Psoriasis is a complicated chronic condition, considered to have genetic (HLA-Cw6), immunologic, and environmental factors as compounding precursors. So what is psoriasis exactly? It is a dermatological disease which results from hyperproliferation of keratinocytes in the epidermis and dermis of the skin, which produces silvery, red, scaly plaques on the skin surface. These plaques can be itchy, which, when scratched, can result in ulceration and bleeding. It is not contagious, but can spread within the same individual from scratching.
There are 5 different forms of psoriasis, based upon the skin lesion that is produced
(1) Chronic stationary psoriasis – This is also known as psoriasis vulgaris and is the most common type of psoriasis, which involves the extensor surfaces, the scalp, the trunk, and gluteal folds
(2) Guttate psoriasis – are pink, drop-like, lesions, 1-10 mm in diameter, predominately on the trunk. The main distinguishing factor with this type of psoriasis is that it predominantly shows up days to weeks after a Streptococcus infection or upper respiratory infection (URI).
(3) Plaque psoriasis – has inflamed, silvery white lesions that can be scraped away to reveal the skin beneath.
(4) Inverse psoriasis – can be characterized as a shiny, smooth, red inflammed lesions without scaling, because it typically occurs in moist areas of the body (skin folds – armpits, genital region, under the breast, etc) or flexor surfaces – areas that are opposite to chronic stationary psoriasis.
(5) Pustular psoriasis – this is the most unique form of psoriasis, as it presents in the palms of the hands and soles of the feet, typically. You will see sterile pustules that are red, scaly, or bleeding. The alternative form of this type of psoriasis is the von Zumbusch variant, which is accompanied by fever, ill-feeling, and widespread pustules over the body.
One important thing to remember is that psoriasis can become systemic, in the form of psoriatic arthritis. This is an unusual complication, that occurs within less than 30% of psoriasis patients, but needs to be considered and differentiated between gouty arthritis, as they both affect large joints, cause pain, and stiffness within the affected areas.
In addition, psoriasis can also affect the ocular areas, presenting with white lesions on the cornea or sclera, with persistent dryness of the eyes.
Pathophysiology of Psoriasis
The rate at which cells divide is controlled by intracellular cAMP (associated with cell maturation and decreased cellular proliferation) and cGMP levels (associated with increased cellular proliferation). In psoriasis patients, there is increased cGMP and decreased cAMP levels reported. Which makes sense if you remember that psoriasis is a disease resulting from hyperproliferation of keratinocytes within the epidermis and dermis, leading to scaly plaques on the skin.
Research has shown that there is evidence behind immunological basis of T cell activation via an unknown antigen. Langerhans cells within the skin, pick up this antigen, present it to T cells, which release cytokines and proliferate a further immune response.
A Naturopathic approach to psoriasis takes into account the whole person, including mental and emotional health as well. Gut issues, liver sub-functioning, reduced bile acid, bowel toxemias, constipation, Crohn’s disease, Ulcerative collitis, food allergies, autoimmunities, stress, and nutritional deficiencies should also be taken into account.
Physical Exam Findings of Psoriasis
• Red, silvery, itchy, scaly patches of skin
• Recent streptococcal infection/URI
• Pain (may have joint involvement, or actual pain of lesions)
• Afebrile
• Pitting and oil staining in the nails
Management of psoriasis
Conventional treatments of psoriasis include
> Topical corticosteroids
- Triamcinolone acetonide
- Betamethasone
- Prednisolone acetate
- Coal Tar
- Anthralin
- Calcitriol, Calcipotriene, or other Vitamin D Analogs
- Tazarotene
> Antimetabolites
- Dexamethasone
> Immunomodulators
- Tacrolimus
- Cyclosporine
- Alefacept
- Ustekinumab
- Infliximab
> Artificial Tears
Naturopathic Treatments of Psoriasis Include
> Vitamin Supplementation + Nutrition
- Vitamin A
- Vitamin E
- Vitamin D
- Zinc, Selenium, Chromium
- Increasing fiber (and water consumption)
- Increasing water intake
- Avoiding alcohol
- Limiting animal protein and fats
- Reducing gluten and sugar intake
> Hydrotherapy
- Constitutional Hydrotherapy
- Ionic foot baths
> Lifestyle factors
- Increase sunlight exposure (15 minutes without sunscreen to stimulate endogenous Vitamin D production)
> Topical Herb Treatments
- Topical capsacin cream (Capsicum frutescens)
- Chamomile (Matricaria recutita)
And many more. Please speak with your Primary Care Physician for the right treatment for you.
