Psoriasis?| Expert Homeopathy

Definition

It is a chronic, non-infectious autoimmune skin disease characterized by well defending, slightly raised, dry erythematous macules with silvery scales and typical extensor distribution.

The main complaint in psoriasis, there is increased epidermal proliferation due to excessive division of cells in the basal layer and a shorter life cycle time.

Etiology/causation

1. The exact etiology is unknown. A genetic predisposition is evidenced by positive family history in 25% of patients and association of HLA B8 and A17
2. Immunopathological: Many immunological abnormalities have been found by their role is uncertain
3. Dermal: The increased epidermal cell proliferation of psoriasis is related to increased replication and metabolism of dermal fibroblasts

Factors causing flare-ups

1. Trauma: Injury or irrigation of normal skin induces lesions of psoriasis at the site. This is called Koebner's phenomenon
2. Infection: B-Haemophilus, Streptococcus
3. Sunlight: 10% becomes worse
4. Drugs: Antimalarial, beta-blockers
5. Emotion: Anxiety

Pathology

1. Parakeratosis
2. Thinning of the supra-papillae portion of the stratum Malpighi
3. Elongation of rete-pegs
4. Micro abscess of 'Munro'
5. Dilated and tortuous capillary in the upper dermis
6. Edema and round cell infiltration in the papillae and upper dermis

Symptoms / Signs

1. A typical distribution is extensor type
2. Common areas affected are the scalp, back of elbows, front of knees, legs, and lower part of the back and trunk
3. It exhibits itself as a dry, well-defined macule, papules, and plaque of erythema with layer upon layer of silvery scales
4. The complete removal of scale produces pinpoint bleeding which is typical of psoriasis
5. Normally characterized by absence of itching but in topical countries, patients complain of slight or moderate pruritus
6. The lesion is slightly raised above the surface of the skin but there is no induration
7. The psoriatic lesion may develop along the scratch lines in the active phase, this is called Koebner's phenomenon
8. On scalp: There is thick, scaly discretely distributed all over with intervening areas of normal skin.

Investigations

1. History is typical
2. The biopsy is rarely required

Differential diagnosis

1. Atopic dermatitis
2. Impetigo
3. Reiter's syndrome

Treatment

1. Explanation, reassurance, and instructions are vital and must relate to the patient's or parent's intelligence
2. The general health of patients should be maintained
3. A moderately warm climate, frequent sunbaths before the onset of winter, and visits to Sulphur springs all are useful in bringing down the relapse rate

Homeopathic medicines

1. Psoriasis of palm: Graphites, Hepar Sulphur, Lycopodium, Petroleum
2. Psoriasis of prepuce, nails: Graphites, Sepia
3. Psoriasis of the tongue: Sepia