Home Treatment of Psoriasis
Evening primrose oil, as well as its combination with fish oils, taken for 16 weeks failed to improve symptoms of atopic dermatitis compared with placebo in another double-blind study of 102 adults (Berth-Jones & Graham-Brown 1993). Another study (Oliwiecki & Burton 1994) found that a combination of EPO and fish oil was ineffective in the treatment of psoriasis, and another found it also to be ineffective in atopic eczema, apart from a certain subgroup who failed to show increased erythrocyte DGLA levels and for whom adherence to inclusion criteria and the study protocol were questionable (Henz et al 1999).
Contact allergy to fragrances usually causes dermatitis of the hands, face, and or armpits 16-18 , the latter site being explained by contact allergy to deodorants and fragranced antiperspirants. In the face, the skin behind the ears and neck is exposed to high concentrations of fragrances in perfumes and aftershaves. Microtraumata from shaving facilitates (photo)contact allergy to aftershave fragrances. The sensitive skin of the eyelids is particularly susceptible to developing allergic contact dermatitis to fragrances in skincare products, decorative cosmetics, and cleansing preparations, as well as from fragrances spread through the air (airborne contact dermatitis) 19 . Most reactions are mild and are characterized by erythema (redness) only with some swelling of the eyelids. More acute lesions with papules, vesicles, and oozing may sometimes be observed. Dermatitis attributable to perfumes or toilet water tends to be ''streaky.'' In some cases, the eruption resembles other skin...
Given the importance of PTK receptors in the control of cell proliferation and migration, it is not surprising that over-activity of PTK receptors occurs in cancer and other diseases that involve excess cell proliferation, such as inflammatory and fibrotic conditions and psoriasis. About half of the PTK receptors are implicated in various human malignancies (Fig. 1) 2 . Often, the receptors are constitutively activated by amplification or mutational events. Several mutations of PTK receptors cause constitutive dimerization (1) by mutations affecting disulfide bonding in the extracellular parts of the receptors, thus causing the formation of covalent dimers, mutations of other residues in the transmembrane, or jux-tamembrane domains that promote dimerization or (2) by formation of fusion proteins between the kinase domains of the receptors and proteins that normally occur as dimers or oligomers. The end result is a constitutively active kinase that drives cell growth.
NME is the hallmark finding in glucagonoma syndrome. It is characterized by a polymorphous eruption that most commonly presents as scaly, erythematous papules and plaques with superficial erosions. The lesions typically are in a perioral distribution on the face (Fig. 9), but also involve the perineum, lower abdomen, thighs, buttocks, and less commonly the distal extremities. NME has been reported to be the presenting complaint in approximately two-thirds of patients with this tumor, but there are only rare cases of glucagonoma without NME ever occurring. Stomatitis, glossitis, dystrophic nails, and alopecia can also be seen. The eruption is frequently misdiagnosed as seborrheic dermatitis or intertrigo and can also resemble pemphigus foliaceus, acrodermatitis enteropathica, chronic mucocutaneous candidiasis, or psoriasis.
Certain nutrients in large amounts, particularly vitamins, act in the body as drugs. The acne medication isotretinoin (Accutane) is a derivative of vitamin A that causes spontaneous abortions and defects of the heart, nervous system, and face. The tragic effects of this drug were noted exactly nine months after dermatologists began prescribing it to young women in the early 1980s. Today, the drug package bears prominent warnings, and it is never prescribed to pregnant women. A vitamin Abased drug used to treat psoriasis, as well as excesses of vitamin A itself, also cause birth defects. This is because some forms of vitamin A are stored in body fat for up to three years after ingestion.
All the available studies indicate that HS is a disease with a remarkable impact on the patient's life. An analysis of American hospitaliza-tion records shows that more patients with HS receive a principal diagnosis - the chief reason for the hospital stay - than those with psoriasis. This indicates that HS has a much higher morbidity than other dermatoses such as psoriasis 22, 23 . In Denmark, the general self-reported level of health is poorer among HS patients. Due to flare-ups, an average 2.7 days of work per year is lost by Danish patients (stages I and II) 14 . The soreness, discharge, and appearance of lesions are described as problems in both work and leisure activities by 51 of all patients. For grades I and II, the main problem was soreness,
The term cosmetic intolerance syndrome (CIS) is applied to the multifactorial syndrome in which certain susceptible individuals are intolerant of a wide range of cosmetic products. CIS is thought to be caused by one or more underlying occult dermatological conditions, such as subjective irritation, objective irritation, allergic contact dermatitis, contact urticaria, or subtle manifestations of endogenous dermatological diseases, such as atopic eczema, psoriasis, and rosacea.
