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T2 Liu Psoriasis
T2, Psoriasis, Liu, Bastyr
| Question | Answer |
|---|---|
| Chinese name for Psoriasis: | Psoriasis is also known as Niu Pi Xian (“cow skin tinea”) because the affected area is like cow’s skin, thick & tough •Also, In TCM, it is called Yin Xue Bing 銀屑病 |
| Describe Psoriasis: | It is a common, chronic, recurrent disease • It varies in severity from one or two lesions to widespread dermatosis, sometimes associated with disabling arthritis or exfoliation |
| Who is effected by Psoriasis: | • ~2-4% of whites and far fewer blacks are affected |
| Onset of Psoriasis: | Onset is usually between ages 10-40, but no age is exempt. A family history of psoriasis is common |
| TCM Etiology of Psoriasis: | Wind heat damp on the skin – channels and collaterals are blocked |
| Main organs involved w Psioriasis: | LV, LU, SP, ST |
| Two primary causes that lead to Psoriasis: | Stress and Genetic |
| WM cause of Psoriasis: | In western medicine, the cause of psoriasis is unknown, but the response of psoriasis to the immunosuppressive drug cyclosporine suggests that the primary pathogenetic factor may be immunologic The thick scaling has traditionally been attributed to epide |
| Describe Factors precipitating psoriasis flare-ups: | Local trauma, Irritation, severe sunburn, viremia Allergic drug reactions, topical and systemic drugs (ex. chloroquine antimalarial therapy, lithium, b-blockers, inferteron) Withdrawal of systemic corticosteroids |
| Onset of Psoriasis: | Usually gradual onset |
| Typical course Psoriasis: | Chronic remissions & recurrences, or occasionally acute exacerbations that vary in frequency and duration |
| Areas affected by Psoriasis: | mostly on yang side of the body Scalp, including postauricular regions. Extensor surface of extremities, especially elbows and knees Sacral area, buttocks, penis Nails, eyebrows, axillae, umbilicus, or anogenital region may also be affected Occasiona |
| Typical lesions of Psoriasis: | Sharply demarcated Pruritic in various degrees. Ovoid or circinate erythematous papules or plaques covered with overlapping thick silvery micaceous or slightly opalescent shiny scales. Papules sometimes extend and coalesce to produce large plaques in annu |
| Sx of Psoriasis: | Itchiness worse at night. Rash with scratching, getting brown. Aggravated recurrence with emotional stimulation. Repeated recurrences make the skin of psoriatic patches thick, dry and tough, cause lickenized change, often symmetric, skin crumb falls off |
| What are the 2 TCM types of psoriasis: | Wind damp heat Wind dry with blood deficiency |
| Describe Wind damp heat Psorasis: | – Initial stage: papules, erosion, red patches, severe itchiness, oozing, scratching and scar, irritability, etc. |
| Describe Wind dry with blood deficiency Psoriasis: | – Chronic and recurrent attacks: psoriatic patches appear dry and thick, lickenized change, scaling, itchiness worse at night, etc. |
| Wind damp heat Psoriasis Treatment principle: | – Disperse wind – Transform damp – Clear heat: must promote bowel movement to release heat |
| Acupuncture prescriptions for Wind damp heat Psoriasis: | – GB 20: clear wind – LI 11 (he sea): clear wind damp heat, alleviate itching – SP 10: blood mover – UB 12 風門 (wind gate): clear wind – SP 6 三陰交 tonify SP, resolve dampness – LI 4 (yuan source): clear wind, move qi |
| Treatment principle Wind dry with blood deficiency Psoriasis: | – Nourish blood – Moisten dryness – Dredge the channels |
| Acupuncture prescriptions for Wind dry with blood deficiency Psoriasis: | – UB 17 (influential point of blood): nourish and move blood – LI 4 (yuan source): clear wind, move qi – LI 11 (he sea): clear wind, alleviate itching – ST 36 (he sea): nourish blood and yin – SP 9 (he sea): regulate urination – REN 6 氣海 |
| Treatment for Wind dry with blood deficiency Psoriasis: | tonify qi, harmonize blood |
| Secondary points for Psoriasis: | Ashi points |
| Points for Severe itching and irritability: | KD 6, HT 7 (yuan source) |
| Points for Lesion on the nape: | – calm shen LU 7 (luo-connecting), UB 40 (he sea)channels go to the nape |
| Points for Lesion in the elbow: | LU 5 (he sea), P 4 (xi-cleft), P 8 (fire) |
| Points for Lesion in the popliteal fossa: | UB 37, UB 40 (he sea), UB 60 (fire) |
| Points for Lesion in the upper eyelid: | ST 8, DU 20 |
| Describe four corners treatment for psoriasis: | In addition, four needles at four “corners” surrounding the area of psoriasis; or transverse needling to make the needles criss-cross the tender point at the focus of the psoriasis. |
| Other therapies for psoriasis: | Moxibustion: BID Seven star needling and cupping: once every other day, Vaseline |
| How do you make Diagnosis of Psoriasis: | Psoriasis may be confused with seborrheic dermatitis. Diagnosis by inspection is rarely difficult; e.g. well-defined, dry, heaped-up psoriatic lesions with large silvery scales are distinguishable from diffuse, greasy, yellowish scaling of seborrheic derm |
| Is biopsy diagnosis useful for Psoriasis: | Although biopsy findings of typical lesions are generally characteristic, atypical lesions have atypical features making biopsy less helpful. Some other skin disorders may have psoriasiform histologic features that may make microscopic diagnosis difficult |
| Prognosis of Psoriasis: | Prognosis depends on extent and severity of the initial involvement – usually the earlier the age of onset, the greater the severity Acute attacks usually clear, but permanent remission is rare |
| Can Psoriasis be cured: | No therapy is curative, but most cases can be adequately or well controlled |
| Over the counter treatment for Psoriasis: | Lubricants, keratolytics, topical corticosteroids, topical vit D derivatives, anthralin (Dritho-Scalp, Drithocreme) should be tried first in patients with a limited number of lesions |
| Is sunlight good for Psoriasis: | Exposure to sunlight is beneficial, but occasionally sunburn may induce exacerbations |
| Complications of western treatment of Psoriasis: | Systemic antimetabolites (ex. methotrexate) should be used only in patients with severe skin or joint involvement. Immunosuppressive drugs (ex. cyclosporine, tacrolimus) have been used in severe and recalcitrant cases. Systemic corticosteroid should not b |
Created by:
bastyr41
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