PSORIASIS AND HOMEOPATHY
PSORIASIS:
Definition: This is a chronic relapsing inflammatory skin disease characterized by circumscribed silvery scaly patches with a particular predilection to the scalp and extensor surface of the body particularly the elbow and knee.
Factors cause psoriasis:
Genetic factors:
Some HLA markers like HLA-CW6 carries very high risk and HLA-B13 and HLA-B17 are also associated with increased risk of this disease. HLA-B27 is seen up to 70% cases of psoriasis associated with ankylosing spondylitis.
Drugs:
Lithium carbonate and propranolol due to their inhibiting action on adenyl cyclase altering epidermal cell kinetic may cause severe psoriasis.
Infection:
Psoriatic skin lesions have been seen in children after a sore throat caused by B haemolytic streptococci of whom 75% are having HLA-CW6 marker. In reiter's syndrome after dysentery or after venereal disease psoriatic skin lesion may develop.
Trauma:
Repeated trauma to the elbow and knee may explain the selection of these sites in Psoriasis.
Mental stress:
The disease is seen to have exacerbations during emotional stress.
Pathogenesis:
In the epidermis, there is an increase in the number of proliferative cells and epidermal cell cycle is shortened. Normally this is limited to the basal cell layer but may involve several layers in Psoriasis. Polyamines and their limiting enzyme ornithine decarboxylase levels are increased via phospholipase pathway. Arachidonic acid and various other inflammatory mediators are formed. However, the major or initial metabolite in this chain is 5-HPETE (5-hydro peroy eicosatetraenoic acid). This substance is a precursor of leukotrienes which has a controlling effect on cell kinetic and chemoattractive property for polymorphs.
As this level is increased many PMN cells are infiltrated in the epidermis forming Munro microabscesses which are the very characteristic feature of this disease.There is the decrease in the cell mediated immune response as there is lack of sensation with Dinitrochlorobenzene. IgA level is elevated and T cell function is altered.
Aetiology:
The exact cause is unknown. Possibly, disturbed fat metabolism, hormonal imbalance, septic focus anywhere in the body, allergy, anxiety states, hereditary influences, etc. may play some part.
The lowered response of the cyclic AMP system to prostaglandins E1 in the epidermis is said to be particularly important in aetio-pathogenesis of Psoriasis.
There are different variants of Psoriasis. Plaque-type is commonest. Eruptive type is seen in an association of streptococcal pharyngitis and stress.
Clinical features:
Age: All ages.
Sex: Both
The initial lesion consists of red spots which vary in sizes and may appear in any part of the body.
These are papular lesions and are covered with silvery scales which after scraping leave behind a shiny bleeding surface (Auspitz sign). Gradually these lesions enlarge and large patches are produced.
These lesions are symmetrically distributed over the scalp, palms, and soles. Extensor surface of knee and elbow and also over the sacrum and back.
Itching is usually absent but may be present when lesions are in the body folds and on the vulva. This is called inverse psoriasis.The psoriatic lesions may develop in the line of scratch during its active phase and this is called Koebner's phenomenon. The nails may also become thickened, pitted and striated. Onicholysis and oil stain colouration may be present(Psoriatic nail). This may be an isolated lesion. In middle-aged patients in addition to skin lesion, joint symptoms similar to rheumatoid arthritis may develop. The distal interphalangeal joints are frequently involved and rheumatoid factor is negative. It is called psoriatic arthropathy. The disease is notorious for remissions and relapses. Psoriasis is possibly immunologically mediated as a beneficial effect is seen after Cyclosporin therapy.
Flexural Psoriasis:
This is a rare type of Psoriasis which is clearly demarcated and without any scale. The groin, genital and perianal skin are very often involved as well as the folds of the axillae. This is very difficult to treat.
