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Psoriasis Edited by:
Joe Hing Kwok Chu
Causes
of Psoriasis
Causes of psoriasis have not been completely understood. The following facts have been observed:
I. Auto-immune system dysfunction:
(1). the ratio of T-helper to T-suppressor lymphocytes (TH/TS) is
abnormal. (2). Immune function of the body fluid overactive: IGE and
IGA are high and IGM is low.
II. Streptococcus infection:
Clearing streptococcus infection has helped to relieve psoriasis because the
toxin of the bacteria causes the diseased cells to speed up division.
III. Metabolism dysfunction: ration
of cAMP and cGMP is abnormal. The diseased skin of psoriasis patients is low in cAMP, which is an epidermal chalone which
inhibits the cells of the skin division.
Effectiveness of Treatments
Traditional Chinese herb medicine
and certain qigong can balance the ratio of
cAMP and cGMP. Currently Western drugs lack the satisfactory
therapy to solve this issue.
There are hundreds of treatment
methods for psoriasis. There is no satisfactory western
medicine for treatment of psoriasis. Individually prescribed
Chinese herbal medicines are more effective. (Acupuncture is not
commonly used in China for psoriasis).
Since
Traditional Chinese herb medicine is more effective for skin
problem, many
Westerners seek Chinese herb therapy for psoriasis; but it is
difficult to locate
knowledgeable Traditional Chinese herb practitioners, especially in the West.
Sometimes psoriasis can be misdiagnosed as fungus infection and vice versa.
At present true psoriasis has no
effective complete cure.
Some claim
certain therapies are effective cures. This can be a misconception and some
skeptics even think the claims can be fraudulent. The truth is that
the cycle of
psoriasis comes in stages:
1. first it progresses and
2. then it goes into remission and
3. then it goes into subsiding.
Then it will be back again.
If a person
uses certain therapy and it happens that it is immediately prior to
the remission
and subsiding stage, the patient or the practitioner may think the therapy is
working. In fact the disease is running its course.
Chinese
Herb Toxicity
Usually
Chinese herbal medicine (not the manufactured "herbs" which
might have mixed with western drugs) is much safer than modern drugs
although there were cases of fatalities reported in Britain after
using herbal medicine. Under normal correct usage, the
toxicity of herbs used in those prescriptions is mild and should
not have caused
death. The incidences of death could have been caused by extreme allergic reactions.
Chinese Herb Therapy
Since 1966 psoriasis has been
officially called "yin xiao bing"
銀
痟 病
in
China.
"Yin xiao bing" literally means "silver
particles sickness". Most Chinese people call it "niu pi
xian"牛
皮 癬 which literally
means "cow hide fungus". But, niu pi xian mentioned in
Traditional Chinese Medicine (TCM) classics is not yin xiao bing which is
psoriasis. There are many highly respectable publications in Chinese
which still use the term niu pi xian for psoriasis. This can be
confusing for the general public, even for
medical people who read Chinese.
The Chinese herb therapy can be
classified into three categories:
1. clearing heat (re),
2. blood
invigorating method
3.
tonifying blood method
(yu, sludge),
and dry (zao)
I. Clearing
Heat Methods
1. rid of heat and cool the blood
method
This method is for the progressing
stage.
Symptoms :
New bright red particle like or blotches of rashes. The surface is covered
with white flakes and under them there are bleeding small particles.
Itchiness,
restlessness, dislike of heat, yellow urine, constipation, red
tongue with thin
moss, strong tight (stringy) pulse.
Prescription:
tu fu ling 30 g, huai hua 30 g, sheng di 30 g, mao gen 30 g, zhi cao 15 g, gan cao 6 g.
Adjustment
of formula:
(1)
constipation is bad, add da huang 10 g.
(2)
New rashes, particle like, bright red, not many particles (flakes),
dry tongue and mouth, swollen tonsils, add jin yin hua, da qing ye,
ban lan gen 15 g each.
(3)
When rashes become larger with more flakes, especially on the upper
limbs and upper torso and on the scalp , add wind ridding herbs like jing jie, fang feng, niu bang zi 10 g each, chan yi 6 g. If the
problem is mainly on the scalp and when the usual herbs for
ridding of wind are not effective, try to use insects or snake type
of herbs like wu gong or wu she.
銀 痟 病
醫 治 法
I. 清
熱 涼 血 法 ﹕ 銀
痟 病 進 行 期 ，
新 疹 出 現 ， 色
鮮
紅 ，
點 滴 或 班 狀 ，
表 面 覆 蓋 白 色 鱗 痟 ， 基
底
有
出 血 小 點 ，
痒 ， 心 煩 ， 怕 熱 ， 尿 黃 赤 ，
便 秘 ，
舌
紅 苔 薄 ， 脈 弦 有 力 。
處
方 ﹕
土
茯 苓 30 克 ，
槐 花 30克
， 生 地 30克 ，
茅
根 30克 ，
紫 草 15克
， 甘 草 6克 。
加
減 ﹕
(1) 便
秘 甚 者 加 大 黃
10克 。
(2) 皮
疹 初 起 ， 呈 點 滴 狀 ， 疹 色 鮮 紅 ， 鱗 痟 少
， 口
乾 舌 燥 ，
扁 桃 腺 腫 大 者 ， 加 銀 花 ， 大 青
葉 ， 板
藍 根 各 15克 。
(3)皮
疹 由 點 滴 狀 丘 疹 散 大 ， 變 為 斑 塊 ， 表 面
鱗 痟
較
多 ，
以 上 肢 或 軀 幹 上 部 為 甚 ， 尤 有 分 布
頭 皮
者
，
加
去 風 的 荊 芥 ，
防 風 ， 牛 蒡 子 各 10克， 蟬
衣 6克 。
(4)頭
皮 為 銀 痟 病 好 發 部 位 ， 用 一 般 驅 風 藥 無
效 時
，
試 加
蟲 類 驅 風 藥 如 蜈 蚣 ， 烏 蛇 之 類 。
2. 清
肝 膽 濕 熱 法
來
源 ﹕ 俞 熄 純 。
2. clearing
damp heat of liver and gall
method
II. Blood
invigorating method
III.