Mation, such as inflammatory bowel diseases, alopecia areata, psoriasis, lichen sclerosus or lupus erythematosus, IL1RN*2 homozygosity increases the severity of the inflammation, suggesting that persons with this allele have a more prolonged and more severe proinflammatory immune response than do persons with other IL-1RA genotypes 73 . Interestingly, the frequency of the two-repeat allele of IL-1RN is increased among patients with acne conglobata but not among those with HS. In addition, IL1RN*2 homozygosity was detected only amongst patients with severe acne conglobata, suggesting that allele 2 of the IL-1RN gene may contribute to the development of acne conglo-bata but not HS 38 .
Skin-pathogenic microorganisms such as S. aureus, B. burgdorferi or C. albicans together with several PAMPs (e.g., LPS or PGN) induce the abundant expression of IL-8 a chemokine now referred to as CXC chemokine ligand 8 (CXCL8) in a TLR-NF-kB-pathway-dependent manner 15, 47, 49, 59, 75 . Pathogen-induced secretion of keratinocyte-derived IL-8 initiates neutrophil chemoattraction and transendothe-lial migration. In addition, IL-8 is selectively involved in the transendothelial migration of CLA+ T cells, emphasizing the role of IL-8 in the homing of specific T cells to inflamed skin (Fig. 13.2). In addition to IL-8, pathogens and microbial products, such as heat-killed S. aureus and staphylococcal PGN, stimulate the expression of other chemokines in keratinocytes, such as RANTES CCL5 (regulated on activation, normal T expressed and secreted, RANTES) or MCP-1 CCL2 (monocyte chemoattractant pro-tein-1) 47 . RANTES-expressing keratinocytes were detected in the lesional skin of patients...
A quantitative approach for measuring QoL in HS was performed 2 . Questionnaires widely used in other skin diseases such as the Dermatology Life Quality Index (DLQI) questionnaire, Skindex and VQ-Dermato 1, 4, 5 were chosen. This approach allows a direct comparison of the results with those from previous studies on other skin diseases. We will discuss two studies, one already published and our unpublished data 2 . In both studies, in addition to this questionnaire, basic demographic data and aspects of the history of HS were collected 114 patients participated in the first one 2 and 61 in the second. In the study of der Werth and Jemec 2 the recorded mean DLQI score was 8.9, higher than scores found in several other dermatological conditions such as alopecia, acne, psoriasis, Hailey-Hailey disease, vascular anomalies of face, and atopic dermatitis. In our center (unpublished data) using two other skin-disease-specific QoL questionnaires (Skindex and VQ-Dermato) 1, 5 , the scores...
Despite the absence of systematic data there are important secular and geographical differences in disease burden that (to this author) seem robust. Atopic dermatitis incidence appears to have increased by a factor of two or more in the last three decades in many developed countries (Williams, 1997). Cancers of the skin in many world populations (chiefly those with pale skin) have also increased two to three-fold over a similar time course (Marks, 1995). By contrast psoriasis incidence seems to have stayed constant. For other
The full potential of aerosol-mousse technology is only beginning to be exploited. Once only a form of presentation novelty, mousse formulations, where direct comparisons with ''conventional'' products have been made, are now showing important, relevant differentiators. Mousse products have in some instances shown to have better efficacy and consumer acceptance than nonaerosol formulations. Clinical studies 5,6 conducted on a scalp psoriasis-treatment mousse have shown greater clinical efficacy and patient acceptability than comparator products. The mousse product is also more likely to be used because it is effective, easy to apply, and well tolerated, thereby further increasing compliance and therapeutic efficacy. Furthermore, it has been shown 7 that an alcohol-based head-lice treatment mousse was able to exert ''a high level of direct ovicidal activity, making it effective with a single application.'' The mousse vehicle was shown to generate synergized pediculicide droplets that...
Inflammatory dermatoses such as psoriasis have well-known rheumatological associations and often lead to collaboration between dermatologists and rheumatologists for the benefit of the patient. Similarly pustular diseases have well recognized rheumatological aspects, e.g. SAPHO syndrome, where SAPHO stands for the combination of synovitis, acne, pustulosis, hyperostosis and osteitis. The association between HS and rheumatological disorders has been less well studied, although a better understanding of it may add significant information about the pathogenesis of HS.
Bartonella occurs far more frequently in North and South America than in Europe. In one study of 382 febrile HIV patients in San Francisco, Bartonella was found to be the causative organism in 18 (Koehler 2003). Bacillary angiomatosis remains an important differential diagnosis in all cases with skin lesions of unknown etiology. The pseudoneoplastic, vascular skin proliferation is very often clinically (and histologically) mistaken for Kaposi's sarcoma or hemangioma. Cats are the main host of Bartonella henselae, and the cat flea is the vector. Bartonella quintana frequently affects patients from poor social background, particularly the homeless. Several possible reservoirs have been discussed for such cases (Gasquet 1998). The vascular nodules or tumors may be isolated, but are usually multiple and reminiscent of fresh Kaposi's sarcoma, with cherry red or purple nodules. One quarter of cases may have bone involvement with painful osteolytic foci (AP elevation ). Here, the skin...