Pustular or Erythrodermic Psoriasis:
This is a form of localized psoriasis in children often involving a digit. Scaling is very much prominent and nails changes including thickening and color changes are very common. Greenish, yellowish or white pustules are seen and when these are dried up brown color develops. This is a grave type of Psoriasis. Rupioid or papular forms are also seen similar to those in Reiter's syndrome.Trunk and limbs or other parts of the body may also be involved in generalized psoriasis.
TYPES:
Chronic plaque psoriasis is the most common type
● Other types include guttate (raindrop lesions), seborrhoeic
(naso-labial and retro-auricular), flexural (body folds), pustular
(palmar-plantar), and erythrodermic (total body redness)
homeopathic therapeutics:
Graphites:
In cases where constipation is also present with psoriasis, graphites is one of the remedies for psoriasis.There may be sticky discharge. The skin becomes rough and hard. The bends of joints and groin area is affected. The graphite is chilly. In female disturbed menstrual cycle may present.
Mezereum:
In cases where the primary area that is involved happens to be the head or the scalp, Mezereum is one of the best homeopathic medicines for psoriasis. The head tends to be covered with thick and leathery crusts under which there is a collection of pus. There is often the formation of white scabs on the scalp. Scaly eruptions are also seen.
Sepia:
Itching of skin at various parts, of external genitalia, burning not relieved by scratching and is apt to change to burning.Foul odor from the eruptions and the affected area.Women ate more likely to be affected and that too after menopause.
Thyroidinum:
Psoriasis associated with adiposity(obesity). Browny swelling. skin dry, impoverished.
Repertorial approach:
complete repertory:
PSORIASIS:
Definition: This is a chronic relapsing inflammatory skin disease characterized by circumscribed silvery scaly patches with a particular predilection to the scalp and extensor surface of the body particularly the elbow and knee.
Factors cause psoriasis:
Genetic factors:
Some HLA markers like HLA-CW6 carries very high risk and HLA-B13 and HLA-B17 are also associated with increased risk of this disease. HLA-B27 is seen up to 70% cases of psoriasis associated with ankylosing spondylitis.
Drugs:
Lithium carbonate and propranolol due to their inhibiting action on adenyl cyclase altering epidermal cell kinetic may cause severe psoriasis.
Infection:
Psoriatic skin lesions have been seen in children after a sore throat caused by B haemolytic streptococci of whom 75% are having HLA-CW6 marker. In reiter's syndrome after dysentery or after venereal disease psoriatic skin lesion may develop.
Trauma:
Repeated trauma to the elbow and knee may explain the selection of these sites in Psoriasis.
Mental stress:
The disease is seen to have exacerbations during emotional stress.
Pathogenesis:
In the epidermis, there is an increase in the number of proliferative cells and epidermal cell cycle is shortened. Normally this is limited to the basal cell layer but may involve several layers in Psoriasis. Polyamines and their limiting enzyme ornithine decarboxylase levels are increased via phospholipase pathway. Arachidonic acid and various other inflammatory mediators are formed. However, the major or initial metabolite in this chain is 5-HPETE (5-hydro peroy eicosatetraenoic acid). This substance is a precursor of leukotrienes which has a controlling effect on cell kinetic and chemoattractive property for polymorphs.
As this level is increased many PMN cells are infiltrated in the epidermis forming Munro microabscesses which are the very characteristic feature of this disease.There is the decrease in the cell mediated immune response as there is lack of sensation with Dinitrochlorobenzene. IgA level is elevated and T cell function is altered.
Aetiology:
The exact cause is unknown. Possibly, disturbed fat metabolism, hormonal imbalance, septic focus anywhere in the body, allergy, anxiety states, hereditary influences, etc. may play some part.
The lowered response of the cyclic AMP system to prostaglandins E1 in the epidermis is said to be particularly important in aetio-pathogenesis of Psoriasis.
There are different variants of Psoriasis. Plaque-type is commonest. Eruptive type is seen in an association of streptococcal pharyngitis and stress.
Clinical features:
Age: All ages.