References:
http://www.mdconsult.com/das/pdxmd/body/265401450-7/0?type=med&eid=9-u1.0-_1_mt_1014894
http://www.mdconsult.com/books/page.do?eid=4-u1.0-B0-443-07300-7..50215-4&isbn=0-443-07300-7&sid=1178506641&uniqId=265401450-6#4-u1.0-B0-443-07300-7..50215-4
http://www.psoriasis.org/
Psoriasis is a complicated chronic condition, considered to have genetic (HLA-Cw6), immunologic, and environmental factors as compounding precursors. So what is psoriasis exactly? It is a dermatological disease which results from hyperproliferation of keratinocytes in the epidermis and dermis of the skin, which produces silvery, red, scaly plaques on the skin surface. These plaques can be itchy, which, when scratched, can result in ulceration and bleeding. It is not contagious, but can spread within the same individual from scratching.
There are 5 different forms of psoriasis, based upon the skin lesion that is produced (1) Chronic stationary psoriasis – This is also known as psoriasis vulgaris and is the most common type of psoriasis, which involves the extensor surfaces, the scalp, the trunk, and gluteal folds
(2) Guttate psoriasis – are pink, drop-like, lesions, 1-10 mm in diameter, predominately on the trunk. The main distinguishing factor with this type of psoriasis is that it predominantly shows up days to weeks after a Streptococcus infection or upper respiratory infection (URI).
(3) Plaque psoriasis – has inflamed, silvery white lesions that can be scraped away to reveal the skin beneath.
(4) Inverse psoriasis – can be characterized as a shiny, smooth, red inflammed lesions without scaling, because it typically occurs in moist areas of the body (skin folds – armpits, genital region, under the breast, etc) or flexor surfaces – areas that are opposite to chronic stationary psoriasis.
(5) Pustular psoriasis – this is the most unique form of psoriasis, as it presents in the palms of the hands and soles of the feet, typically. You will see sterile pustules that are red, scaly, or bleeding. The alternative form of this type of psoriasis is the von Zumbusch variant, which is accompanied by fever, ill-feeling, and widespread pustules over the body.
One important thing to remember is that psoriasis can become systemic, in the form of psoriatic arthritis. This is an unusual complication, that occurs within less than 30% of psoriasis patients, but needs to be considered and differentiated between gouty arthritis, as they both affect large joints, cause pain, and stiffness within the affected areas.
In addition, psoriasis can also affect the ocular areas, presenting with white lesions on the cornea or sclera, with persistent dryness of the eyes.
Pathophysiology of Psoriasis The rate at which cells divide is controlled by intracellular cAMP (associated with cell maturation and decreased cellular proliferation) and cGMP levels (associated with increased cellular proliferation). In psoriasis patients, there is increased cGMP and decreased cAMP levels reported. Which makes sense if you remember that psoriasis is a disease resulting from hyperproliferation of keratinocytes within the epidermis and dermis, leading to scaly plaques on the skin.
Research has shown that there is evidence behind immunological basis of T cell activation via an unknown antigen. Langerhans cells within the skin, pick up this antigen, present it to T cells, which release cytokines and proliferate a further immune response.
A Naturopathic approach to psoriasis takes into account the whole person, including mental and emotional health as well. Gut issues, liver sub-functioning, reduced bile acid, bowel toxemias, constipation, Crohn’s disease, Ulcerative collitis, food allergies, autoimmunities, stress, and nutritional deficiencies should also be taken into account.
Physical Exam Findings of Psoriasis • Red, silvery, itchy, scaly patches of skin
• Recent streptococcal infection/URI
• Pain (may have joint involvement, or actual pain of lesions)
• Afebrile
• Pitting and oil staining in the nails
Management of psoriasis
Conventional treatments of psoriasis include
> Topical corticosteroids
- Triamcinolone acetonide
- Betamethasone
- Prednisolone acetate
- Coal Tar
- Anthralin
- Calcitriol, Calcipotriene, or other Vitamin D Analogs
- Tazarotene
> Antimetabolites
- Dexamethasone
> Immunomodulators
- Tacrolimus
- Cyclosporine
- Alefacept
- Ustekinumab
- Infliximab
> Artificial Tears
Naturopathic Treatments of Psoriasis Include
> Vitamin Supplementation + Nutrition
- Vitamin A
- Vitamin E
- Vitamin D
- Zinc, Selenium, Chromium
- Increasing fiber (and water consumption)
- Increasing water intake
- Avoiding alcohol
- Limiting animal protein and fats
- Reducing gluten and sugar intake
> Hydrotherapy
- Constitutional Hydrotherapy
- Ionic foot baths
> Lifestyle factors
- Increase sunlight exposure (15 minutes without sunscreen to stimulate endogenous Vitamin D production)
> Topical Herb Treatments
- Topical capsacin cream (Capsicum frutescens)
- Chamomile (Matricaria recutita)
And many more. Please speak with your Primary Care Physician for the right treatment for you.
References:
http://www.mdconsult.com/das/pdxmd/body/265401450-7/0?type=med&eid=9-u1.0-_1_mt_1014894
http://www.mdconsult.com/books/page.do?eid=4-u1.0-B0-443-07300-7..50215-4&isbn=0-443-07300-7&sid=1178506641&uniqId=265401450-6#4-u1.0-B0-443-07300-7..50215-4
http://www.psoriasis.org/