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.

Psoriasis is a hereditary, papulosquamous skin disorder can have multiple clinical presentations and varies widely among different individuals. It is typically a chronic and recurring disease that is best characterized by well-demarcated erythematous plaques with scaling. The plaques can be localized, which is the most common presentation, and are confined to only certain delineated areas of the body. Typically, plaques are seen most commonly on the elbows, knees, and scalp. There are other variants of psoriasis. In palmoplantar psoriasis, lesions are limited to the soles of the feet and palms of the hands. In contrast, generalized pustular psoriasis and generalized erythrodermic psoriasis can involve the entire body and be a life-threatening condition, even necessitating hospitalization, especially when seen in association with acute respiratory distress syndrome. Inverse psoriasis in intertriginous and tends to be on flexural areas of the skin.

Sign and symptoms of psoriasis

• PRIMARY LESIONS
• Plaque Psoriasis

These lesions are well-demarcated, salmon-colored papules and plaques with thick silvery scaling that typically bleeds when removed (Auspitz’s sign). Lesions can vary greatly in size and shape in addition to distribution, which may be localized or generalized.

• Pustular Psoriasis

The lesions are typically yellow pustules that can coalesce and evolve into dark red crusty lesions.

• SECONDARY LESIONS

Secondary lesions are less common, but can include excoriations, lichenification, (thickening) oozing, and secondary infection.

Distribution

Psoriatic patches most commonly occur on the elbows, knees, and scalp, although involvement can occur on any area of the body, including palms, soles, and even nails

Course

Psoriasis is typically a chronically recurring disease, although cases of complete resolution do occur. The onset of the disease can occur at any age, but the peaks of onset are in the 20s and 50s. HIV-positive patients can have recalcitrant psoriasis.

Causes of psoriasis

Although the exact etiology of psoriasis is unknown, there is clearly a hereditary component. When one parent has psoriasis, a child has an 8% chance of having the disease; if both parents have psoriasis, the child’s chance of developing psoriasis increases to as high as 41%. Specific HLA types have been noted to have a higher frequency of association with psoriasis, specifically HLA-B13, HLA-B17, HLA-Bw57, and most notably HLA-Cw6.

An acute form of guttate psoriasis, which characteristically develops in children and younger adults, often follows a streptococcal infection and has characteristic smaller sized, drop-shaped lesions

Triggering factors include physical trauma, which can elicit the lesions or any type of excessive rubbing or scratching, which can stimulate the proliferative process. Aggravating factors include psychological stress and certain medications such as systemic glucocorticoids, oral lithium, antimalarial drugs, systemic interferon, β-blockers, and potentially angiotensin-converting enzyme inhibitors. Alcohol and smoking (especially pustularpsoriasis) may also aggravate psoriasis. Rarely, ultraviolet light worsens psoriasis especially after a sunburn.

Season

Exacerbation is typically seen in the winter, most likely owing to the lack of sunlight and low humidity. Natural ultraviolet light typically cause psoriatic symptoms to improve.

Age Group

The disease can occur at any age. However, the average onset is typically bimodal, with one peak at approximately 23 years old (although in children, mean onset is 8 years old), and another at age 55.

Contagiousness

Psoriasis is not contagious.

Laboratory Findings

The diagnosis of psoriasis is usually made on clinical grounds, and biopsy is not necessary. If biopsy is performed, histologic findings include the following:

• acanthosis (thickening of the skin);
• increased mitosis of keratinocytes, fibroblasts, and endothelial cells; and
• Inflammatory cells in the dermis and epidermis.

Homeopathic treatment for psoriasis

Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat psoriasis but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat psoriasis that can be selected on the basis of cause, sensations and modalities of the complaints.  For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of psoriasis:

Arsenic Iod – psoriasis that often occurs in emaciated and elderly women; dry, scaly, and itchy skin, scales peel off easily, leaving a raw surface exposed.

Berberis aquifolium – psoriasis, eruptions appear on scalp and extend to the face and neck, pimply, dry, rough and scaly skin.

Thyrodoinum – psoriasis associated with adiposity; skin dry, impoverished. Cold hands and feet. Eczema. Itching without eruptions, worse at night.

Asterius Rubens – skin is itchy and psoriasis mostly affects the left arm and chest; feels worse at night and in damp weather.

Hydrocotyle – dry eruptions with great thickening of the outer skin layer and exfoliation of scales; psoriasis appears on the trunk, extremities, palms and soles with the usual circular spots with scaly edges.

Magnum Acetum – suppuration of skin around joints; red, elevated, itching; better, scratching . Deep cracks in bend of elbows, etc. Psoriasis and pityriasis. Burning around ulcers. Chronic eczema associated with amenorrhea, worse at menstrual period or at menopause.

Chrysarobinum – acts well in skin conditions; useful for skin diseases especially in ringworm, psoriasis, herpes, acne rosacea.

Cuprum Met – bluish, marbled. Ulcers, itching spots, and pimples at the folds of joints. Chronic psoriasis and lepra.

Corallium Rubum – skin is red with dark red spots which usually change to copper colored spots. Psoriasis develops in the palms and soles.

Iris Versicolor – skin is affected with pustular eruptions and gastric derangements; psoriasis with appearance of irregular patches with shining scales.

Borax – psoriasis; erysipelas of face, itching on back of fingers joints; unhealthy; herpes; trade eruptions on fingers and hands, itching and stinging. Ends of hair become tangled.

Kali Ars – skin is dry, scaly with intolerable itching which feels worse when undressing; psoriasis leading to fissures in the bends of the arms and knees. Also suffering with gout, nodosites which feels worse with the change of weather.

Other important remedies are:

Arsenic Album, Carbolic acid, Fluoric Acid, Mercurius, Natrum Ars, Natrum Mur, Graphites, Hepar Sulph, Phosphorous, Petroleum, Sepia, Tuberculinum, Sulphur, Nitric Acid, and many other medicines.