Psoriasis

Psoriasis is a common, chronic, disfiguring, inflammatory and proliferative condition of the skin, in which both genetic and environmental influences have a critical role.

The most characteristic lesions consist of----

 Red, scaly, sharply demarcated, indurated plaques, present particularly over extensor surfaces and scalp.

 The disease is enormously variable in duration, periodicity of flares and extent.

Morphological variants are common.

Sex: Male and female difference

Males and females are equally affected by psoriasis vulgaris.

Many studies indicate that age of onset is younger in females. Thus, one German study demonstrated a peak age of onset of 22 years in males and 16 years in females in early-onset disease.

However, results of studies are highly dependent on sampling techniques used and are variable in their results. There is no evidence that the disease is phenotypically different between the sexes.

Some Causes:---

Environmental risk factors

Present evidence indicates that interactions between genes and the environment are important in disease causation. Many environmental factors have been linked to psoriasis, and have been implicated in, for example, initiation of the disease process and exacerbation of pre-existing disease. However, conclusive evidence is so far lacking.

Trauma

Psoriasis at the site of an injury is well known. A wide range of injurious local stimuli, including physical, chemical, electrical, surgical, infective and inflammatory insults, has been recognized to elicit psoriatic lesions.

Drugs

There are many drugs reported to be responsible for the onset or exacerbation of psoriasis. Chief amongst these are lithium salts, antimalarials, beta-adrenergic blocking agents, non-steroidal anti-inflammatory drugs (NSAIDs), angiotensin-converting enzyme (ACE) inhibitors and the withdrawal of corticosteroids. Their risk,however, has never been formally assessed in controlled epidemiological

studies. The risk of withdrawal of systemic or potent topical corticosteroids requires careful re-evaluation.

Sunlight

Although sunlight is generally beneficial, in a small minority of patients, psoriasis may be provoked by strong sunlight.

Psychogenic factors

Considerable clinical evidence exists for the role of stress in onset and exacerbation of psoriasis.

 In a UK study, over 60% of a sample of psoriasis patients believed stress was a principal factor in the cause of their psoriasis.

Also it is reported that several psychocutaneous characteristics, including increased exacerbations and worse disease, correlated with stress reactivity. It is without doubt, however, that psoriasis has a detrimental effect on the psychosocial quality of life of patients and that stress management programmes significantly shorten the time to clearance with standard therapies.

Furthermore, psoriasis in patients who are categorized as being high or pathological worriers

is less likely to clear with photochemotherapy (PUVA) than in those patients with low worry.

Without doubt, the emotional and physical disability that psoriasis may cause is underestimated. One study showed the impact of psoriasis on physical and mental components of the health related quality of life index is very similar to that of many other major diseases, including heart disease and arthritis.

Homeopathy

Homeopathy takes into consideration not only body but also mind; as human being is unity of both mind and body. It also considers emotional, intellectual aspect of mind. Thus we can many a times identify what specific ‘Stress’ factor may have triggered psoriasis.

Homeopathy has many medicines for psoriasis which are selected after considering---

• Origin of lesion, its size, shape, character, location
•  Aggravating and ameliorating factors
•  Trying to identify trigger-- if present it will be most important point in selection of homeopathic medicine.
• Other associated illness/ complaints
•  Reaction of patient to his suffering