Psoriasis is a chronic inflammatory disease caused by excessive immune activity of the T-cells in the skin. It usually ranges from mild to severe and occurs in both children and adults of both genders. It is not a contagious disease, it manifests as reddish or silvery patches on the skin surface of the scalps, palms and soles of feet. It also occurs in other areas but this is less common. About 2% of the world population suffers from psoriasis, 10% of which begins before the age of 10.
Mechanism of occurrence
The T-cells are cells responsible for immune response in the body, they exist to protect the body against foreign substances, however in the case of psoriasis the T-cells become over-active resulting in excessive release of the substance cytokines which causes excessive growth of skin. This excessive skin growth in turn results in an increased rate of dead skin cells being deposited on the skin surface appearing as rather disfiguring patches. Psoriasis could be plaque, gutate, pustular ot erythrodermic. Each type is characterized by severity and nature of occurrence.
There is a variety of options for treatment of psoriasis. These include use of drugs, phototherapy, topical creams and calorie restriction. Management of psoriasis is based on a patient to patient basis and the choice of treatment recommended include factors such as age, severity, nature, effect on psychology of patient, effect on quality of life of patient, available options and general preference. Combination of MTX and calcipotriosis has been shown to be effective treatment for psoriasis. Although the mechanism of action of drugs acting against psoriasis is yet to be fully established, some findings point to a link with the bacteria streptococcus pyrogenes such that antibiotics acting against these bacteria and caring for the skin against this bacteria is an option for treatment.
Topical therapies used include corticosteroids, vitamin D analogs (calcipotren and calcitrion), calcineurin inhibitors (such as tacrolimus and pimecrolimis) and Anthralin, stemic therapeutics include retinoids, methotrexate cyclosporine, antibiotics, biologics such as etanercept, infiximale and alalimumab and Usktekinumab, Etanercept, Infiximab, Ustekinumab. A range of drugs and topical for treatment of psoriasis available at www.my-lifespan.com.
Psychological stress has also been indicated as a possible trigger for occurrence of psoriasis. Avoiding fatigue and maintaining a healthy body system could help to reduce the severity and occurrence of the disease. Furthermore, psoriasis has also been linked with co morbidities such as cardiovascular diseases and arthritis pointing to possibility of treatments used for these conditions could also apply to management of psoriasis.
Psoriasis and calorie restriction
Various studies have looked into treatment of psoriasis using calorie restriction. Apart from newly reported 25year long study on monkeys that shows the benefit of restricted diet on reduced mortality and age related diseases, there are a number of studies on both humans and lab animals which show that fasting and restricted diet are an effective treatment for skin diseases such as psoriasis. In one study led by Dr. H. Lithell in 1983, 20 patients who had various skin diseases including those with psoriasis, showed significant improvement following a 2-week fasting period which was followed by 3 weeks on vegetarian diet. The fasting had a stronger and more lasting effect on the skin conditions, however, during the vegetarian diet stage the signs and symptoms of the skin diseases returned for most of the skin conditions study except for psoriasis. Thus, fasting and restricted diet had notable effect on psoriasis in particular. In another study an open trial on 20 adult patients showed results which indicate controlled vegetarian diet as an effective treatment for atopic dermatitis, a condition which is also characterized by skin inflammation like psoriasis. In the study striking change in skin condition was observed after 2 months on the vegetarian diet and the severity of the condition was notably ameliorated. More recent studies present novel method of measuring cell proliferation rate which could be used as a measure of effectiveness of treatment on conditions such as psoriasis. The results presented in the study showed calorie restriction to reduce cell proliferation by 45% compared to topical administration of lunasin which reduced cell proliferation by 16% when administered alone.
Lithell H, Bruce A, Gustafsson IB, Hoglund NJ, Karlstrom B, Ljunghall K, Sjolin K, Venge P, Werner I, Vessby B. (1983) Afasting and vegetarian diet treatment trial on chronic inflammatory disorders. Acta. Derm. Venereol. 63(5): 397-403.
Tanaka T, Kouda K, Kotani M, Takeuchi A, Tabei T, Masamoto Y, Nakamura H, Takigawa M, Suemura M, Takeuchi H, Kouda M. ( 2001) Vegetarian diet ameliorates symptoms of atopic dermatitis through reduction of the number of peripheral eosinophils and of PGE@ synthesis by monocytes. J. PHysiol. Anthropol. Appl. HUmna Sci. 20(6): #53-61.