Psoriasis is one of the most stubborn skin diseases. It is characterised by thick, red silvery scaled patches of skin. This disease may appear at any age, though it is rare in infancy and early childhood. The incidence increases throughout chldhood, after the age of five years, to reach a peak at adolescence. Girls suffering from this disease outnumber boys by two to one.
Symptoms
Generally, the skin of the child suffering from psoriasis appears red and irritated and may be covered with bright silvery scales. Irritation of the skin is usually slight, but irritation of the mind may be more of a problem as the child is being constantly reminded that he is different from other children. Sometimes there is also a little itching. Scratching may cause fresh lesions. Areas usually involved are elbows, knees, the skin behind the ears, trunk and scalp. The lesions vary in size from minute papules only just visible, to sheets covering large parts of the body. The lesions of psoriasis are always dry and rarely become infected.
A special form, guttate psoriasis, is typically seen in children between five and 12 years old. A rash,mainly on the trunk and consisting of pink maculopapaules, appers 10 – 20 days after a sore throat. After a few days, the maculopapules become more typically psoriatic. They can clear up within a few months or lead to chronic psoriasis. Some patients with long-standing psoriasis develop nail changes including small pits on the nail plate and separation of part of the nail from the nail bed. Discoloration of the nail resembling grease spots is also seen.
Causes
Recent studies have shown that psoriasis involves an abnormality in the mechanism in which the skin grows and replaces itself. This abnormality is related to the metabolism of amino acids, the protein chemicals which are nature’s basic building blocks for the reprooduction of cell tissues. Some authorities also believe that this disease is caused by lack of essential acids. Heredity also plays a role in the development of this disease and about one-third of patients have a positive family history.
The factors that aggrvate and precipitate the outbreak of psoriasis are injury to skin in the form of cut, burn, minor abrassion, changes in the seasons, physical and emotional stress, infections and use of certain oral drugs for the treatment of other diseases.
Treatment
Since psoriasis is a metabolic disease, it would be desirable to cleanse the system in the begining of the treatment. For this purpose, the child-patient should be encouraged to take vegetable and fruit juices for about two days. Carrots, beats, cucumbers and grapes may be used for juices. Juices of citrus fruits should be avoided. Child should be persuaded to take warm-water enema daily during this peiod to cleanse the bowels. Thereafter, he may be allowed to gradually embark upon a well balanced diet, according to his age. The emphasis should be on whole grain cereals, raw or lightly cooked vegetables and fresh fruits.
All animal fats, including milk, butter and eggs should be avoided. Refined or processed foods and foods containing hydrogenerated fats or white sugar, all condiments, tea and coffee should also be avoided. After noticeable improvement, goat’s milk , yoghurt and home made cottage cheese may be added to the diet.
The cabbage leaves have been successfully used in the form of compress in the treatment of psoriasis. The thickest and greenest outer leaves are most effective for use as compresses. They should be thoroughly washed in warm water and dried with a towel. The leaves should be made flat, soft and smooth by rolling them with a rolling pn after removing the thick veins. They should be warmed and then applied smoothly to the affected part in an overlappng manner. A pad of soft woollen cloth should be put over it. The whole compress should then be secured with a elastic bandage.
The use of curd in the form of buttermilk has proved useful in psoriasis, and the child-patient should drink it in liberal quantities. The application of buttermilk compresses over the affected parts will also be useful in treating this condition.
The oil of avocado (kulu naspati) has been found beneficial in the treatment of this disease. It should be applied gently to the affected parts. The oil extracted from the outer shell of cashewnut has also been found valuable in psoriasis. It is acrid and rubefacient and can be applied beneficially on the affected areas.
Too frequent baths should be avoided. Soap should not be used. Regular sea-water baths and application of sea water externally over the affected parts once a day are beneficial. After a bath, a little olive oil may be applied. The skin should be kept absolutely clean by dry friction or sponge. The procedure for these baths have been explaned in the Appendix.
In many cases, psoriasis responds well to sunlight. The affected parts should be frequently exposed to the sun. The daily use of a sunlamp or ultra-violet light are also beneficial.
The use of mud packs in the treatment of psoriasis have also been found highly beneficial. The packs are made by mixing the clay with a little water and applying to the affected areas. After the clay has dried, it is removed and a fresh pack applied. Mud packs are eliminative in their action. They absorb and remove the toxins from the diseased area.