Dr. Nitin Hundre

PSORIASIS

Psoriasis is a common chronic auto immune inflammatory skin disease marked by circumscribed scaly macules affecting chiefly the extensor surfaces of the body characterized by Thickening of the epidermis, tortuous and dilated blood vessels, sharply demarcated erythematous plaque with silvery white scale.

Three Cardinal Signs of psoriasis are plaque elevation, Erythema, Scales.

Clinically psoriasis can be divided in to several types as follows Gutted, Chronic Plaque, Pustular, Erythroderma, Nail Psoriasis, Flexural, Arthropathy psoriasis.

Guttate psoriasis occurs in children, adolescents, and young adults It manifests as an erythematous, papular eruption with lesions less than 1 cm in diameter on the trunk and extremities.

Chronic plaque (psoriasis vulgaris) form comprising approximately 90 percent of cases. Sharply demarcated erythematous silvery scaling plaques occur most commonly on the extensor surface of the elbows, knees, scalp, sacral, and groin regions. Other involved areas include the ears, glans penis, perianal region, and sites of repeated trauma.

Pustular psoriasis is also an acute psoriatic eruption. The patient presents with fever and small monomorphic painful sterile pustules, often precipitated by secondary infection may leads to septicemia. It can be localized to the palms and soles (palmar-plantar psoriasis) or it can be generalized and potentially life-threatening.

Erythrodermic psoriasis, also life threatening, involves the entire body surface and can result in hypothermia, hypoalbuminemia, anemia, infection, and cardiac failure.

Psoriatic nail disease occurs in approximately 50 percent of psoriasis patients and most commonly manifests as pitting.

Risky factors

Anyone can develop psoriasis, but these factors can increase your risk of developing the disease:

Family history.Perhaps the most significant risk factor for psoriasis is having a family history of the disease. About 40 percent of people with psoriasis have a family member with the disease.

Stress.Because stress can impact your immune system, high stress levels may increase your risk of psoriasis.

Obesity.Excess weight increases your risk of inverse psoriasis. In addition, plaques associated with all types of psoriasis often develop in skin creases and folds.

Smoking.Smoking tobacco not only increases your risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease.

Viral and bacterial infections.People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.

Pathophysiology:

In order to properly understand the immune dysfunction present in psoriasis, it is important to understand the normal immune response of skin. Skin is a primary lymphoid organ with an effective immunological surveillance system equipped with antigen presenting cells, cytokine synthesizing keratinocytes, epidermotropic T cells, dermal capillary endothelial cells, draining nodes, mast cells, tissue macrophages, granulocytes, fibroblasts, and non-Langerhans cells. Skin also has lymph nodes and circulating T lymphocytes. Together these cells communicate by means of cytokine secretion and respond accordingly via stimulation by bacteria, chemical, ultraviolet light, and other irritating factors. Generally, this is a controlled process unless there is some prolonged continues disturbance in physical or mental level which leads to imbalanced cytokine production leads to a pathological state such as psoriasis.

CLINICAL FEATURE

Psoriasis signs and symptoms vary according to the morphology, stage, type and anatomical site of involvement of the psoriasis rashes, which are scaly red plaques.

Psoriasis is characterized by the development of erythematous (reddish), well defined, dry, scaly, papules and plaques of sizes ranging from a pin head to palm sized or larger. Lesions have a full rich red color in the skin of Caucasians. Rarely, lesions on the legs or trunk may show a violaceous or bluish hue.

Pustular psoriasis can be life threatening were patient presents with fever and small monomorphic, painful, sterile pustules, often precipitated by secondary infection and may leads to septicemia.

Complication:

Depending on the type and location of the psoriasis and how widespread the disease is, psoriasis can cause complications. These include:

Thickened skin and bacterial skin infections caused by scratching in an attempt to relieve severe itching

Fluid and electrolyte imbalance in the case of severe Pustular psoriasis

Low self-esteem, Depression, Stress, Anxiety, Social isolation

If you have psoriasis, you're at greater risk of developing certain diseases, such as metabolic syndrome, a cluster of conditions that include high blood pressure and elevated insulin levels, inflammatory bowel disease, cardiovascular disease and cancers.

Psoriatic arthritis can be debilitating and painful, making it difficult to go about your daily routine. Despite medications, psoriatic arthritis can cause joint damage.

DIAGNOSIS:

Physical examination Carefully examining skin, scalp, fingernails, and toenails for reddening or scaling skin that is characteristic of psoriasis. Small pits on the fingernails are also signs of psoriasis. Doctor will also examine joints for signs of psoriatic arthritis.

Treatment in Genetic Homoeopathy

Complete History of patient i.e. Family history, past history since his child hood till date, Personal history in order to assess the cause, and also to find out the constitution of the particular person. Based on this analysis Genetic constitutional medicine is given along with other genetic combination medicines, which work on genetic level and there for progress of disease and complications are nullified and leads to cure. Some of commonly used homoeopathic medicines in psoriasis are as follows but should be taken under strict medical supervision Kali ars, Baryta carb, Nit acid, Graphitis, Staph, Sepia, Lycopodium, Kali carb, Kali Phos, Bryonia, Merc sol etc.

Dr. Nitin Hundre

Vitiligo / Leucoderma is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin are destroyed. As a result, white patches appear on the skin in different parts of the body. Similar patches also appear on both the mucous membranes (tissues that line the inside of the mouth and nose) and the retina (inner layer of the eyeball). The hair that grows on areas affected by vitiligo sometimes turns white.

