Psoriasis

Psoriasis Causes, Symptoms & Treatment

Psoriasis is an autoimmune condition affected the skin causing an overproduction of skin cells. It is a chronic, recurring condition that can vary in severity, and can occur anywhere on the body, but commonly affects the elbows, knees, scalp, sacrum and genitals.

Unlike eczema, it tends to occur on surfaces on the outside of joints such as the elbows and knees.

Psoriasis is a Th1 dominant disease.  Th1 cells promote cell-mediated immune responses.  They are required for host defense against intracellular pathogens of a viral and bacterial nature.

The increased proliferation of skin cells is directly caused by an increase in cyclic GMP and a decrease in cAMP.  These are messengers of the body that interfere with the proliferation of skin cells and impaired cell maturation.

Psoriasis affects both sexes equally and can occur at any age, with the mean age estimated to be 33 years.  It is estimated to affect around 3% of the population.

Causes of Psoriasis

The cause of the disease is not well understood but is thought to involve genetic susceptibility and immunological pathways, specifically migration of T-cells to the dermis which triggers the release of cytokines, leading to inflammation and rapid production of the skin cells.  As with all autoimmune diseases, there are very strong links back to gut bacteria’s and infections as well as various external immune triggers such as foods and environmental toxins.

Risk factors

• Genetic predisposition
• Infections (especially streptococcal throat) or injury to the skin may precipitate psoriasis
• Incomplete protein digestion (increases toxic compounds which inhibit cAMP)
• Excessive consumption animal fats
• Bowel toxicity (increases cyclic GMP)
• Impaired liver function (increases blood toxins leading to increased cAMP
• Obesity
• Stress
• Smoking and excessive alcohol consumption
• Medications: beta-blockers, lithium, quinine, steroids, contraceptive pill
• Pregnancy or menopause
• Sunlight: 10% of patients develop more severe psoriasis with exposure to sunlight

Signs & symptoms of Psoriasis

• Thickening and scaling of skin leading to pink or reddish demarcated lesions covered with silvery, opaque scales
• Pitting of nails (common)
• Inflammation of the joints (psoriatic arthritis): 10-30%

Differential diagnosis

• Dermatitis
• Eczema
• Squamous cell carcinoma
• Lupus
• Tinea
• Balance immune system / decrease TH1 dominance
• Reduce antigenic load
• Reduce dermal inflammation and oxidative stress
• Promote tissue repair and growth of healthy skin
• Stimulate digestion (especially gastric acid)
• Address dysbiosis / repair intestinal permeability
• Support lymphatic drainage
• Reduce stress

Diet plan guidelines for Psoriasis

• Reduce antigenic load
• Avoid allergenic foods: a gluten-free casein-free diet should be trialed
• Minimise pro-inflammatory foods: sugar, refined carbohydrates, trans fats, excessive commercial red meat, omega-6 fatty acids, caffeine and alcohol
• Nightshades may promote inflammatory reaction in some people.
• Emphasise anti-inflammatory foods: in cold-water oily fish, berries, nuts and seeds, turmeric, ginger, green tea, olive oil
• Emphasise antioxidant-rich foods to promote tissue repair: berries, green tea, turmeric, fruits and vegetables
• High fibre diet to support bowel function and growth of beneficial gut flora
• Probiotic foods to support healthy immune response and reduce intestinal permeability
• Include bitter foods, lemon juice and/or apple cider vinegar to support digestion of food
• Include garlic as a broad-spectrum antimicrobial

Supplements that support Psoriasis

• Omega-3 EFA’s: reduce inflammation
• Evening primrose oil: reduce inflammation and modulate Th1/Th2 balance
• Vitamin D (depending on status): promotes Th2 responses while down-regulating Th1
• Folinic acid or methylfolate: especially for patients on methotrexate
• B6: reduces homocysteine and may improve psoriasis
• Zinc: supports immune system and promotes tissue repair
• Vitamin C: supports immune system, reduces inflammation, promotes tissue repair
• Probiotics: modulates immune response, promotes intestinal repair
• Antioxidants: selenium, vitamin E, vitamin A
• Digestive enzymes: with betaine hydrochloride & pancreatic enzymes
• Glutamine: promote intestinal repair

Herbal medicine for Psoriasis

• Immune system modulation: astragalus, echinacea, reishi/shitake, withania, Siberian ginseng
• Anti-inflammatory: turmeric, ginger, boswellia, bupleurum, rehmannia
• Promote tissue repair: gotu kola, gingko, grapeseed
• Increase cAMP: coleus, milk thistle
• Stimulate digestion /liver function: gentian, ginger, barberry, dandelion, bupleurum, St Mary’s, goldenseal, greater celandine
• Repair gut mucosa: calendula, aloe
• Topical creams: celandine (inhibits keratinocyte proliferation), chickweed, calendula, gotu kola, aloe vera, comfrey, licorice, goldenseal, chamomile, plaintain, evening primrose oil (Vit E cream base)

Lifestyle / Physical measures to support Psoriasis

• Sunlight / UV light often beneficial: expose for at least ½ hour daily (avoid sunburn)
• IR sauna
• Sea water bathing
• Manage stress: exercise, meditation, breathing, yoga

FUNCTIONAL MEDICINE TREATMENT OF PSORIASIS

The above considerations may assist with the management of Psoriasis.  It is important to investigate the underlying imbalances that are driving the disease. 

At our Perth clinic of Advanced Functional Medicine we use thorough investigation methods such as comprehensive blood chemistry panels, organic acids testing, advanced stool testing and SIBO breath testing to uncover factors that may be at the root cause of the disease. 

Underlying intestinal permeability, food intolerances and infections of the gut are commonly present in our patients.

If you or a family member are suffering from psoriasis or require assistance with another skin condition we would love to hear from you.  How have you treated your psoriasis?  What are your main triggers?  Please write a comment below.

Book Appointment