Abstract:
Psoriasis is a chronic, inflammatory skin disorder characterized by erythematous, scaly patches. It is primarily autoimmune in origin and often has genetic predisposition. Homoeopathy offers a holistic approach in managing psoriasis by treating the patient based on the totality of symptoms and addressing the underlying constitutional tendencies. This article explores the homoeopathic perspective of Psoriasis, key remedies, and the clinical approach.One of the most prevalent diseases that people suffer from is skin illnesses. Most of the skin diseases are treated with topical steroid or ointment in conventional medicine, which suppresses the condition and invites other troublesome diseases. Homoeopathy, with its holistic approach to treatment, plays a key role in such circumstances.
Epidemiology:
Psoriasis affects around 2-3% of the world population. It is more common in Caucasians and is rarely seen in African and Asian populations. Peak incidence is observed in the age groups of 15–25 years and 50–60 years. Psoriasis affects both males and females equally, though some studies suggest a slight male predominance.
- A positive family history is seen in 30–40% of cases, supporting a genetic predisposition.
- Environmental factors like stress, infections (especially streptococcal), trauma (Koebner phenomenon), cold climates, and certain medications (like beta-blockers, antimalarials, and NSAIDs) are well-known triggers.
- In India, recent epidemiological studies show a prevalence of 0.44% to 2.8%, with plaque psoriasis being the most common variant observed in clinical practice.
Keywords:
Psoriasis, psychology, Autoimmune skin disorder, Chronic inflammation, Homoeopathic Management.
Introduction:
The word Psoriasis originates from the Greek word “Psora ” meaning itch. Psoriasis is a chronic, non-contagious autoimmune skin condition characterized by rapid turnover of epidermal cells resulting in thickened, red, scaly plaques. It often runs in families and is influenced by genetic and environmental factors. Psoriasis is classified based on clinical patterns. The worldwide prevalence of psoriasis is approximately 2–3% and 0.44-2.8 percent in India. Psoriasis can present at any age but commonly affects in the third or fourth decade with males being affected two times more commonly than females.
Classification of psoriasis– There are two types of psoriasis.
Type 1 Psoriasis- Psoriasis which has a positive family history, starts before age 40 and is associated with HLA-Cw6.
Type 2 Psoriasis- Psoriasis with no such family history, presents after age 40, and is not associated with HLA-Cw6.
Types of Psoriasis:
- Plaque Psoriasis (Psoriasis Vulgaris):
The most common form of psoriasis, characterized by raised, red patches covered with a silvery white buildup of dead skin cells.
- Guttate Psoriasis:
This type of psoriasis presents as small, drop-shaped sores on the trunk, limbs, and scalp, often after a streptococcal infection.
- Inverse Psoriasis:
This type occurs in skin folds such as under breasts, armpits, and around the groin, presenting as shiny, smooth lesions.
- Pustular Psoriasis:
This is characterized by white pustules surrounded by red skin.
- Erythrodermic Psoriasis:
The most severe form of psoriasis involves widespread redness, shedding of scales in sheets, and can even be life-threatening.
Pathophysiology:
Psoriasis is primarily an immune-mediated condition. There is an abnormal activation of T cells which release cytokines leading to hyperproliferation of keratinocytes and inflammation. The usual cell turnover time of 28 days is reduced to 3–5 days in psoriatic skin.
Clinical Approach:
Clinical features vary based on type and severity. Psoriasis has remissions and relapses and can be triggered by various factors.
Sign & Symptoms:
~ Red, raised, scaly patches (plaques)
~ Itching, burning, or soreness
~ Cracking and bleeding of the skin
~ Nail changes such as pitting, thickening, discoloration
~ Joint pain in Psoriatic Arthritis
Investigations:
~ Clinical diagnosis based on history and physical examination
~ Skin biopsy in doubtful cases
~ Rheumatoid factor and X-rays for Psoriatic Arthritis
~ KOH test to rule out fungal infection
Management:
Lifestyle modification and supportive management include:
~ Stress management and mental well-being
~ Avoidance of known triggers (e.g., infections, medications)
~ Use of mild soaps and emollients
~ Avoiding alcohol and smoking
~ Exposure to moderate sunlight
Homoeopathic Management:
Homoeopathy treats the patient as a whole. The remedy is selected after thorough case taking considering physical symptoms, mental state, past history, family history, and triggers. Homoeopathy aims to stimulate the immune system and bring long-term relief without side effects.
Homoeopathic Remedies:
➢ Arsenicum Album:
Dry, rough, scaly skin with intense burning, worse at night, and from cold. The patient is anxious and restless.
➢ Arsenicum Iodatum:
Dry ,scaly, itchy skin scales peel off easily ,leaving a raw surface exposed. Psoriasis that often occurs in emaciated and elderly women.
➢ Graphites:
Cracks behind ears, on hands and feet with oozing of sticky fluid. Obese, chilly patients with constipation.
➢ Sulphur:
Red, itchy eruptions worse from warmth and bathing. Scratching causes burning. Dirty appearance of skin.
➢ Petroleum:
Cracked skin that bleeds easily. Affected areas become thick, hard, and painful. Symptoms are worse in winter.
➢ Kali Arsenicosum:
Scaly eruptions with itching and burning, especially in palms and soles. Useful in psoriatic arthritis. Eruptions with black patches, size of a crown and indolent .
➢ Lycopodium Clavatum:
Scaly eruptions with yellowish crusts, worse in the evening. The patient is irritable and anxious with digestive issues. The scales are sometimes fissured and bleeding.
➢ Sepia:
Eruptions that get worse before menses, especially in women. Indifferent and depressed mental state. Eruption on the chin with circular spots. Yellowish brown spots appear on the skin with itching and rawness.
References:
API Textbook of Medicine.
Clinical Dermatology by Thomas P. Habif
Textbook of Pathology by Harsh Mohan
Homoeopathic Therapeutics by S. Lilienthal
Materia Medica by William Boericke
A Dictionary of Practical Materia Medica by J.H. Clarke
