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Psoriasis

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Psoriasis

Psoriasis is a common skin condition that speeds up the life cycle of skin cells. It causes cells to build up rapidly on the surface of the skin. The extra skin cells form scales and red patches that are itchy and sometimes painful.

Psoriasis is a chronic disease that often comes and goes. The main goal of treatment is to stop the skin cells from growing so quickly.

There is no cure for psoriasis, but you can manage symptoms. Lifestyle measures, such as moisturizing, quitting smoking and managing stress, may help.

Symptoms
Psoriasis signs and symptoms are different for everyone. Common signs and symptoms include:

Red patches of skin covered with thick, silvery scales
Small scaling spots (commonly seen in children)
Dry, cracked skin that may bleed
Itching, burning or soreness
Thickened, pitted or ridged nails
Swollen and stiff joints
Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.

Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission.

There are several types of psoriasis. These include:

Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques might be itchy or painful and there may be few or many. They can occur anywhere on your body, including your genitals and the soft tissue inside your mouth.
Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth, and discoloration. Psoriatic nails might loosen and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.
Guttate psoriasis. This type primarily affects young adults and children. It's usually triggered by a bacterial infection such as strep throat. It's marked by small, water-drop-shaped, scaling lesions on your trunk, arms, legs and scalp.

The lesions are covered by a fine scale and aren't as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes.

Inverse psoriasis. This mainly affects the skin in the armpits, in the groin, under the breasts, and around the genitals. Inverse psoriasis causes smooth patches of red, inflamed skin that worsen with friction and sweating. Fungal infections may trigger this type of psoriasis.
Pustular psoriasis. This uncommon form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips.

It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters may come and go frequently. Generalized pustular psoriasis can also cause fever, chills, severe itching and diarrhea.

Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.
Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes swollen, painful joints that are typical of arthritis. Sometimes the joint symptoms are the first or only manifestation of psoriasis or at times only nail changes are seen. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. Although the disease usually isn't as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.
When to see a doctor
If you suspect that you may have psoriasis, see your doctor for an examination. Also, talk to your doctor if your psoriasis:

Causes you discomfort and pain
Makes performing routine tasks difficult
Causes you concern about the appearance of your skin
Leads to joint problems, such as pain, swelling or inability to perform daily tasks
Seek medical advice if your signs and symptoms worsen or don't improve with treatment. You may need a different medication or a combination of treatments to manage psoriasis.

Causes
The cause of psoriasis isn't fully understood, but it's thought to be related to an immune system problem with T cells and other white blood cells, called neutrophils, in your body.

T cells normally travel through the body to defend against foreign substances, such as viruses or bacteria.

But if you have psoriasis, the T cells attack healthy skin cells by mistake, as if to heal a wound or to fight an infection.

Overactive T cells also trigger increased production of healthy skin cells, more T cells and other white blood cells, especially neutrophils. These travel into the skin causing redness and sometimes pus in pustular lesions. Dilated blood vessels in psoriasis-affected areas create warmth and redness in the skin lesions.

The process becomes an ongoing cycle in which new skin cells move to the outermost layer of skin too quickly — in days rather than weeks. Skin cells build up in thick, scaly patches on the skin's surface, continuing until treatment stops the cycle.

Just what causes T cells to malfunction in people with psoriasis isn't entirely clear. Researchers believe both genetics and environmental factors play a role.

Psoriasis triggers
Psoriasis typically starts or worsens because of a trigger that you may be able to identify and avoid. Factors that may trigger psoriasis include:

Infections, such as strep throat or skin infections
Injury to the skin, such as a cut or scrape, a bug bite, or a severe sunburn
Stress
Smoking
Heavy alcohol consumption
Vitamin D deficiency
Certain medications — including lithium, which is prescribed for bipolar disorder, high blood pressure medications such as beta-blockers, antimalarial drugs, and iodides
Risk factors
Anyone can develop psoriasis, but these factors can increase your risk of developing the disease:

Family history. This is one of the most significant risk factors. Having one parent with psoriasis increases your risk of getting the disease, and having two parents with psoriasis increases your risk even more.
Viral and bacterial infections. People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.
Stress. Because stress can impact your immune system, high-stress levels may increase your risk of psoriasis.
Obesity. Excess weight increases the risk of psoriasis. Lesions (plaques) associated with all types of psoriasis often develop in skin creases and folds.
Smoking. Smoking tobacco not only increases your risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease.
Complications
If you have psoriasis, you're at greater risk of developing certain diseases. These include:

