How To Cure Psoriasis Naturally

Psoriasis Revolution

Psoriasis Revolution is a natural program that has been well researched by the experienced medical nutritionist and a psoriasis sufferer Dan Crawford. It is designed to guide users on how they can completely cure psoriasis and eliminate red, silvery scales, patchy itchy skin, haemorrhage and also boost the immune system, essentially a life-time solution. Psoriasis is not only a long-term solution, but also provides instant remedy to psoriasis. For example, the program can lower the burning sensation and itchiness within 24 hours. Although results will vary from one person to another, many users have reported significant results within 1 to 2 months of its use. Dan is a popular medical nutritionists, wellness adviser, research worker and a person who has suffered psoriasis for 27 years. Dan spent more than 12 years, 47,000 hours doing clinical analysis and a lot of money doing trial and error methods to develop a program that can truly cure any type of psoriasis at any level of severity. Read more here...

Psoriasis Revolution Summary

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4.9 stars out of 27 votes

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Author: Dan Crawford
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Highly Recommended

I usually find books written on this category hard to understand and full of jargon. But the author was capable of presenting advanced techniques in an extremely easy to understand language.

Overall my first impression of this book is good. I think it was sincerely written and looks to be very helpful.

Psoriasis Free Manual By Katy Wilson

Psoriasis Free For Life is a revolutionary treatment, developed Katy Wilson that does not just curb the peripheral symptoms of psoriasis, but kills the disease at the very root. Unlike most other treatments, this scheme is 100% natural and deliver results that last a life-time, without exposing the sufferers to any kind of health-risk. Psoriasis Free For Life works by 100% natural methods. Holistic healing is the very foundation that the whole program is laid upon, so there are no chemicals involved in the entire procedure at all. Be it any kind of psoriasis, of any intensity. So are you looking for a treatment for psoriasis that is cost-effective, works fast, lasts forever and does not precipitate any side effects? If yes, cruise on over to the following sections of this Psoriasis Free For Life review to find out how the program can do what it can do for you. Read more here...

Psoriasis Free For Life Summary

Contents: EBook
Author: Katy Wilson
Official Website: www.psoriasisremedyforlife.com
Price: $29.97

Psoriasis

Psoriasis, like atopic eczema, is an inflammatory skin disease with a multifactorial aetiology. It is a chronic, immune-mediated disorder (Kreuger, 1989) associated with significant physical and psychological morbidity. The psychological factors have been summarised by Ginsburg and Link (1989) and instruments have been developed to measure psoriasis-related stress (Wang et al., 1990 Fortune et al., 2002). In psoriasis there is an overexpression of INF gamma and TNF alpha and a relative underexpression of the Th2 cytokines, IL-4 and IL-10. It appears that the T-cells involved are Th1 lymphocytes and that the disease may be influenced by a cell-mediated autoimmune process. There is an early influx of T-cells into psoriatic lesions, increased antigen presentation in psoriatic cells and ablative effect with anti-T cell therapy, and the common antigens considered in the pathogenesis of psoriasis are bacterial proteins and superantigens. However, clinical and histological features in...

NK cells and killer immunoglobulinlike receptors KIR

HLA and KIR genes are on different chromosomes and segregate independently meaning that in an individual KIR may be expressed for which there is no HLA ligand. Alternatively, activating KIR for non-self and self HLA molecules may be present in an individual although, as all NK cells acquire an inhibitory receptor for self HLA during development, NK cells will not kill self cells under normal circumstances. However, NK cells can lack inhibitory receptors for non-self HLA and in this case the activating KIR for non-self may stimulate the NK cell. As there is the potential for interaction between particular KIR receptors and HLA molecules in an individual, epistatic effects of KIR and HLA genes might be expected and indeed have now been reported. Subjects with psoriasis with activating KIR2DS1 and or 2DS2 3 are susceptible to the development of the disease only if the HLA-C ligands for the corresponding inhibitory KIR, 2DL1 and 2DL2 3 are missing (Martin et al., 2002a). Progression to...

