psoriasis

PSORIASIS

Psoriasis is an endogenous immune mediate condition(believed to be autoimmune) where there is increased epidermal cell proliferation which is result of excessive cell division in basal layers and transit time of keratinocytes through epidermis is reduced and reduced epidermal turnover from 28days to 5-6 days; its clinically characterized by well-defined erythematous plaques with silvery scales and flakes

CAUSES OF PSORIASIS

i)Genetic

A strong association has been noticed between certain loci on genome , many genes have been identified but still it remains unclearance how they all might be interelated

Most of the gene identified are related to MHC (Major Histocompatibility Complex) and T cells.

  • 9 Loci on different Chromosomes are identified by Genome-wide linkage Analysis which are supposed to be linked with Psoriasis and named Psoriasis Susceptibility 1 to 9 (PSORS1 till PSORS9) within this locus are also found genes contributing in pathways of inflamation and certain mutations in this region have been found in psoriasis. Genome Wide Association Scan identified many other non-specific genes which are responsible in expressing inflamatory protiens which affects the cells of immune system which are also involved in psoriasis.
  • PSORS1 is located on chromosome 6 in Major Histocompatibility Complex ; 3 Genes in this Locus are associated with Psoriasis vulgaris viz:- 1)HLA-C variant HLAC-w6 it encodes a MHC Class 1 Protien 2)CCHCR1 variant WWC it encodes coiled protein which if found to be overexpressed in epidermis of Psoriatic patch on skin 3)CDSN Variant allele5 which encodes Corneodesmosin it is expressed in Granular and Cornified layers of Epidermis and upregulated in Psoriasis.
  • IL12βgene on chromosome 5q which expresses Interlukin12B(IL12B)
  • IL23Rgene on Chromosome 1p which expresses interlukin23 receptor and is inlolved in T cell differentiation;psoriasis is belived to be T cell medaited inflamatory condition
  • Both this above mentioned genes are also involved in upregulating Tumour Necrosis Factor α (TNFα) and Nuclear Factor κB
  • Gene encoding CARD14 is found directly linked to Plaque type Psoriasis; any mutation in this gene and environmental trigger causes plaque type psoriasis

ii)Envirinmental and lifestyle

Harsh environment like excess of heat and cold, extreme dry wether, irregular diet and sleep pattern, excess of mental and physical stress, substance abuse, regular exposure to excess of chemicals and other pollutants etc have been associated with aggravations in those with prexisting psoriasis and precipitates in those  genetic predesposition to develop psoriasis

iii)Microbes

After infection with certain bacteria and virus its been observed that body develops an autoimmune state resulting into psoriasis

iv)Medicines

Certain medicines induce psoriasis, like beta blockers calcium channel blockers , antihyperlipidaemic medications , captopril , anti malarials,  lithium, NSAIDS, terbinafin, glyburide, interleukins, interferons , TNF inhibitors like infliximab and adalibumab, terbinafin , Granulocyte colony stimulating factor, glyburide, withdrawal of cortocosteroidal topical applications shows severe rebound aggravations in psoriasis

DIFFERENT TYPES OF PSORIASIS

  • Plaque Psoriasis

  • Guttate Psoriasis

  • Pustular Psoriasis

  • Erythrodermic Psoriasis

  • Inverse/flexural Psoriasis

  • Seborrheic-like Psoriasis

  • Oral Psoriasis

OTHER MAJOR SUBTYPES OF PSORIASIS :-

  • Palmo-Plantar Psoriasis

  • Napkin Psoriasis

  • Acrodermatitis continua

  • Generalised pustular psoriasis/pustular psoriasis of Von Zumbusch; during pregnancy its termed as impetigo herpetiformis

  • Annular Pustular Psoriasis

  • Any of above type of psoriasis may present with involvement of nail and joints and it will be termed as nail psoriasis and psoriatic arthritis respectively

SIGNS & SYMPTOMS FOR DIAGNOSIS OF PSORIASIS

Though all signs may not be present or common in every case and also many different type of psoriasis present in different manner but still there are few signs and symptoms ; the presence of which may help us in diagnosis

  • Silvery adherent scales and flakes
  • Well defined margins
  • Itching irritation and pain restricted only on papuler/pustules /plaque
  • Red erythematous base with plaque above
  • Frequently observed cyclic pattern of eruptions
  • Extensor surface involvement
  • Auspitz’s sign ; there is pin point bleeding when the scale is removed
  • Koebner Phenomenon; in this we observe psoriatic lesions are induced at the site of trauma to the skin.

Common Homoeopathic medicines for Psoriasis

A constitutional approach is required in treatment of psoriasis

Remedies are selected after proper case taking and repertorisation ; Few of the remedies frequently prescribed in psoriasis are:

  • Sulphur
  • Arsenic
  • Phosphorus
  • Silicea
  • Natrum Muriaticum
  • Thuja
  • Calcarea Carb
  • Graphites
  • Petroleum
Few solved Psoriasis cases at Dr. SHAH’s Homoeopathy with before and after pics  in links below

case 1

 

Psoriasis Before Treatment at Dr SHAH's Homoeopathy ; image by Dr Deepan P Shah
Psoriasis Before Treatment at Dr SHAH’s Homoeopathy

 

 

Psoriasis Resolving During Treatment at Dr SHAH's Homoeopathy
Psoriasis Resolving During Treatment at Dr SHAH’s Homoeopathy
Psoriasis Resolving During Treatment at Dr SHAH's Homoeopathy
Psoriasis Resolving During Treatment at Dr SHAH’s Homoeopathy
Psoriasis Resolving During Treatment at Dr SHAH's Homoeopathy
Psoriasis Resolving During Treatment at Dr SHAH’s Homoeopathy
Psoriasis Resolving During Treatment at Dr SHAH's Homoeopathy
Psoriasis Resolving During Treatment at Dr SHAH’s Homoeopathy

 

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case 2

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case 3

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case 4

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case 5

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