Psoriatic arthritis. This complication of psoriasis can cause joint damage and a loss of function in some joints, which can be debilitating.
Eye conditions. Certain eye disorders — such as conjunctivitis, blepharitis, and uveitis — are more common in people with psoriasis.
Obesity. People with psoriasis, especially those with more severe disease, are more likely to be obese. It's not clear how these diseases are linked, however. The inflammation linked to obesity may play a role in the development of psoriasis. Or it may be that people with psoriasis are more likely to gain weight, possibly because they're less active because of their psoriasis.
Type 2 diabetes. The risk of type 2 diabetes rises in people with psoriasis. The more severe psoriasis, the greater the likelihood of type 2 diabetes.
High blood pressure. The odds of having high blood pressure are higher for people with psoriasis.
Cardiovascular disease. For people with psoriasis, the risk of cardiovascular disease is twice as high as it is for those without the disease. Psoriasis and some treatments also increase the risk of irregular heartbeat, stroke, high cholesterol and atherosclerosis.
Metabolic syndrome. This cluster of conditions — including high blood pressure, elevated insulin levels and abnormal cholesterol levels — increases your risk of heart disease.
Other autoimmune diseases. Celiac disease, sclerosis and the inflammatory bowel disease called Crohn's disease are more likely to strike people with psoriasis.
Parkinson's disease. This chronic neurological condition is more likely to occur in people with psoriasis.
Kidney disease. Moderate to severe psoriasis has been linked to a higher risk of kidney disease.
Emotional problems. Psoriasis can also affect your quality of life. Psoriasis is associated with low self-esteem and depression. You may also withdraw socially.

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सोरायसिस

Dr. HelloDox Care #
HelloDox Care
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सोरायसिस

सोरायसिस एक त्वचारोग आहे. इतर सर्वसामान्य त्वचारोगांसारखाच सुरुवातीला वाटणारा हा त्वचारोग मात्र अचानक गंभीर वळण घेऊ शकतो. मानवी त्वचेचे डोळ्यांनी न दिसणारे अनेक पातळ थर असतात. सर्वात वरचा थर हा परिपक्व असा थर असून संपूर्ण वाढ झालेल्या पेशी यात असतात. आतील सर्व अवयवांचे रक्षण करणे व तापमान नियंत्रण अशा महत्त्वाच्या कार्यात त्या मदत करतात. हा परिपक्व थर बनवण्यासाठी साधारण 21 ते 28 दिवस लागतात; परंतु हे 28 दिवसांचे चक्र काही विशिष्ट कारणांमुळे 5 ते 7 दिवसांवर जेव्हा येऊन पोहोचते तेव्हा हा परिपक्व पेशीचा थरावर थर साचत जातो. त्यालाच सोरायसिस असे म्हणतात.

डोक्यात होणा-या कोंड्यांच्या स्वरूपातील सोरायसिसला स्कल्प सोरायसिस असे म्हणतात, संपूर्ण शरीरावर छोट्या-छोट्या थेंबांप्रमाणे येणा-या सोरायसिसला गटेट सोरायसिस म्हणतात, संपूर्ण शरीरावर मोठ्या आकाराच्या सोरायसिसच्या चट्ट्यांना प्लेक सोरायसिस म्हणतात. फक्त तळहात व तळपायावर येणा-या सोरायसिसला पाल्मोप्लँटर सोरायसिस असे म्हणतात. काही सोरायसिसच्या रुग्णांमध्ये नखे काळीनिळी पडतात व वेडीवाकडी होतात. याला नेल सोरायसिस म्हणतात. संपूर्ण शरीरावर पसरलेल्या सोरायसिसमध्ये जेव्हा पू किंवा पाणी भरलेले लहान पुरळ दिसतात त्याला पस्टलर सोरायसिस म्हणतात. काखेमध्ये, जांघेमध्ये व इतर झाकून राहणा-या या भागांमध्ये होणा-या सोरायसिसला इन्व्हर्स सोरायसिस म्हणतात. तसेच त्वचेबरोबर काही वेळा सोरायसिस रुग्णांना संधिवात होतो याला सोरायाटिक आथ्रिटिस असे म्हणतात.

सोरायसिसवर उपचार करताना प्रकार कोणता आहे यावरदेखील लक्ष देणे आवश्यक असते. कारण ब-याचदा वेगवेगळे प्रकार बरे होण्यासाठी वेगवेगळा कालावधी लागतो. तसेच उपचारांमध्ये बदल करावा लागतो. एकाच सोरायसिस रुग्णामध्ये एकाच वेळी एकापेक्षा अनेक प्रकार असू शकतात. अनुभवी चिकित्सक चाणाक्ष नजरेने हे ओळखून उपचारामध्ये बदल करतात.

सोरायसिसच्या रुग्णांना पडणारा प्रश्न एकच - मलाच सोरायसिस का झाला? या प्रश्नाचे उत्तर देणे प्रत्येक डॉक्टरला जरा जडच जाते. आधुनिक वैद्यकशास्त्रात सुरुवातीला सोरायसिस हा एक मिसिलेनिअस स्किन डिसिज म्हणून ओळखला जात असे. या प्रकारात बरेचसे आजार कारणाअभावी पडून असतात. त्यामुळे अर्थातच ठोस अशी उपचारपद्धतीसुद्धा नसतेच. ब-याच दिवसांनी काही संशोधकांनी सोरायसिसला अ‍ॅटोम्यून स्किन डिसिजच्या पंक्तीमध्ये नेऊन ठेवले. या प्रकारातील आजार हे मानवी रोगप्रतिकारशक्तीमध्ये झालेल्या बिघाडामुळे होतात; परंतु अ‍ॅटोम्यून स्किन डिसिज या आजारात रुग्णाच्या शरीरात अँटिजेन-अँटिबॉडी कॉम्प्लेक्सेस आढळतात किंवा फक्त अ‍ॅटोएॅटिबॉडीज तरी आढळतातच; परंतु सोरायसिसच्या रुग्णांमध्ये अशा प्रकारचे काहीच घटक न आढळल्यामुळे सर्वांनी आता हा आजार अ‍ॅटोम्यून नसल्याचे मान्य केले आहे.