Social phobia social anxiety disorder

Social phobia (American Psychiatric Association, 1994) is characterised by a marked or persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to the possible scrutiny of others (American Psychiatric Association, 1994). The individual fears that he or she will act in a way or show anxiety symptoms that will be humiliating or embarrassing. For example, some patients with hyperhydrosis and rosacea often perspire or blush more prominently in embarrassing situations and may develop a social phobia as a result. Exposure to the feared social situation almost always provokes anxiety, which may take the form of a situationally bound panic attack, which in turn also results in an exaggerated autonomic reactivity of the skin. In social phobia the individual recognises that the fear is excessive or unreasonable however, intense anxiety results if the feared situation is not avoided. The anxious anticipation or distress of the feared...

Clinical Findings and Diagnosis

Bacteriological investigations and sensitivity profile to antibiotics must be carried out if available. Disseminated, chronic, or severe infections require an immediate referral to a dermatologist or to an infectious disease specialist. Uncommon cases of streptococcal infection of the throat may express clinically with a sudden eruption of guttate psoriasis as a result of bacterial superantigen stimulation (Figure 9.12).

Management and Treatment

Figure 9.12 Guttate psoriasis on the back. Sudden eruption in a young traveller, characterised by erythemato-scaling 'drops' and small plaques Figure 9.12 Guttate psoriasis on the back. Sudden eruption in a young traveller, characterised by erythemato-scaling 'drops' and small plaques

Why does stigmatisation occur

For dermatological conditions, however, there could be a more direct type of threat - a threat to physical health. There is a growing consensus that stigmatisation has an evolutionary origin because, in our species' past, avoidance of potential threats had advantages for survival. The evolutionary explanation has been outlined by Kurzban and Leary (2001). They argue that this approach to stigmatisation provides a parsimonious and elegant explanation over a wide range of conditions and behaviours, but it might be particularly relevant to skin conditions. As noted above, people with psoriasis and vitiligo can often cite instances when someone avoided making physical contact or touching any object they have used. Such examples lend themselves to understanding stigmatisation and rejection of those with skin conditions in terms of potential contagion. Many people with vitiligo and psoriasis complain that others often do not understand the nature or causes of their conditions, and assume...

What effects does stigmatisation have

Vardy et al. (2002) took this argument one step further, by using structural equation modelling to examine the link between disease severity, felt stigma and quality of life in patients with psoriasis. They showed that any link between disease severity and quality of life was completely mediated by expectations of stigmatisation. That is, severity of psoriasis had an impact on quality of life only insofar as it influenced expectations of being stigmatised by others.

Defining skin conditions

Consideration of dermatological diagnoses is outside of the remit of this chapter and those interested are referred to an appropriate medical text (e.g. Gawkrodger, 2002). However, it is important to acknowledge that there are multiple types of skin conditions, which can differ widely in terms of both specific symptoms and treatments, as such factors may have an impact upon the adjustment process (Porter et al., 1986). The term 'skin condition' as opposed to skin disease, will be used here when discussing this population in general, so as to be inclusive of the full range of dermatological conditions. This will include those acquired congeni-tally, such as port wine stains, as well as those resulting from diseases, such as psoriasis.

The symptoms and their treatments

'Smearing on the evil-smelling, sticky, staining stuff could take up to two or more hours a day, soaking in it another hour or so. Visits to the clinic absorbed another five or six hours a week.' ('Evidence' submitted by a man living with psoriasis to the All Party Parliamentary Group on Skin (2003, p. 5))

Disease and treatment factors

Numerous studies have found only a weak association between disease severity and psychological functioning (Finlay et al., 1990 Clark et al., 1997 Fortune et al., 1997 Fortune et al., 2002). Clinician and self-report measures of severity generally do not correlate, nor do clinical ratings of severity and measures of disability. Whilst, Finlay et al. (1990) found a moderate correlation between clinically measured severity and disability (as measured by the Psoriasis Disability Index (PDI)), the majority of other studies have not found such a relationship. For example, Root et al. (1994) also used the PDI in their study of psoriasis and found that there was not a correlation between clinician-rated severity, and distress or disability. However, they found that there were 'moderately high' correlations between self-rated severity and disability and distress. Their analyses further suggested that the relationship between self-rated severity and distress was mediated by disability. They...