Sex: Both
The initial lesion consists of red spots which vary in sizes and may appear in any part of the body.
These are papular lesions and are covered with silvery scales which after scraping leave behind a shiny bleeding surface (Auspitz sign). Gradually these lesions enlarge and large patches are produced.
These lesions are symmetrically distributed over the scalp, palms, and soles. Extensor surface of knee and elbow and also over the sacrum and back.
Itching is usually absent but may be present when lesions are in the body folds and on the vulva. This is called inverse psoriasis.The psoriatic lesions may develop in the line of scratch during its active phase and this is called Koebner's phenomenon. The nails may also become thickened, pitted and striated. Onicholysis and oil stain colouration may be present(Psoriatic nail). This may be an isolated lesion. In middle-aged patients in addition to skin lesion, joint symptoms similar to rheumatoid arthritis may develop. The distal interphalangeal joints are frequently involved and rheumatoid factor is negative. It is called psoriatic arthropathy. The disease is notorious for remissions and relapses. Psoriasis is possibly immunologically mediated as a beneficial effect is seen after Cyclosporin therapy.
Flexural Psoriasis:
This is a rare type of Psoriasis which is clearly demarcated and without any scale. The groin, genital and perianal skin are very often involved as well as the folds of the axillae. This is very difficult to treat.
Pustular or Erythrodermic Psoriasis:
This is a form of localized psoriasis in children often involving a digit. Scaling is very much prominent and nails changes including thickening and color changes are very common. Greenish, yellowish or white pustules are seen and when these are dried up brown color develops. This is a grave type of Psoriasis. Rupioid or papular forms are also seen similar to those in Reiter's syndrome.Trunk and limbs or other parts of the body may also be involved in generalized psoriasis.
TYPES:
Chronic plaque psoriasis is the most common type
● Other types include guttate (raindrop lesions), seborrhoeic
(naso-labial and retro-auricular), flexural (body folds), pustular
(palmar-plantar), and erythrodermic (total body redness)
homeopathic therapeutics:
Arsenic Iodatum:
Skin is dry, scaly and itching. There is marked exfoliation of skin in large scales, leaving a raw exudating surface beneath. Aggravation in the warm room.The patient is usually thin and emaciated
Graphites:
In cases where constipation is also present with psoriasis, graphites is one of the remedies for psoriasis.There may be sticky discharge. The skin becomes rough and hard. The bends of joints and groin area is affected. The graphite is chilly. In female disturbed menstrual cycle may present.
Mezereum:
In cases where the primary area that is involved happens to be the head or the scalp, Mezereum is one of the best homeopathic medicines for psoriasis. The head tends to be covered with thick and leathery crusts under which there is a collection of pus. There is often the formation of white scabs on the scalp. Scaly eruptions are also seen.
Sepia:
Itching of skin at various parts, of external genitalia, burning not relieved by scratching and is apt to change to burning.Foul odor from the eruptions and the affected area.Women ate more likely to be affected and that too after menopause.
Thyroidinum:
Psoriasis associated with adiposity(obesity). Browny swelling. skin dry, impoverished.
Repertorial approach:
complete repertory:
Head, ERUPTIONS, Psoriasis of scalp: Pitu-a
Face, ERUPTIONS, Psoriasis around eyebrows: 2Phos
Male sexual, ERUPTIONS, Psoriasis, penis: 1graph, red-br, sep
Male sexual, ERUPTIONS, Psoriasis, penis prepuce: 2Sep, 1graph
Male sexual, ERUPTIONS, Psoriasis, patches: 2Nit-ac, 2 Petr, 1thuj
Back, ERUPTIONS, Psoriasis, patches: 2Mez, 1calc, 1kali-ar
Extrimities, ERUPTIONS, Psoriasis, upper limbs: 2Iris, 2Kali, 1kali-ar, 1rhus-t,1sil
Extremities, ERUPTIONS, Psoriasis, elbow, patches: 2Iris, 1kali-s, 2phos, 1kali-ar, 1morg-g
Extrimities, ERUPTIONS, Psoriasis, hand psorisis, diffusa: 3Petr, 2Ars, 2calc,2cham, 2Graph, 2kali-
2Lyc, 2Rhus-t, 2Sulph.