Tonifying blood method
Note: Chinese herbal
medicine is a completely different branch of Traditional Chinese Medicine (TCM) by itself. Traditionally it is practised by specially trained
Chinese herb doctors
and not by acupuncturists. An herb doctor is not necessarily a trained
acupuncturist. In America, Chinese herbal medicine and acupuncture
were grouped together by some of the law making bodies to save administrative
expenses. A licensed acupuncturist in America is not necessary a
trained herbalist.
Modern
Drug Therapy and its Toxicity
During the sixties, the Western drug
aminopterin caused many cases of death in China.
During the seventies, bimolane
(AT-1727) was used. Reports in China mentioned that it caused
more than 200 deaths.
Psoralen
(补 骨 脂 素) is an extract of the medicinal
part of a Chinese herb, bu gu zhi
(补 骨 脂)
which is also known as po gu zi (破 故 子).
It is being used for treatment of psoriasis,
eczema and
vitiligo. It
is a modern version of an old Chinese herb.
Click here to go to ultra violet
therapy with psoralen.
Methoxypsoralen
(甲
氧 补 骨 脂 素)
is another extract of the medicinal
part of a Chinese herb, bu gu zhi. It is being used for treatment of
psoriasis, eczema and vitiligo. Its use is similar to that of psoralen, and
it is considered more effective than psoralen in psoriasis therapy.
Click here to go to
ultra violet therapy with methoxypsoralen.
Steroids:
When given in oral applications or
injections, steroids can cause full moon face, whole body water
retention, osteoporosis, weight gain, bleeding ulcers, memory loss,
diabetes, and worsening of lung TB.
Aminopterin and ethylenediamine
tetraaccetylimide can cause decrease of white cell count, thus
lowering the immune system, and even cause leukemia.
Retinoic
acid (Retin-A, Vitamin A Acid) has caused many cases of deformed
fetuses.
Prolonged usage of methotrexate,
a folic acid antagonist and cancer drug, can
cause cirrhosis of the liver.
Dithranol (Anthralin)
can cause tumors.
Ultra
Violet Therapy
(Phototherapy), a Complementary Method
(1) Ultra Violet with Psoralen
(补 骨 脂 素)
Take
40 to 80 mg of
psoralen orally
(patients with lighter body weight should take lesser amount). Two hours
after taking the medicine, use ultra violet light for the whole body for
about 15 to 30 minutes at a distance of 7 to 17 cm and at shorter
distance for areas that are more serious. Treatment should be applied
daily or every other day, three to six times per week. After symptoms
are gone, continue the treatments, gradually spacing them further apart.
(2)
Ultra Violet with
methoxypsoralen
(甲
氧 补 骨 脂 素)
The method of light therapy of using
methoxypsoralen is the same as
that of using psoralen.
Oral dosage is 30 to 50 mg to be taken
after a meal. One hour later, soak the whole body in water from a
mineral hotsprings for 20
to 30 minutes. After two hours, apply long wave ultra violet light,
starting from a small dosage of light, and gradually increasing the amount.
External application of 0.5% of methoxypsoralen tincture can also be
used.
Treatment record: Under this method,
therapy was applied once a day (except Sunday). It was continued
until symptoms gradually subsided, then the frequency of therapy was
decreased to once a week, then down to once a month, then long term treatments were continued to secure
long term remission. Total patients: 46. Healed: 45. Obviously
improved: 1. The effectiveness of therapy showed after 9
treatments, and patients were totally healed after 60 treatments.
Warning:
Methoxypsoralen can affect the blood
producing
function of the bone marrow. It may
decrease the total white cells.
(3).
Ultra Violet with Psoralen
(补 骨 脂 素)
and Bai Zhi
(白 芷 )
Inject 2 ml (1 mg of psoralen), and apply
externally 30% bai zhi tincture. After 2 hours, use light therapy as
above, once
a day.
Treatment record: 20 patients.
Healed:15. Obviously improved: 5. Follow up investigation: 3 months to 1
year with no relapses.
Side effects: minor headaches, nausea,
decreased appetite and itchiness.
Available dosage forms and strengths:
Injection liquid (oil base): 2 ml per tube, with 1 mg of
psoralen.
Solution for external use: 50 ml per bottle with 25 mg of
psoralen.
Capsules: 40 mg of psoralen each.
Caution: when
using ultra violet therapy (phototherapy)
(1) Do not apply to patients who are allergic to
sunlight.
(2) Discontinue the treatments if after sunbathing or
receiving ultra violet therapy, local areas become swollen and
inflamed. After the inflammation has subsided, continue with the
treatments but shorten the sunbathing or the ultra violet therapy time.
(3) If the injection liquid of
psoralen shows crystallization, place
the tube in boiling water until the crystals have dissolved. Cool
the liquid before using. If the liquid becomes cloudy during heating, it is
because of the increased density of the solution. After cooling off, it should
become clear again.
(4) Store the medicine in a dark place and avoid freezing.
(5) Long term exposure to sun light (or
ultra violet lamps) may cause damages the DNA and cause skin cancer.
Other Therapy
Folk therapy includes using:
evening primrose oil,
witch hazel, tea tree oil, mahonia
aquifolium, capsaicin.
Other psoriasis sites:
National
Skin Center, Singapore
National Psoriasis
Foundation
MedlinePlus/NIH Psoriasis Page
Unfinished. Writing in progress...
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