Changes in social networks

In the course of their relationship, couples create substantial social contexts that involve sharing domestic, recreational or occupational activities. When skin disease changes companionship in any one of these areas, the maintenance or nature of the relationship may be threatened (Lyons & Sullivan, 1998). Changes in a couple's social network may occur through reduced interactions with others and an increase in companionate activities at home (Morgan et al., 1984). More than often, withdrawal is a response to the damaging effects of social stigma. Porter et al. (1990) reported that vitiligo patients experienced embarrassment and anxiety when meeting strangers and that many had been victims of rude remarks in the face of public ignorance. In the short term, avoidance may serve a protective function, but it may also lead to loss of friendships and activities that would typically increase a couple's social network. In an early survey, Jobling (1976) asked 186 members of the British...

Cognitivebehavioural therapy

CBT has been successfully applied to various skin conditions. For example, Horne et al. (1989) used cognitive-behavioural therapy along with standard medical treatment in treating three patients suffering with atopic eczema. All three showed a post-treatment reduction in symptom severity, an increase in their ability to control the disorder and a decrease in their reliance on medication. Four controlled studies have also used a cognitive-behavioural approach with psoriasis patients (Price et al., 1991 Zacharie et al., 1996 Fortune et al.,2002 Fortune et al., 2004). Findings have shown adjunctive cognitive-behavioural interventions result in a reduction of psychological distress and in the clinical severity of the condition. Additionally, Papadopoulos et al. (1999b) compared two matched groups of vitiligo patients, one of which received CBT while the other received standard medical treatment alone. Results suggested that patients could benefit from CBT in terms of coping and living...

Why QoL measurement is important

Allocation to dermatology is inadequate. Thankfully few patients die from their skin disease but this makes it harder to argue for dermatology resources. The use of general QoL measures allows comparison of the major effects of skin diseases with the effects of other non-skin diseases. In clinical research there has traditionally been an emphasis on using clinical signs as outcome measures but QoL measurement gives an additional and patient-orientated outcome assessment, which does not necessarily parallel change in signs. The importance of this distinction has been emphasised by recent work in psoriasis (Sampogna et al., 2004). This study has clearly demonstrated that measurement techniques cluster into two groups, one formed by clinical severity measurements and the other comprising QoL and psychological indexes, stressing the need for more comprehensive assessment. Many pharmaceutical companies are recognising this and adding QoL measurement to clinical drug assessment protocols.

Psychological symptoms and compliance

Insights into the problems of compliance of dermatology patients with treatment can be gained by using QoL measures. Two hundred and one patients with psoriasis were interviewed and re-examined 3 months later to assess actual treatment use and compare this with expected use (Zaghloul & Goodfield, 2004a). There was an inverse relationship between medication adherence and impairment of QoL patients with facial disease and more extensive disease had lower medication adherence. This information will encourage appropriate strategies to try to enhance adherence in groups who can now be identified as being at high risk of poor adherence. The same group has demonstrated that outpatients with psoriasis under the direct supervision of a consultant demonstrated better adherence and had lower DLQI scores (i.e. less impairment of QoL) than similar patients attending the nurse-led clinic (Zaghloul & Goodfield, 2004b).

