Jul 2015|Vol 12|Is 7

   
 
Case
 
   
Homoeopathic Positive Perspectives in Psoriasis
 

 

Dr.R.Gnanasambandam, a renowned clinician and academician, research scholar writes and shares his views in this article Homoeopathic Positive Perspectives in Psoriasis. He had authored books and articles published in scientific journal. He also presented many papers in the scientific conferences, lectured in many Homoeopathic Medical Colleges. He served in many positions in the state and central Government. He can be contacted at 6, Llyod's II Lane Royapettah, Chennai -600014

 
 
 

Introduction
      Psoriasis is an inflammatory skin disorder which may affect the skin, nails and joints. It is fairly common and affects individuals of all ages. It frequently manifests in the skin overlying the joint, elbow and lumbosacral areas. There are periods of quiescence of varying length, when the disease is in apparent remission and periods of flare. Even though a number of treatment modalities exist for psoriasis, homoeopathy gives positive results without topical. The genius of Homoeopathy lies in on the individualization and potentisation

Pathophysiology

      We know psoriasis is an Auto immune disease. The involvement of the immune system in psoriasis is discussed since early and studies identified complex infiltrates of leukocytes involvement in both innate and adaptive immunity in psoriatic skin. The concept that interactions between dendritic cells, T cells, keratinocytes, neutrophils, and the cytokines released from immune cells likely contribute to the initiation and perpetuation of the cutaneous inflammation that is characteristic of psoriasis.
      The clinical appearance of characteristic red, raised, scaly skin lesions of psoriasis is defined by a set of underlying cellular changes. The impressive growth and dilation of superficial blood vessels causes redness and hyperplasia of the epidermis. Epidermal growth occurs as typical pattern of ‘‘psoriasiform’’ hyperplasia. The thickening and differentiation of cells may lead to Acanthosis. In some cases in psoriatic epidermis, keratinocytes proliferate in long run to form severe “Keratinaisation” giving a toad skin appearance and mature rapidly so that terminal differentiation.
The lesions are characterized by pink to red plaques that are covered with silver-white scales. Lesions are commonly found on the elbows, knees, back, scalp and vulva. The lesions may coalesce to form large areas of erythema with smaller plaques. The nails are commonly involved, which show oncolysis and pitting. Severe psoriatic conditions will also have associated inflammatory bowel disease and arthritis.

Clinical Organon

      Psoriasis fits Hahnemann’s classification of Disease as dynamic, chronic disease with fully developed symptoms and denotes its miasmatic background predominantly as “Psora”. The dirty, dry, scaly lesions with itching lead the disease as “Psora” in many cases. However the lesions eruptions with pus undergoes as Pseudo Psora and the rough, cicatrized lesions shows the differentiation of cells as sycotic manifestions in few individuals. Dr.H.A Robert said “Psoriasis has been called the marriage of all miasms, or stigmata, but its characteristics are predominantly psoric and sycotic”

      The chronicity of the disease is well marked by its recurrence in all systems of medical disciplines, even in homoeopathic treatment because the dyscrasia is not eradicated from the victims in accordance to the Hahnemann’s understanding. Hahnemann expressed his views to derive a indicated remedy by “Key symptom” from totality of symptoms. The expressions of that key Characteristic symptom is derived as prime symptom of case by understanding the Constitution that derived from miasmatic background in each case studies

He states in Aphorism § 5

      Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations, the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, etc., are to be taken into consideration.

      Hence we can interpret quickly Hahnemann’s views in treating a Psoriasis case by understating the expression of symptoms under miasmatic interpretation

Clinical Materia Medica

     The anamnesis on Psoriasis can be easily made out thorough our vast Materia Medica. A similitude can be arrived based on the totality of symptoms, however the clinical choice of remedy make a physician to interpret the miasmatic expression in particular constitution of the patient

Arsenicum Album

      A dry and scaly skin lesion with silvery, blue, dark lesions all over the body always lead the remedy. The sensation is expressed as itching, burning < a night and warm application in many cases indicates the key symptom as per Hahnemann in most cases. A personal or family history of bronchial asthma, Allergic Rhinitis, allergic skin diseases in past history gives a clue to the physician .In each and every case miasmatic expression can be corroborated with constitutional features of Asenicum Album

Petroleum
     Early formation of thick, hard, cracked, fissured will call a physician to think this remedy. Further the lesions may yellowish, green crust is also the most characteristic symptom. Psoriatic eruptions develop in winter season and get aggravated periodically. The eruptions itches violently and one must scratch until they bleed. The parts become cold after scratching.

