Psoriasis



What is Psoriasis?

While still talking about skin inflammations in general, let’s consider that nasty chronic disorder called psoriasis. Fortunately it’s uncommon in children before the age of three years, and is still not common under the age of ten years. It is a disease of the skin, and affects 1-2 per cent of the white population. It is characterised by clearly demarcated areas called papules that coalesce into larger areas called plaques. Generally, these are not itchy but form silvery scales. When these are removed, it leaves minute bleeding points. Once it begins; it often becomes chronic, and persists for many years, probably for the rest of one’s life. It is common, and about 5 per cent of the community suffer from it. Many claim the true figure is much higher.

Although Psoriasis is a chronic skin disorder that occurs infrequently in young children. the name comes from the Greek word psora meaning itch, the lesions are usually not very irritable. Typically it involves the scalp, the ears (externally), the elbows, knees and trunk (about 75 per cent of cases). It varies, and may involve chiefly the scalp, area behind the cars, armpits, and “anogenital region” (i.e. area about the external genitals extending around to the anus). Due to its appearance, and the disfigurement it can produce, it is among the “socially disabling” diseases. If the palms of the hands or soles of the feet are involved, and this is common, deep fissuring can take place. This can be painful and highly irritable, and may interfere with normal working duties.



Sometimes arthritis accompanies it, flaring up if the rash worsens. Most psoriasis patients are reasonably healthy, apart from the joint pains. Sometimes minor illnesses can aggravate the rash. It is often worse during cold weather, and when sunshine is prevented from gaining access to the lesions. In about 30 per cent of cases, there is a family history of psoriasis, and several members of the one family may have the disorder.

Frequently, the nails are affected, and sometimes this is a dominant feature, with characteristic pitting. The cause of psoriasis is unknown, but many doctors now believe that there could be a psychosomatic factor.



Psoriasis Treatment

Innumerable routines have been suggested over the years for this very difficult skin disorder. The fact that there are so many suggests that no single cure is at present available. Many can be tried at home. Some of them offer temporary (and sometimes long-standing) relief. They are worth a trial, for they will do no harm, and could be beneficial. A “spontaneous cure” is unlikely. Cleanse daily, scrubbing the affected areas with soap arid water and a soft brush often helps. It removes surplus scales. “Pinctarsol” may help.

Ointments

Many ointments have been used. Dithranol has been used with reasonable success for many years. It is still widely prescribed in 1-2 per cent creams. Ammoniated mercury ointment 5 per cent applied morning and night, or Anthralin 0.25 per cent may be applied once daily (NB avoid contact with the eyes as it is very irritating). Coal tar ointment 2 per cent smeared on at night and moved next day with liquid paraffin ten assists.



Sebitar is good for the scalp. More acute cases should use applications, such as calamine lotion containing 5 per cent detergent solution coal tar. Lecithin, is claimed by some to give favourable results when taken over a period of time, maybe many months. Ten il7E1MS of the powdered form is sprinkled on the breakfast cereal each morning. This is available from health food shops.

Ascorbic acid

Given in daily doses of 2,000 mg for an extended period of time (months), this may bring relief to some sufferers and is worth a trial. (It is also known as vitamin C.)



Ultra-violet light

Lesions often respond favourably to ultraviolet light. The cheapest and most readily available source is sunshine. Lamps are sometimes ordered and must be used under proper medical supervision.

Other Treatment

See the doctor if the simple remedies do not help. Recent research has made new treatment available that is often curative:



The Psoralens

This family of preparations is available, and is often effective. It is given in the form of trioxsalen or methoxsalen. By concentrating on the five points in life, attention may be diverted from the skin problems to more important facets of life. This is at present debatable. Many different forms of therapy have been tried, and the condition tends to wax and wane, treated or not. Often daily scrubbing with soapy water and a nailbrush will get rid of scales. It helps, so does plenty of sunshine and bathing in the salty water at the beach.

Ointments containing tar are used, salicylic acid, dithralin are popular. Severe cases are treated by the doctor with the corticosteroid family of drugs, but medical supervision is essential. There are some other forms of treatment for severe cases which is the so-called PUVA therapy. A family of drugs called the psoralens (taken by mouth), followed by exposure to the sunlight, or to a special light called ultraviolet (or “black”) light is claimed to effect a cure in certain cases. This again is the field of the skin specialist, for adverse side effects can occur, but many successes have been recorded in the medical journals. Fish oil capsules are also claimed to clear the skin in some people.