There is strong evidence that people with vitiligo inherit genes that make them susceptible to depigmentation. The most widely accepted view is that the depigmentation occurs because vitiligo is an autoimmune disease a disease in which a person's immune system reacts against the bodies own organs or tissues. People's bodies produce proteins called cytokines that, in vitiligo, alter their pigment-producing cells and cause these cells to die. Another theory is that melanocytes destroy themselves such as sunburn or emotional distress, triggered Vitiligo.

Who can be Affected by Vitiligo?

About 0.5 to 1 percent of the world's population have vitiligo. The average age of onset is in the mid-twenties, but it can appear at any age. The disorder affects both sexes and all races equally; however, it is more noticeable in people with dark skin. Vitiligo seems to be somewhat more common in people with certain autoimmune diseases, including hyperthyroidism (an overactive thyroid gland), adrenocortical insufficiency (the adrenal gland does not produce enough of the hormone called corticosteroid), alopecia areata (patches of baldness), and pernicious anemia (a low level of red blood cells caused by the failure of the body to absorb vitamin B12). Vitiligo runs in families. Children whose parents have the disorder are more likely to develop vitiligo. However, most children will not get vitiligo even if a parent has it, and most people with vitiligo do not have a family history of the disorder.

Symptoms of Vitiligo

People who develop vitiligo usually first notice white patches (depigmentation) on their skin. These patches are more commonly found on sun-exposed areas of the body, including the hands, feet, arms, face, and lips. Other common areas for white patches to appear are the armpits and groin and around the mouth, eyes, nostrils, navel, genitals, and rectum.

Vitiligo generally appears in one of three patterns:

Focal pattern depigmentation limited to one or only a few areas.

Segmental pattern depigmented patches that develop on one side of the body only.

Generalized pattern the most common pattern. Depigmentation occurs symmetrically on both sides of the body.

In addition to white patches on the skin, people with vitiligo may have premature graying of the scalp hair, eyelashes, eyebrows, and beard. People with dark skin may notice a loss of color inside their mouths.

Will the vitiligo Patches Spread?

Focal pattern vitiligo and segmental vitiligo remain localized to one part of the body and do not spread. There is no way to predict if generalized vitiligo will spread. For some people, the depigmented patches do not spread. The disorder is usually progressive, however, and over time the white patches will spread to other areas of the body. For some people, vitiligo spreads slowly, over many years. For other people, spreading occurs rapidly. Some people have reported additional depigmentation following periods of physical or emotional stress.

How Can People Cope With the Emotional and Psychological Aspects of Vitiligo?

Although vitiligo emotional and psychological effects can be devastating.

White patches of vitiligo can affect emotional and psychological well-being and self-esteem. People with vitiligo can experience emotional stress, particularly if the condition develops on visible areas of the body (such as the face, hands, arms, and feet) or on the genitals. Adolescents, who are often particularly concerned about their appearance, can be devastated by widespread vitiligo. Some people who have vitiligo feel embarrassed, ashamed, depressed, or worried about how others will react.

Fortunately, there are several strategies to help people cope with vitiligo. Also, various treatments discussed in the next section can minimize, camouflage, or, in some cases, even eliminate white patches. First, it is important to find a doctor who is knowledgeable about the disorder and takes it seriously. You must let your doctor know if you are feeling depressed, because doctors and other mental health professionals can help people deal with depression.

Complications of Vitiligo

Vitiligo is a skin disorder which produces milky white patches on skin. The treatments that are currently available just help in re-pigmentation of the milky white patches that are produced by vitiligo. Vitiligo has several different complications; in this post I will discuss these complications so that people with vitiligo can have a better understanding of vitiligo.

As vitiligo is thought to be related with other autoimmune diseases so you may be at increased risk to other autoimmune diseases such as thyroid conditions, such as hyperthyroidism (overactive thyroid gland), pernicious anemia (an autoimmune disease which affects your stomach), and diabetes mellitus (a chronic condition that is caused by too much sugar in the blood).

Other complications that vitiligo can have are related to the eyes and ears. You may also experience lack of pigment in parts of your eye especially in the layers of tissue that surround the outer surface of your retina, choroids or uveitis. Another problem which vitiligo can cause is the partial loss of hearing.

The major complication that vitiligo causes are not related to physical health, infact these complications are linked with the mental health. As most of the people are concerned about their appearance so this sudden change in appearance caused by vitiligo effects the mental health. Vitiligo may affect your self confidence. For dealing with these mental health problems you must consult a psychologist as he/she can help you in overcoming the psychosocial problems you are facing.

If the change in appearance caused by vitiligo has become a big problem for you then you must opt a re-pigmentation treatment so that your skin becomes uniform in color.

How effective is homoeopathy?

Homoeopathy cures Vitiligo that is due to the fact that homoeopathic treatment enhances the natural production of pigments. According to homoeopathic philosophy Vitiligo not a disease in itself but an expression of an inner disturbed state of the body. Thus, the cure should occur at a level where things have gone wrong. In order to archive this, the patient is analyzed on various aspects of mental and physical and familial attributes and also a complete study is done on the psychological-environment that the patient has gone through in his life. The prescription is then based at the deepest level of understanding of the patient?s disturbed inner force. Although many homoeopathic medicines Arsenic Sulph Falvus, Arsenic Album , Baryta Mur and Baryta Carb are known to give good results in Vitiligo; I would again reiterate the fact that real cure of Vitiligo occurs when the prescription is made according to the true principles of homoeopathic philosophy i.e. treating that ?deep causative factor ? which caused this inner disturbance. Also remember that Vitiligo is a chronic disorder and can take considerable time even with the best of the homoeopathic treatment, for it to be completely cured

Dr Nitin Hundre

Nucleus Homeocare

Hyderabad, Vijayawada

Belgaum

7899198686

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