Psoriasis is a non- infectious ,chronic inflammatory disease of the skin , characterized by well-defined erythematous plaques, with silvery scale , with a predilection for extensor surfaces and scalp. It has a chronic fluctuating course. Psoriasis may start at any age but is unusual before 5 years. The clinical course is very much variable. Homoeopathy has a firm answer to psoriasis. This can be removed from root and can be completely cured.

causes :

• GENETIC CAUSE: A large number of genes are thought to be important in its pathogenesis.
• FAMILIAL COMPONENT: It can be inherited in 20% cases if one parent is affected and in 50% cases if both parents have disease.
  PATHOGENESIS (What happens at cell level)
• There is keratinocytes hyperproliferation with increased mitotic index and an abnormal pattern of differentiation.
• It is a disorder of cell turnover.
• It is consequence of large inflammatory cell infiltrate.
• Also,there is association with HLA Cw6.

Symptoms :
There are different forms of psoriasis :

• STABLE PLAQUE PSORIASIS: This is the most common type with elbows,knee and lower back being involved . There is involvement of scalp , nails, flexures and palms.
• GUTTATE PSORIASIS: It is seen in children and adolescents. Lesions are droplet shaped and scaly.
• ERYTHRODERMIC PSORIASIS: Skin becomes red and scaly with danger of either hypothermia or hyperthermia.
• PUSTULAR PSORIASIS: In generalised pustular psoriasis onset is sudden with large numbers of small sterile pustules erupting on a red base whereas in localised pustular psoriasis involvement of palms and soles is common.
• PSORIATIC ARTHROPATHY: Between 5-10 % individuals develop chronic seronegative inflammatory arthropathy.

INVESTIGATIONS

• GRATTAGE TEST: The appearance of punctate bleeding spots when psoriasis scales are scraped off is known as auspitz’s sign seen in psoriasis.
• SKIN BIOPSY: This is also done for diagnosis.
• RHEUMATOLOGICAL ASSESSMENT : To be done if joint involvement is there.

GENERAL MANAGEMENT

• Maintainence of personal hygiene is very important .
• Traditionally topical agents , UV and PUVA therapy is the mainstay of conventional medicine.

HOMOEOPATHIC APPROACH
Psoriasis can be efficiently treated by homoeopathy with the help of constitutional remedy covering the totality of all signs and symptoms. The response in skin diseases is appreciable with homoeopathy. Remedy differs from case to case , so reaching right homoeopathic remedy under consultation of a registered homoeopathic practitioner is important. Its the constitutional remedy which can remove this tendency and patient can get rid of this life long condition otherwise.
Some of the homoeopathic therapeutics for psoriasis are as follows ; please note following medicines will give temporary relief. For complete removal of psoriasis a constitutional remedy ( which is a homoeopathic remedy selected on basis of patient’s physical and emotional makeup) is needed for complete removal of disease.

GRAPHITES: Suited for moist scabby eruptions on scalp , face , bends of joints, between fingers and behind the ears. Great itching always accompanies the eruptions. The hair is dry and falls out.

ARSENICUM: When sensations of itching, burning and swelling is there with papules and pimples.

SULPHUR: The skin is rough , coarse with soreness in the fold of the skin. Dryness and heat of scalp with intense itching especially at night and scratching causing soreness.

NATRUM MUR: It is dry scaly eruptions in bends of joints.

HYDROCOTYLE: Great dryness and desquamation of the epidermis.

PSORINUM: Skin is dirty , greasy, unwashed in appearance. Eruptions with much itching. Eruptions in bends of joints.

BIBLIOGRAPHY

1. Davidson’s principles and practice of medicine, 21st edition
2. Boericke W. Boericke O.E. New Manual of Homoeopathic Materia Medica and Repertory(with relationship of remedies)
3. W.A. Dewey Practical Homoeopathic Therapeutics