the skin. It is used to treat mild or moderate psoriasis.
It includes

1. Steroid creams – they help in reduction of redness and swelling. They should be used as directed by the physician as they can burn or thin the skin especially of sensitive areas like face & genitals.
2. Salicylic acid – It softens & thins scaly skin. It might irritate the skin and weakens hair follicles it left for too long.
3. Immuno-suppressants – They suppress the action of immune cells. They are prescribed for sensitive area of the body like groin, skin folds and face.
4. Coal tar ointment and shampoo –  Coal tar reduces inflammation related to psoriasis, scales and itching. It can cause side effects like redness and dryness of the skin and should only be use if prescribed by a doctor.
5. Treatment of Psoriasis by photo-therapy
   Machines are used that slow down the growth of cells by shining UV light directly on the skin, usually done by dermatologist.
   Different type of Photo-therapy includes-
6. Narrowband UVB therapy –  Safest way for sensitive people. The individual is asked to stand in a light box targeted form of UV is passed all over the body.
7. Broadband UVB therapy – Wider range of UV is passed all over the body.
8. Excimer Laser therapy (VTRAC) – It helps in getting rid of red patches on the skin by exposing to targeted UVB rays.
9. Psoralen + UVA (PUVA) – A drug, Psoralen is mixed with UVA light. The drug is taken by mouth or bath to boost the absorption of UVA light by the skin. It is a very effective way to treat psoriasis and not in much use nowadays.
10. Physiotherapy raises the risk of getting skin cancer and can cause long and short-term side effects. It may also make you feel like you have skin cancer. Phototherapy is not recommended if:
    – You have a skin condition that raises your chances of skin cancer
    – Have or had skin cancer
    – Have a medical condition that makes you sensitive to UV light

WHAT IF YOU ARE TAKING IMMUNOSUPPRESSANTS?

If psoriasis is being treated using immunosuppressive medicines then there are chances that psoriasis resurfaces with more intensity and thus it becomes difficult to treat it.
Patients with new onset of psoriasis , flares of existing psoriasis and psoriasis that is obstinate to therapy is to be evaluated for a possible underlying medicine that is driving the psoriasis .

Few of the medicines are

• Hydroxychloroquine,
• Beta – blockers
• Antibiotics like tetracycline
• Lithium
• Non steroidal antiinflammatories like ibufren ,naproxen ,
• Interferons
• Corticosteroids like prednisone

Thus psoriasis treated with homoeopathy has a much better future when treatment is taken in early phase.

DO’s AND DON’Ts

There is no cure for psoriasis but it can be treated and managed

Do’s

• Stop smoking
• Manage stress
• Moisturise
• Limit alcohol consumption
• Lose weight if you’re obese
• Include green leafy veggies in your diet
• Fruits like berries
• Salmon, sardines and fish rich in other omega 3 fatty acids
• Antioxidant rich herbs like thyme, cumin, ginger
• Avoid processed food, refined sugars, dairy
• Eat gluten-free diet
• Tropical Creams
• Photo-therapy

Don’ts

• Stress too much
• Ignore flare ups
• Scratch or scrub the lesions
• Give up
• Isolate yourself

There is no scientific proof that claims eating certain food product may increase or decrease the symptoms but certain people affected claim that their food choices affect their skin. Listen to your body and choose food accordingly.

PSORIASIS HOMEOPATHIC MANAGEMENT:

Homeopathic medicines are natural medicines free from any side effects. Some of the homeopathic medicines which are helpful in the case of psoriasis are:

1. Graphites Naturalis

• The skin is dry and cracked.
• It is mainly given in scalp psoriasis.
• The scalp area is sensitive to touch with itching.
• Burning sensation mainly the top of the head.
• Rough, thick, and deformed nails.

2. Arsenic Album

• It is the best-suited medicine for silver scales.
• Dry, rough, red papular eruptions.
• Itching is aggravated by cold things.
• Pain on the affected skin areas after scratching.
• Restlessness.
• It also works well in cases of guttate Psoriasis.

3. Sulphur

• This medicine helps in cases with severe itching and burning in the eruptions.
• Patient scratching the skin until it bleeds.
• Burning sensation affected area.
• Skin is rough, scaly.
• The patient having a history of excessive use of ointments in the past.

4. Petroleum

• Petroleum is a very suitable medicine for deeply cracked eruptions of psoriasis.
• Burning sensation and intolerable itching is present on the affected skin.
• Bleeding is also present in the cracks.
• The skin of the affected area is intensely sore, painful, and hard.

5. Sepia

• This medicine is given when there is the presence of big oval lesions on the skin.
• There are shiny, whitish, and adhesive scales present on the papules. Itching
• Burning sensation after scratching.
• The eruptions are mainly present in the face, chest, back, arms and legs.