Extremities, ERUPTIONS, Psoriasis, hand back of chronic: 3Graph, 3Petr, 2Ars, 2Lyc, 2Maland, 2
Phos, 2Rhus-t, 2Sulph,
Extremities, ERUPTIONS, Psoriasis, hand palm: 3Phos, 2Clem, 2Hep, 2Lyc, 2Mur-ac, 2Nat-s,
2Psor,2Sel, 2 Sulph.
SKIN, ERUPTIONS, Psoriasis: 3Ars-i, 3Lyc.3Marg-g,3Phyt, 3Sep, 3Staph, 3Thyr. 2Ars, 2calc,2canth,2 chin,2chrysar,2 clem,2 graph, 2iris, 2kali-br,2 kali-c,2 lob, 2 mang,2 mez, 2nit-ac, 2petr,2phos,2psor, 2puls,2 rhus-t, 2sars, 2 sil, 2sulph.
Skin,ERUPTIONS, Psoriasis,syphilis: 3Ars-i, 3Merc, 3Phyt, 2cor-r, 2graph, 2kali-bi, 2nit-ac, 2phos, 2sars.
Skin,ERUPTIONS, Psoriasis,diffusa: 2graph, 2mez,2puls
Skin,ERUPTIONS, Psoriasis,inveterate: 2kali-ar,2mang,2sep,sil
Phatak's repertory of the BIOCHEMIC REMEDIES:
PSORIASIS: CS, Kp,KS;Nm, SIL
inveterate: SIL.
A Concise repertory of Homeopathic medicines by Dr.S.R.PHATAK :
ERUPTIONS: Psoriasis: Ars-io, clem, dul, grap, pho, ran-b, sep, sul, Berb-aq, Bor, kali-m+,mang, merc, phyt, psor, radm,thyr, tub+
Itching without: Cup-ac
Scales, shining+: Iris
SKIN, ERUPTIONS, Psoriasis: 3Ars-i, 3Lyc.3Marg-g,3Phyt, 3Sep, 3Staph, 3Thyr. 2Ars, 2calc,2canth,2 chin,2chrysar,2 clem,2 graph, 2iris, 2kali-br,2 kali-c,2 lob, 2 mang,2 mez, 2nit-ac, 2petr,2phos,2psor, 2puls,2 rhus-t, 2sars, 2 sil, 2sulph.
Skin,ERUPTIONS, Psoriasis,syphilis: 3Ars-i, 3Merc, 3Phyt, 2cor-r, 2graph, 2kali-bi, 2nit-ac, 2phos, 2sars.
Skin,ERUPTIONS, Psoriasis,diffusa: 2graph, 2mez,2puls
Skin,ERUPTIONS, Psoriasis,inveterate: 2kali-ar,2mang,2sep,sil
Phatak's repertory of the BIOCHEMIC REMEDIES:
PSORIASIS: CS, Kp,KS;Nm, SIL
inveterate: SIL.
A Concise repertory of Homeopathic medicines by Dr.S.R.PHATAK :
ERUPTIONS: Psoriasis: Ars-io, clem, dul, grap, pho, ran-b, sep, sul, Berb-aq, Bor, kali-m+,mang, merc, phyt, psor, radm,thyr, tub+
Itching without: Cup-ac
Scales, shining+: Iris
Dr. Farooq Khan's Elite Clinic
Shop No. 6, Darul falah colony,
Kausa-mumbra. Thane 400612
Phone no: 022-25350699
WhatsApp: 8097166756
Facebook page: Dr. Farooq khan's Elite clinic
Skype for online consultation: Khan.farooq0
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