Sib and other family studies have identified a number of loci, some of which show overlap with those implicated in psoriasis. The genes underpinning the linkage are not known. Special mention should be made of the gene underlying Netherton's syndrome (OMIM 256500, SPINK5).
In psoriasis, a chronic skin disease, cells in the epidermis divide seven times more frequently than normal. Excess cells accumulate, forming bright red patches covered with silvery scales, which are keratinized cells. The drug methotrexate is sometimes used to treat severe cases. Five million people in the United States and 2 of all people worldwide have psoriasis.
There is a broad base of clinical experience with etretinate and acitretin in the treatment of chronic keratinizing disorders 33 . If ductal hy-perkeratinization is crucial in the pathogenesis of HS, etretinate and acitretin could be good alternatives to isotretinoin, because these drugs have a clearly greater effect on hyperkeratiniza-tion 3 . In addition, etretinate and acitretin show considerable immunomodulatory and anti-inflammatory effects 33 . Acitretin, the active retinoid metabolite, has generally replaced etretinate in retinoid therapy, certainly in psoriasis because of its more favorable phar-macokinetic profile, including a significantly shorter half-life.
Or isotretinoin for as many as 15 years and had not developed any signs of severe toxicity 39 . Acitretin has been established as a safe, effective treatment for psoriasis 39-41 . Retinoids, including etretinate and acitretin, are potent teratogens, leading to strict requirements for pregnancy prevention during and after their use 39-41 . Etretinate can be prescribed for male patients or postmenopausal female patients 41 . Premenopausal fertile woman should not be treated with etretinate but can be considered for acitretin therapy providing they use adequate contraception during therapy and for 24 months 39, 41 or even 36 months 40 after discontinuation. In fertile female patients it is also suggested to do a pre-treatment pregnancy test and repeated pregnancy tests every month of therapy 41 .
Historical note Red clover has been used for a long time as an animal fodder as well as a human medicine. Traditionally, it is considered an alternative remedy with good cleansing properties useful in the treatment of skin diseases such as psoriasis, eczema and rashes. A strong infusion was used to ease whooping cough and other spasmodic coughs due to measles, bronchitis and laryngitis. It was recommended for 'ulcers of every kind, and deep, ragged-edged, and otherwise badly-conditioned burns. It possesses a peculiar soothing property, proves an efficient detergent, and promotes a healthful granulation'. Combined with other herbs, red clover was recommended for syphilis, scrofula, chronic rheumatism, glandular and various skin affections (Felter & Lloyd 1 983). Interestingly, red clover was not traditionally used for the treatment of menopausal symptoms.
Aloe is used in the treatment of wounds, burns, radiation burns, ulcers, frostbite, psoriasis and genital herpes. The healing properties may be attributed to antimicrobial, immune-stimulating, anti-inflammatory and antithromboxane activities. Allantoin has also been shown to stimulate epithelialisation, and acemannan has been shown to stimulate macrophage production of IL-1 and TNF, which are associated with wound healing (Liptak 1997). Psoriasis A double-blind placebo-controlled study found topical aloe vera extract 0.5 in a hydrophilic cream to be beneficial in the treatment of psoriasis. Sixty patients aged 18-50 years with slight to moderate chronic psoriasis and PASI (psoriasis area and severity index) scores between 4.8 and 16.7 (mean 9.3) participated in the study, which was scheduled for 16 weeks with 12 months of follow-up. Patients were examined on a weekly basis and those showing a progressive reduction of lesions, desquamation followed by decreased erythema, infiltration...
I will take a selective approach dealing with the most common diseases acne, dermatitis, psoriasis and skin cancer account for over half the dermatology cases seen in primary care and around 80 of the workload of a secondary care dermatologist (Harris et al., 1990). What (little) we know of the genetics of acne, atopic dermatitis and psoriasis will be summarized briefly, and the role of genetic factors in skin cancer dealt with in more detail.
The scientific evidence also suggests that meditation is particularly helpful in treating anxiety-related disorders and in reducing symptoms of anxiety triggered by stress. For example, researchers conducted a study in 1998 of 37 patients with psoriasis a chronic, stress-related skin condition. They found that patients who practiced mindfulness meditation and who received standard ultraviolet light treatment experienced a more rapid clearing of their skin condition than the control subjects. Another study found that meditation moderated the symptoms of fibromyalgia (a chronic condition where people suffer diffuse muscular pain at several sites on the body) over half of the patients reported significant improvement. Meditation was one of several stress management techniques used in a small study of HIV-positive men. The study showed improvements in immune function and psychological well-being.
Natural Treatments For Psoriasis
Do You Suffer From the Itching and Scaling of Psoriasis? Or the Chronic Agony of Psoriatic Arthritis? If so you are not ALONE! A whopping three percent of the world’s populations suffer from either condition! An incredible 56 million working hours are lost every year by psoriasis sufferers according to the National Psoriasis Foundation.