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What is Psoriasis and who does it affect?
- Chronic, non-contagious, multisystem, inflammatory disorder.
- 2-5% of the Western population affected
- Influenced by climate and genetic heritage
- Less common in the tropics and in dark-skinned persons.
- Slightly more common in women than in men
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S&S
- Sharply bordered reddened rash/plaques covered with silvery scales.
- Scalp and the extensor surfaces (back of the wrists, elbows, knees, buttocks and ankles)
- Family history in 50% of cases.
- Possible arthritis
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Causes and risk factors
- Not well understood
- Possible infectious episode, traumatic insult and/or stressful life event.
- Activated immune cells release cytokines = proliferation of keratinocytes (rate of cellular division in psoriatic lesions is 1000 times greater than in normal skin)
- Imbalance in cGMP:cAMP ratio
- Possible autoimmune link (especially Crohns, Coeliac, RA)
- Greater intestinal permeability
- Dietary considerations including:
- Incomplete Protein Digestion = inhibits formation of cAMP, leading to hyperkeratinisation.
- Low fibre = increases risk of bowel toxaemia
- Impaired liver function (due to excess levels of microbial toxins) alcohol also worsens condition
- Excessive AA in keratinocytes = inflammatory leukotrienes
- Gluten/food allergies = antigenic load
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Diagnosis and Conventional Treatment
- Sharply bordered reddened rash/plaques covered with silvery scales.
- Scalp and the extensor surfaces (back of the wrists, elbows, knees, buttocks and ankles)
- Family history in 50% of cases.
- Possible arthritis
- Topical corticosteroids
- Vitamin D analogues (e.g. calcipotriene) slow keratinocyte growth, flatten lesions, and remove scale.
- Anthralin and Tazarotene to normalises DNA activity in skin cells
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Nutritional protocol and supplements
- Elimination diet, food diary and reintroduction (start with gluten as this is highly implicated)
- Whole, unprocessed plant based diet
- Omega 3 – Salmon, Mackerel, flaxseed, supplements
- Minimise animal products
- Minimise processed foods and alcohol
- Omega 3 – in order that EPA can compete for AA binding sites and inhibit production of inflammatory compounds.
- Zinc – skin health and wound healing
- Vit A – help reduce gut permeability
- Vit D – anti-proliferative / controls rate of replication. Low in psoriatic patients
- Probiotics – reduce dysbiosis
- Herbs – burdock root tea for liver support.
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