Further research challenges

Relate them to the clinical situation. Although this information is now becoming available for the DLQI (Hongbo et al., 2004), such data is not yet available for other measures. The validated banding of DLQI scores with simple descriptive terms will allow physicians, and indeed perhaps, in time, patients to use this questionnaire to guide decision-taking. More data is required, however, to understand the link between score bands and types of decision that are taken. There is preliminary data relating to psoriasis, which suggests that in routine clinical practice there is a relationship between decision type and patient QoL impairment (Katagumpola et al., 2004). More information is required relating to the most common inflammatory diseases. It will be necessary to seek similar data for other measures before they are likely to find a place in routine clinical use. Therapy for inflammatory skin diseases, which is already complex, is likely to become much more so over coming years....

Compare Alexithymia And Coping Style Between People With Ms And Other People

Finlay, A.Y., Khan, G.K., Luscombe, D.K., & Salek, M.S. (1990). Validation of sickness impact profile and psoriasis disability index in psoriasis. British Journal of Dermatology, 123, 751-756. Fortune, D.G., Main, C.J., O'SulIivan, T.M., & Griffiths, C.E.M. (1997). Quality of life in patients with psoriasis the contribution of clinical variables and psoriasis-specific stress. British Journal of Dermatology, 137, 755-760. Fortune, D.G., Richards, H.L., Griffiths, E.M., & Main, C. (2002). Psychological stress, distress and disability in patients with psoriasis consensus and variation in the contribution of illness perceptions, coping and alexithymia. British Journal of Clinical Psychology, 41, 157-174. Fortune, D.G., Richards, H.L., Griffiths, C.E.M., & Main, C.J. (2004). Targeting cognitive-behaviour therapy to patients' implicit model of psoriasis results from a patient preference controlled trial. British Journal of Clinical Psychology, 43, 65-82. Hill, L., & Kennedy,...

What types of stigmatisation do people encounter

People with dermatological conditions often claim that their main difficulties arise from others' reactions to their disease, rather than the disease itself (e.g. Rapp, 1999). Perceptions of stigmatisation are common amongst those with a visible skin difference. For example, Gupta et al. (1998) found that 26 of their patients with psoriasis reported that they had experienced an episode when someone made an effort not to touch them because of their psoriasis. Ginsburg and Link (1989) also explored feelings of stigmatisation in people with psoriasis. They asked patients to complete a questionnaire containing 33 items covering a range of possible feelings and beliefs about how other people react to their psoriasis. A factor analysis indicated that beliefs about stigmatisation could be grouped into six dimensions anticipation of rejection (e.g. 'I feel physically unattractive and sexually unattractive when the psoriasis is bad') feelings of being flawed (e.g. 'I often think that others...

The social and psychological impact of skin conditions

Appearance and illness are relevant to the adjustment process. There is no doubt that living with a chronic skin condition can be stigmatising (Kent, Chapter 4, this volume). As early as 1976 Jobling found that for psoriasis sufferers the greatest psychosocial impact of having the condition were interpersonal difficulties. It is now widely established that individuals with a disfiguring skin condition can suffer negative and intrusive reactions from others as well as experiencing interpersonal difficulties, such as in the formation of relationships (e.g. Jowett & Ryan, 1985 Lanigan & Cotterill, 1989). The following quote typifies the simple intrusive reactions that people living with a skin condition can experience

Obsessivecompulsive disorder

OCD (American Psychiatric Association, 1994) is characterised by recurrent obsessions or compulsions severe enough to be time consuming or cause marked distress or significant impairment. OCD is an anxiety disorder, and some of the compulsive behaviours of OCD may in fact further exacerbate skin disorders that are associated with or exacerbated by anxiety such as atopic dermatitis. Some of the compulsions involve repetitive behaviours such as hand washing, hair plucking, trichotillomania, onychophagia, picking of a minor irregularity in the skin or lesions on the skin and repetitive bathing or scratching (Hatch et al., 1992 Stein & Hollander, 1992 Monti et al., 1998 Calikusu et al., 2003). The patient with OCD feels driven to perform in response to an obsession which, if resisted, produces anxiety. The compulsive scratching of OCD may exacerbate a primary skin disorder such as psoriasis, eczema and other pruritic conditions, or cause flare-ups of acne as in acne excoriee. OCD...

