Psoriasis

Psoriasis is a common skin disorder that affects between 2%-4% of the U.S. population. Psoriasis is a hyperproliferative skin disorder characterized by sharply bordered reddened rashes and silvery, scaly plaques on the skin. Eruptions often involve the scalp, the extensor surfaces of the extremities, the back, and the buttocks. Removal of the superficial scales typically causes pinpoint bleeding, or the Auspitzsign. The rate of cellular division in psoriatic lesions is very high, at approximately 1,000 times the rate of normal skin. Psoriasis predominately affects Caucasians and a family history of psoriasis is present in 35%-50% of patients. Genetic factors are likely to be involved. The rate at which cells divide is controlled by a balance of cAMP and cyclic guanidine monophosphate (cGMP). Increased levels of cGMP are associated with increased cell proliferation while increased levels of cAMP are associated with cell maturation and decreased cell replication. Increased levels of cGMP and decreased levels of cAMP have been demonstrated in the skin of patients with psoriasis, resulting in excess cell replication.15 Natural medicine interventions may help to rebalance the cyclic AMP:GMP ratio and thus improve the skin's condition.

Optimizing bowel and liver function may be useful for managing psoriasis. Individuals with psoriasis have increased levels of polyamines in the skin and blood, which are toxic by-products of incomplete protein digestion and assimilation. Polyamines inhibit the formation of cAMP and may, therefore, contribute to the excessive rate of skin-cell replication seen in psoriasis.16,17 Several natural compounds may inhibit the formation of polyamines. These include vitamin A and the alkaloids from goldenseal (Hydrastis canadensis).18,19 Another study investigated topical application of a 10% Mahonia aquifolium cream in patients with mild to moderate bilateral psoriasis. The results showed 84% of patients rated the Mahonia treatment as good to excellent compared with standard treatment, and 63% of patients rated Mahonia aquifolium equal to or better than the standard psoriatic treatment.20

One of the best ways to prevent polyamine formation is via evaluating digestive function with such tests as Heidelburg analysis or functional medicine assessments and then correcting problems with protein digestion or absorption by way of appropriate therapies. The Heidelburg analysis is a simple test that involves swallowing a radiotelemetry capsule that measures the stomach's pH at baseline and then after a pH-buffered test to see how the stomach compensates with acid production. Functional medicine tests include a closely monitored clinical trial of betaine hydrochloride. For patients who cannot get access to the Heidelburg analysis, the best second-line option is the betaine trial provided that there is no overt GI disease, such as ulcers or esophagitis, for example. Other intestinal toxins are implicated in psoriasis. These include endotoxins from gram-negative bacteria, C. albicans, and yeast compounds. These compounds lead to increased cGMP levels within skin cells.21,22 Therefore, treating intestinal Candida or bacterial overgrowth may ameliorate psoriasis. A low-fiber diet is associated with increased levels of gut-derived toxins.21 Thus, a fiber-rich diet helps to bind bowel toxins and promote their excretion. Patients with psoriasis need to consume plenty of beans, fruits, and vegetables.

Zinc supplements may help to reduce the severity of acne and assist in skin healing.

Improving liver function is often helpful for treating psoriasis. Silymarin, the flavonoid component of milk thistle (Silybum marianum) has been reported to be useful for treating psoriasis.23 Silymarin improves liver function, inhibits inflammation, and reduces excessive cellular proliferation.24 Alcohol consumption worsens psoriasis, presumably because such

Figure 31-1. Matricaria chamomilla. Photo by Brian Hunter, huntergrafx.net.

consumption damages liver function and increases absorption of toxins from the gut,25 thus, avoidance of alcohol is recommended for patients with psoriasis.

Manipulating dietary fats may also be useful. Several double-blind clinical studies have demonstrated that fish-oil supplements that are rich in EPA and DHA ameliorate the condition.26,27 Yet some studies have shown less improvement, emphasizing the importance of selecting the proper nutraceutical interventions. Patients with the condition should generally be advised to minimize intake of arachidonic acid because of its pro-inflammatory effects.

Fumaricacid has been found, in some studies, to be effective. Fumaricacid is an intermediate of the Krebs cycle and is formed in the skin in response to ultraviolet rays. Patients with psoriasis may suffer from a biochemical defect that reduces their production of adequate amounts of fumaric acid. Controlled studies have demonstrated improvements in patients following the administration of oral dimethylfumaric acid combined with topical fumaricacid. However, side effects, including nausea, diarrhea, malaise, and liver and kidney disturbances, can occur,28 requiring close medical supervision of such therapy.

Topical applications such as licorice root and chamomile may provide anti-inflammatory and antiallergic activity when used on dry, flaky, irritated skin.29,30 Both topical and oral doses of vitamin D (in the form of calcitrol-1,25-dihydroxyvitamin D3) have also been effective as a result of their ability to regulate terminal differentiation of basal cells of epidermal keratino-cytes.31

Natural Treatments For Psoriasis

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.

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