Evidence based cure of psoriasis cases l.jpg
This presentation is the property of its rightful owner.
Sponsored Links
1 / 45

Evidence based cure of Psoriasis cases PowerPoint PPT Presentation


  • 100 Views
  • Uploaded on
  • Presentation posted in: General

Evidence based cure of Psoriasis cases . Prof G R Mohan MD(Hom),PG Dip(Env Stud) Principal, Devs Homoeopathic Medical College, [email protected] www.drgrmohan.c. Skin disease infrequently kills, But Often produces unhappiness, Usually loss of work and social

Download Presentation

Evidence based cure of Psoriasis cases

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Evidence based cure of psoriasis cases l.jpg

Evidence based cure of Psoriasis cases

Prof G R Mohan

MD(Hom),PG Dip(Env Stud)

Principal, Devs Homoeopathic Medical College,

[email protected]

www.drgrmohan.c

Prof G R Mohan


Slide2 l.jpg

Skin disease infrequently kills,

But Often produces unhappiness,

Usually loss of work and social

Deprivation as well as considerable

Physical discomfort.

Prof G R Mohan


Slide3 l.jpg

Physician should know what not to do in treating skin diseases

is an important thing to know.

Prof G R Mohan


Slide4 l.jpg

Concentration comes

out of a combination

of confidence and hunger

-- Arnold palmer

Prof G R Mohan


Slide5 l.jpg

Hahnemann's rule to treat

the totality of symptoms

complained of by the patient,

the only method by which

we may cure our patients.

Prof G R Mohan


How patients come to us l.jpg

How patients come to us

  • Skin eruption that has been for years with Cortisone used suppressed eruptions.

  • Eruptions cured earlier and suffering from various other problems.

Prof G R Mohan


Slide7 l.jpg

If Skin eruption that has been for years and suppressed with Cortisones

Prescribe best indicated remedy

based on the generals, mental

emotional and on skin problems.

Prof G R Mohan


If eruptions cured earlier and suffering from various other problems l.jpg

If Eruptions cured earlier and suffering from various other problems

If eruptions are treated, there will be problems

  • The organism should be stimulated by right remedy to evoke a skin eruptions

Prof G R Mohan


Slide9 l.jpg

Body must be left to fight the eruptions it self.

How long to leave the eruption ?

It depends up on the severity.

If treated earlier for cosmetic reasons or itching

The case will be spoiled . Case will be partially suppressed with half the eruption being driven inside and other half reaming on the skin

Prof G R Mohan


Psoriasis l.jpg

Psoriasis

Psoriasis is a common , genetically determined, inflammatory skin disorder of unknown cause which in its most usual from is characterized by well-demarcated raised red scaling patches that preferentially localize to the extensor surface.

Prof G R Mohan


Pathophysiology l.jpg

Pathophysiology

  • The keratinocytes hyper proliferation due to excessive division of cells in the basal layers.

  • Epidermis and dermis are involved Hyperkinetic with increased cell production of new cells 20-30 times, Increased epidermal volume, Rate of nail growth increased, Formation of abnormal nucleated ,loose scaly stratum cornea.

Prof G R Mohan


Psoriasis12 l.jpg

PSORIASIS

Occurs in 1% to 2% population.

Affects males( more)

Age on set: early : 16-22y

late : 55-60y

Prof G R Mohan


Aetiology l.jpg

Aetiology

  • The cause is unclear but involves immune stimulation of epidermal keratinocytes; T cells seem to play a central role. Family history is common, and certain genes and HLA antigens (Cw6, B13, B17) are associated with psoriasis. An environmental trigger is thought to evoke an inflammatory response and subsequent hyperproliferation of keratinocytes.