Psychosocial impact of skin diseases

Used by these patients were concealment and avoidance, which were mostly utilised in order to avoid negative reactions from others. Moreover, acne patients have been shown to limit exposure through social avoidance and to conceal skin lesions (Kellett & Gilbert, 2001). Psoriasis patients have also been found to engage in anticipatory and avoidance coping behaviours, which are unrelated to the severity of their condition and this is hypothesised to relate to stigmatisation and rejection (Griffiths & Richards, 2001). Like previous work on disfigurement and social anxiety, skin disease patients use these dysfunctional behavioural strategies to manage the impression they make on others and their frequent use illustrates the overriding concerns about social exclusion (Thompson et al., 2002). Studies have also highlighted a higher prevalence of psychiatric disorder in dermatology patients (Hughes et al., 1983). Although it seems a little premature to make links between dermatological...

Sunrelated Skin Diseases And Cancer

Appearance Kaposi Sarcoma

Many dermatoses may be provoked by exposure to ultraviolet (UV) radiation and they may be acute or chronic. In addition, a number of other dermatoses may be exacerbated by exposure to sunlight these include acne, atopic eczema, dermatomyositis, erythema multiforme, herpes simplex, Darier disease, lichen planus, autoimmune blistering disorders, psoriasis, rosacea, and seborrhoeic dermatitis. Some of the more common problems included in this section are presented in Table 9.4.

Body image and sexual intimacy

Avoidant Attachment Style 'I'm a 23 year-old male and I have psoriasis on my chest, back, butt, arms and legs. Fortunately it is not on my hands, face, in my hair or on my privates. People don't know I have it because I keep all the evidence covered. I've been dating a girl for 6-months and we were getting serious but I still hadn't told her about my psoriasis. I didn't know how to do it. Then I read this forum and got some courage. I think she had been waiting for me to take the you have to know. She knew nothing about psoriasis and cooled right away I got as far as showing her one arm and that was the end of it. Now I feel so low, I don't know whether to dump her because she's so closed-minded or to just give up.' A negative body image can damage the perception of self as a sexual being and thus disrupt intimacy in a relationship. Gupta and Gupta (1997) investigated the impact of psoriasis on the sexual activities of 120 sufferers and found that 40 experienced a decline in sexual...

Cognitive factors personality characteristics and core beliefs

Further support to the important role played by these overlapping concepts is provided by the findings of Fortune et al. (1997) with a group of people living with psoriasis. Whilst, they found only a modest association between visibility and distress, their analyses revealed that stress resulting from anticipating negative reactions from others accounted for more of the variance in disability scores than any other disease-related factor. This finding is lent further support by qualitative research which suggests 'social vulnerability' is a key concern for those living with a skin condition (Thompson et al., 2002 Wahl et al., 2002). Further, quantitative evidence is provided by Leary et al. (1998) and Kent and Keohane (2001) who made use of the Brief Fear of Negative Evaluation Scale (FNE Leary, 1983) and found that this conceptually-related factor moderated the degree of distress experienced. Papadopoulos et al. (1999b) and Kent (2002) have also found heightened levels of...

Major depressive disorder

Depressive disease is a clinically important feature of psoriasis (Russo et al., 2004). Onset of psoriasis prior to age 40 years has been associated with greater difficulties with the expression of anger (Gupta et al., 1996), a personality trait which may predispose the patient to develop depression and be more vulnerable to psychosocial stressors. Psoriasis-related stress has been associated with greater psychiatric morbidity (Fortune et al., 1997) as patients who feel stigmatised in social situations have higher depression scores. Adult psoriasis patients who experienced greater deprivation of social touch as a result of their psoriasis had higher depression scores than patients who did not feel stigmatised (Gupta et al., 1998). Pruritus, which is reported to be one of the most bothersome features of psoriasis, has been associated with suicide. In psoriasis, severity of pruritus correlates directly with the severity of depressive symptoms (Gupta et al., 1988 Gupta et al., 1994)....