Sulphur

     The psoriatic skin shows all features, reddish rashes initially, then dry, rough, wrinkled and scaly. The eruptions break out on almost any part of the body having following characteristic. There is volvouptuos violent itching which is aggravated at night, in bed, relieved by washing. The skin burns whenever the patient scratches. The skin surrounding the eruption is worse during spring time and in damp weather. Similar to Arsenicum Album im most cases in establishing a personal family history of skin diseases and respiratory diseases. The constitutional expression as stoop shouldered, unwashed, tall and lean, untidy with offensive body odour. It is to be thought of a chronic obstinate case of psoriasis or it should be given after an acute exacerbation of psoriatic attack to prevent relapse as per Hahnemann’s directions

Psorinum

     The psoriatic eruptions disappear in summer only to occur in winter. The skin is dirty, rough, scabby and greasy. Nape of the neck, scalp, folds of skin and groins are typically affected. Eruption itches intolerably which are worse by heat of bed. The patient scratches until it becomes raw and bleeds. It is usually indicated when well related remedies fall to relieve or permanently cure or when sulphur seems indicated but fails to relieve. Psoriatic eruption developing after maltreated infectious diseases or long lasting grief reactions. The patient is extremely chilly and hungry with foul carrion like odour

Kali Ars
     The Remedy Kali Ars is a beneficial remedy for psoriasis. The lesions with patches on back, arms and spreading from elbows; scaly itches, scaling off leaves behind red skin.

Kali Sulph
     Kali Sulph fits a patient who gives the origin of scalp as initial manifestation.

Thyrodinum

     One of the best psoriasis remedy for patients with hypothyroidism and predisposition to obese. They are Chilly and anemic subjects. Dry impoverished skin; cold hands and feet.

Clinical applications

     We are quite privileged in clinical applications to make a verdict in the scientific community that “Psoriasis is a curable Disease” since the applications guided by Hahnemann is not only speculative but also practically proved by clinical evidences. Even though we are not competent to challenge each psoriatic patient on certainty of cure, clinical evidences had proved that remissions can be aborted in psoriasis

     Most of the Psoriasis patients likely to give the history of severe dandruff incidentally make a physician to understand the thick white, profuse scales, leaving redness in the bottom. A usual remedy Kali Sulph might have brought a palliation, further remissions seeks a constitutional remedy with miasmatic interpretation. Clinically, Arsenicum Album and petroleum had shown high statistics of recovery. The typical lesions on the extensor places elbow, knee and low back always benefited by these remedies

     An excellent improvement with dynamic remedy without any external application will definitely make a young Homoeopath to inspire the effectiveness of highly potentisation and realize a cure in individualization and effectiveness of dynamisation. Of course remissions in few cases may frustrate and struggle to give relief to the patients by finding an another remedy


     Here we should be very careful in understanding the remissions and always repetition of the same remedy with same potency will eradicate many cases over a period of time. I have treated a 25 years old Psoriatic patient with keratinized lesions in scalp, ear lobes, elbows, knee and low back. Arsenicum Album 1M was prescribed initially on understanding miasmatic background and repeated every month. While the expression of syphilitic changes with rough, cracked, fissured lesions with bleeding was managed petroleoum 200. The patient has improved without any trace of lesion and only the earlobe undergo remissions and continues with the miasmatic prescription. The patient is ready to receive an antipsoric remedy “Sulphur” to conclude the sayings of Hahneman as per Aphorism 2. The lesions expressed syphilitic changes during the first consultation

Conclusion

     Homoeopathy renders great service to the human community by inspiring the guidelines of Hahnemann in treating a psoriasis patient. The radical cure is positive in many cases by understanding the genius of Homoeopathy on individualization and potentisation, applying them understanding the layer of a disease on positive medicines perspectives in a patient.