Prof G R Mohan


Basic defects l.jpg

Basic defects

  • Genetic

  • Bio chemical

  • Immunological

Prof G R Mohan


Precipitating factors l.jpg

Precipitating factors

  • Trauma

  • Infection

  • Sun light

  • Emotion

  • season

Prof G R Mohan


Clinical patterns l.jpg

Discoid

Guttate

Napkin

Flexural

Rupioid

Pustule

Nail

Clinical patterns

Prof G R Mohan


Psoriasis17 l.jpg

PSORIASIS

Prof G R Mohan


Psoriasis sites l.jpg

Psoriasis-sites

  • Extensor aspects of trunk& limbs

  • Knees, elbows & scalp

  • Mucosa seem spared

  • Nails

  • Flexural areas (genital, axillae, Inframamary folds, abdominal folds, umbilicus.

  • Face

  • Site of minor injury.

Prof G R Mohan


Slide19 l.jpg

Prof G R Mohan


Clinical features l.jpg

Clinical features

  • common, chronic, and recurrent

  • Very demarcated margin (plaque)

  • Papulo -squamus disorder.

  • dry ,well circumscribed, silvery, scaly papules &plaques of various sizes

Prof G R Mohan


Symptoms signs l.jpg

SYMPTOMS & SIGNS

Gradual onset,

Remitting &relapsing.

Usually non itchy

Horny layers

Increased epidermis thickening.

Prof G R Mohan


Slide22 l.jpg

These cycles of flare-ups and remissions often lead to feelings of sadness, despair, guilt and anger as well as low self-esteem. Depression is higher in people who have psoriasis than in the general population. Feelings of embarrassment also are common.

Prof G R Mohan


Severity of psoriasis l.jpg

Severity of psoriasis

  • Psoriasis is graded as mild (affecting less than 3% of the body);

  • moderate (affecting 3-10% of the body) or severe several scales exist.

Prof G R Mohan


Psoriasis area severity index pasi l.jpg

Psoriasis Area Severity Index (PASI)

  • The Psoriasis Area Severity Index(PASI) is the most widely used measurement tool for psoriasis. PASI combines the assessment of the severity of lesions and the area affected into a single score in the range 0 (no disease) to 72 (maximal disease).3

Prof G R Mohan


Diagnosis l.jpg

Diagnosis

  • Clinical evaluation

  • Rarely, biopsy

Prof G R Mohan


Slide26 l.jpg

Patient Ms T, aged 33y,house wife, came (03/01/2009)with eruptions over ears, scalp, hands ,Weight 47 Kgs, hand s, scalp, neck ,hairline margin with itching, thirst less,

Case was Diagnosed as Psoriasis by local dermatologist.

F/H : DM & HTN

Prof G R Mohan


Slide27 l.jpg

Prof G R Mohan


Slide28 l.jpg

The case was repertorised by Phataks method

Reportorial analysis is : Graphites 20/2, Pulsatilla 20/2, sepia 21/2,

3/01/09 : eruption over ears, scalp, hands with itching ,sadness, Pulsatilla was selected giving importance to Thirst less ,aversion to water Pulsatilla 30,3 doses were given placebo for 30 days, advice about diet was given.

06/02/09 – eruption increased with itching, oozing was present, Graphites 30,3 doses, Placebo for 15 days, advice about diet and personal cleanliness was given.

Prof G R Mohan


Slide29 l.jpg

21/05/09

Prof G R Mohan


Slide30 l.jpg

21/05/09 Due domestic problems she came late for one month and half she was better and again itching, oozing started in the same places, Graphites 30,3 doses, Placebo for 15 days,

30/07/09 oozing is lees ,itching is less ,sadness still persisting Graphites 200,3 doses, Placebo for 30days were given.

Prof G R Mohan


Slide31 l.jpg

03/08/09 no oozing ,itching is less ,sadness is less ,scalp still scales are seen, hair fall still persisting, Graphites 200,3 doses, Placebo for 30days were given.

Prof G R Mohan


03 8 2009 l.jpg

03/8/2009

Prof G R Mohan


03 08 09 l.jpg

03/08/09

Prof G R Mohan


30 10 09 l.jpg

30/10/09

30/10/09 no oozing , occasional itching ,sadness is less ,scalp scales are few seen, hair fall better , Placebo for 30days were given.