Appearance attraction and shame

Romantic couples spend exclusive time together, they share social and leisure experiences, and allow themselves to be mutually vulnerable in ways they rarely do with others. Consequently, the feelings and perceptions romantic partners have about one another and the feedback they give on each other's appearance could substantially impact on how each will feel about themselves, their bodies and their relationship (Tantleff-Dunn & Gokee, 2002). Sixteen per cent of dermatology patients investigated by Hughes et al. (1983) reported that their skin condition affected their married life Lannigan and Coterill (1989) found that a small proportion of women (9 ) would not reveal their birthmarks, even to their husbands, and according to Koo (1996), many patients with psoriasis claim that their disease is a major obstacle in forming and sustaining intimate relationships. This demonstrates that, in both established and new relationships, disfigurement can be profoundly shaming if skin disease...

Psychological approaches to treatment for dermatological conditions

Increasingly then, within the dermatological literature, attention was given to the therapeutic benefits that might derive from psychological interventions beyond those of standard medical care. Given the close and clear associations between psychological factors and cutaneous conditions, it is not surprising that the effects of such treatment have been investigated. The literature has documented psychological interventions for a number of cutaneous conditions, such as vitiligo, psoriasis, acne and atopic dermatitis, which have been suggested to be as effective for each of these types of disorders as classical medical procedures (Van Moffaert, 1992 Papadopoulos & Bor, 1999). For example, in their review of psychological therapies for the treatment of psoriasis, Winchell and Watts (1998) describe a case in which two psychiatric patients with psoriasis were given a suggestion that imipramine would have beneficial effects on their skin condition. Following this suggestion one of the...

Development of QoL research in dermatology

A 21-question format was suggested in 1970 to record, in a standard way, the impact of skin disease on QoL (Whitmore, 1970). Other suggestions concerning criteria for assessing the impact of permanent skin impairment (Committee, 1970) and systems for wider assessment of disability (Robinson, 1973) were also proposed. The first dermatology disease-specific instrument, the Psoriasis Disability Index (PDI) (Finlay & Kelly, 1985 Kelly & Finlay, 1987) was initially used to assess the impact of hospital admission on disability in patients with psoriasis and has subsequently been used widely (Lewis & Finlay, 2004). The use of validated, standardised general health measures in dermatology, such as the UK Sickness Impact Profile (Finlay et al., 1990) and the Short Form-36 (SF-36) (Nichol et al., 1996) followed in the early 1990s. Several dermatology disease-specific QoL measures for use in acne, psoriasis, atopic dermatitis, alopecia, leg ulcers and others were described during the...

Drugs and Vaccinations

Concurrent medication for underlying illness may cause or exacerbate symptoms. For example, aspirin taken to prevent travel-related thrombosis may cause or worsen gastrointestinal bleeding, and diuretic therapy increases the dehydration associated with diarrhoeal illness. Mouth ulcers are common in patients taking proguanil chloroquine can exacerbate psoriasis prophylactic doxycycline is associated with vaginal thrush and with photosensitive rashes and mefloquine use has been linked with various neuropsychiatric effects (Nosten and van Vugt, 1999).

Changes in disease

The catecholamines released in chronic stress appear to have a related effect by inhibiting IL-12 and enhancing IL-10 (Hazko et al., 1998). Paradoxically it has been proposed that the acute stress reaction seen in inflammatory dermatoses, such as psoriasis and eczema, (Dhabar et al., 1996) is induced also by corticos-teroids and catecholamines, which have a particular effect in the acute stress response of inducing enhanced cell-mediated immunity via INF gamma and the cytokine IL-2.