अगदी अलीकडच्या संशोधनाअंती असे स्पष्ट झाले आहे की, सोरायसिस हा काही विशिष्ट गुणसूत्रांमध्ये होणा-या बदलामुळेच होतो. मानवी शरिरातील प्रत्येक पेशींमध्ये 46 गुणसूत्रे असतात. प्रत्येक गुणसूत्रांवर असणा-या विविध जनुकांकडे विविध प्रकारची कार्ये वाटून दिलेली असतात. जीवनात विविध टप्प्यांवर सद्य:स्थितीतील गुणसूत्रांमध्ये विविध बदल संभवतात. सर्वात महत्त्वाचा टप्पा म्हणजे पुढील पिढीची गुणसूत्रे तयार करणे. फलोत्पादन प्रक्रियेवेळी पुरुष व स्त्री बीजांकडून काही गुणसूत्रे येऊन पुढील पिढीची गुणसूत्रे तयार होतात. या गुंतागुंतीच्या प्रक्रियेत जे गुणसूत्रामध्ये चांगले-वाईट बदल घडतात ते पुढच्या पिढीमध्ये दिसतात. या प्रक्रियेत जर त्वचेच्या परिपक्वतेच्या कामामध्ये भाग घेणा-या जनुकांमध्ये काही वाईट बदल घडल्यास सोरायसिस आजार होतो, असे म्हटल्यास अतिशयोक्ती होणार नाही.

अशी गुंतागुंतीची कारणीमीमांसा असणा-या आजारावर उपचार सहज होतील काय? आयुर्वेदामध्ये प्राचीन काळापासून सोरायसिसचा उल्लेख, त्याची लक्षणे, कारणे व उपचारासहित आढळतो. आयुर्वेदाच्या मदतीने आपण कफ व वात यावर नियंत्रण मिळवण्यात यशस्वी झालो तर सोरायसिसविरुद्धची लढाई जिंकू शकतो. सोरायसिस घालवताना आयुर्वेदिक तसेच संयुक्त उपचार पद्धतीचाही वापर करता येतो. त्यासाठी आपणास अनुभवी, चिकित्सक व मार्गदर्शकांची आवश्यकता असते.

अशा या सोरायसिस या गंभीर त्वचारोगाने संपूर्ण जगातील वैद्यकशास्त्राला आव्हान दिलेले असताना या रोगावर उपचार सुरू करण्याचे धाडस दाखवले व आम्ही सुरू केलेली सुरुवात आज इंडियन सोरायसिस फाउंडेशन या संस्थेला लिम्का बुक ऑफ रेकॉर्डमध्ये घेऊन गेली आहे. दूरदर्शन वाहिनीवर सलग सहा वर्षे समाजप्रबोधनपर माहितीपट ‘सोरायसिस मुक्तिगाथा’ ही प्रसारित होत आहे. या संस्थेतर्फे महाराष्ट्रासह देशभर मार्गदर्शन शिबिरे घेतली आहेत.

आता सोरायसिसवर अधिक प्रभावीपणे उपचार करण्यासाठी आवश्यक असलेली संयुक्त उपचार पद्धतीची गरज ओळखून आयुर्वेदिक संशोधन केंद्राची स्थापना केली आहे. मुंबईस्थित हे मुख्यालय केवळ सोरायसिस व इतर त्वचारोगांवर संयुक्त उपचार करणारे भारतातील एकमेव सुसज्ज रुग्णालय आहे. महाराष्ट्रभर सीमित असलेले हे कार्य आता भारतभर नेण्यासाठी मुंबई, दिल्ली, इंदूर, जयपूर, अहमदाबाद, कोलकाता व बंगळुरूसारखी विभागीय कार्यालयेदेखील सज्ज झाली आहेत.

Dr. ATUL KALE
Dr. ATUL KALE
MS/MD - Ayurveda, Ayurveda Neurotologist, 15 yrs, Pune
Dr. Sandeep Awate
Dr. Sandeep Awate
BAMS, Ayurveda Panchakarma, 15 yrs, Pune
Dr. Ashwin Prasad
Dr. Ashwin Prasad
BDS, Cosmetic and Aesthetic Dentist Cosmetic Surgeon, 2 yrs, Pune
Dr. Minal Sapate
Dr. Minal Sapate
BDS, Dentist Cosmetic and Aesthetic Dentist, 15 yrs, Pune
Dr. Amar S. Shete
Dr. Amar S. Shete
BAMS, Family Physician, Pune
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