Prof G R Mohan


30 10 0935 l.jpg

30/10/09

Prof G R Mohan


Slide36 l.jpg

24/11/09 : itching increased,

Graphites IM,1doses,Placebo for 30days were given

25/12/09 skin totally cleared from eruptions, Placebo for 30days was given

Prof G R Mohan


29 6 10 l.jpg

29/6/10

29/06/2010 she came after 6 months after stopping medication (as shown in visual )

Prof G R Mohan


Slide38 l.jpg

Patient Mr. A, aged 30y,Software eng, came (21/01/09)with fissures over tongue since 3years diagnosed as Psoriasis of tongue by Dermatologist. , sleeplessness, Weight 53 Kgs, thirst less,


Case no 2 l.jpg

Case no 2

Patient Mr. A, aged 30y,Software eng, came (21/01/09)with fissures over tongue since 3years diagnosed as Psoriasis of tongue by Dermatologist, sleeplessness, Weight 53 Kgs, thirst less,

Prof G R Mohan


Slide41 l.jpg

21/01/09 itching increased, Acid Nitricum 30c ,5 doses, Placebo for 30days were given

5/03/09 no change no difference in taste , sleeplessness . Acid Nitricum 30c , Placebo for 30days were given

16/08/09 patient is feeling fissures are reducing , no difference in taste , sleeplessness is better, Acid Nitricum 200c, 3 doses, Placebo for 30days were given.

19/09/09 fissures are reducing , no difference in taste , sleeplessness is better, Acid Nitricum 200c, 3 doses, Placebo for 30days were given.

23/10/09 : had fever a month back was admitted in hospital took allopathic medicines, fissures are reducing, Ars Alb 200c,( because he was still felling after affects of fever) 3doses, Placebo for 30days were given.

29/12/09 no change , Thuja 1m I dose was given, Placebo for 30days were given


Slide42 l.jpg

21/02/10 anterior part of tongue improved a lot as shown in visual, thickness of tongue reduced a lot , Acid Nitricum IM, 1doses, Placebo for 30days were given.


Views of authors about psoriasis of tongue l.jpg

Views of authors about psoriasis of tongue

They report that fissured tongue (FT) and benign migratory glossitis (BMG; geographic tongue) were the two most frequent findings. FT affected 33% of psoriasis patients and 9.5% of controls, while BMG affected 14% of patients and only 6% of controls.

Notably, the frequency of BMG increased with the severity of psoriasis in a sub-group of patients with plaque-type disease, as assessed by Psoriasis Area and Severity Index, Daneshpazhooh et al report in the journal BMC Dermatology.

They conclude: "Overall, although oral lesions might not be considered authentic oral psoriasis unless proven histologically and with a parallel clinical course, nonspecific tongue lesions are significantly more frequent in psoriatic cases."

The team recommends further studies to "evaluate the clinical significance of these seemingly nonspecific lesions in a suspected psoriatic case".

Tongue lesions common in psoriasis patients

12 November 2004

BMC Dermatol 2004; 4: 16. http://www.medwire-news.md/60/30030/Psoriasis/Tongue_lesions_common_in_psoriasis_patients.html


Conclusion l.jpg

Conclusion

Skin disease infrequently kills, But Often produces unhappiness, Usually loss of work and social Deprivation as well as considerablePhysical discomfort. has proved to be correct in both cases.

Concentration to treat comes out of a combination of confidence in system and hunger to learn is a fact.

Prof G R Mohan


References l.jpg

References

  • Marks. R, Roxburgh’s Common Skin Diseases, 16th Edition, Chapman & Hall Medical, London [page no.124-140]

  • Behl. P.N., Practice of Dermatology, Eighth Edition, CBS Publishers & Distributors, New Delhi, India [page no.253-260]

  • http://psoriasis,about.com/od/psoriasisfags/f/pasi.htm

Prof G R Mohan


  • Login