Pellagra

Finally, a number of chronic skin conditions, ec-zematous in nature, result in bilateral and remarkably symmetrical hyperpigmented skin patches. A symmetrical rash suggests contact dermatitis, but complex cases involve a vascular deficit secondary to venous hypertension. Psoriasis may also present with a chronic recurrent eczematous picture affecting the heel and medial plantar aspects on both feet.

Disease

Any damaged or diseased area of the skin is likely to display compromised barrier properties and consequently higher drug absorption. Skin permeability is increased in psoriasis and ichthyosis24 25. This is unusual since both of these conditions result in thickening of the stratum corneum, but presumably it does not retain structural integrity.

Behaviour therapy

Systematic desensitisation is an appropriate technique for the treatment of dermatoses which feature anticipatory anxiety (Van Moffaert, 1992). The fear and apprehension that patients with skin disease may feel about themselves may be challenged by this technique. Through graded exposure, the patient enters situations that they may fear and avoid. The habit-reversal technique is a common strategy used to inhibit scratching and it has been reported to have some success with skin disorders, such as eczema and psoriasis (Ginsburg, 1995). It involves self-monitoring for early signs and situational cues of scratching and practising alternative responses, such as clenching the fists (Ehlers et al., 1995). Relaxation has beneficial effects on skin disorders because it reduces stress levels. It is a useful way to help patients prepare for anxiety-provoking situations or to cope with stressful social predicaments. Relaxation can be used on its own as a means to reduce anxiety or tension or can...

Group therapy

Group therapy is a mode of intervention that helps individuals with a common problem enhance their social functioning though group exercises. Group members are given the opportunity to share their experiences, feelings and difficulties in a safe atmosphere under the auspices of a group facilitator. Using a combination of instruction, modelling, role-play, feedback and open discussion, members of the group are encouraged to discover more about the interaction process. In most cases 6-12 clients meet with their therapist at least once a week for about 2 hours. Usually groups are organised around one type of problem (such as coping) or type of client (such as psoriasis patients). Various approaches, such as social skills training to group therapy have been tried with patients with skin disorders (Robinson et al., 1996). Patients with chronic skin conditions, such as psoriasis or eczema are known to benefit from group therapy and such therapy has increased their confidence in coping with...

Causes

Perceived causes of the disease This can take a wide range of forms including causes due to the individual's own behaviour (i.e. scratching, poor diet), environmental pathogens (bacteria or viruses) or genetic factors. Chronic, episodic illnesses such as psoriasis and vitiligo tend that patients can often create their own illness beliefs as regards events, behaviours and substances that exacerbate their condition, and this can lead to curious and sometimes dangerous reactions. For instance, the mistaken belief that vitiligo is caused by white foods could cause the parent of the vitilig-inous child to ban certain essential foods from the child's diet. The consequences of this action could have negative long-term effects on the child's generic health.

The case of Jake

The example below of Jake1, a 29 year-old psoriasis sufferer who developed the condition 10 years ago is instructive 'I had always been a real sports fan for as long as I can remember. Through my teens I had been involved in county and school teams at cricket, rugby and football. That changed when I started to develop psoriasis on my legs in my late teens. I became really aware of it and self-conscious and couldn't face going in the showers in case team-mates saw it and felt repulsed. I knew that they would think it was contagious. I certainly did at first, you know, like I was a leper or something so rather than let this happen I gradually dropped out of sport, certainly team sport anyway. I suppose the same thing happens when the weather gets warm in the summer. My psoriasis is more progressive now and so I always cover it up, regardless of the weather. This can mean that I'm often uncomfortable in the summer heat and feel almost permanently vigilant but at least this disease...

Gerry Kent

One of Goffman's central ideas was that the mark or sign comes to take on 'master' status, becoming the most important characteristic of the affected individual. This is illustrated by the following description, given by a person with psoriasis. He is recalling a time when his psoriasis took on more importance in the eyes of others than his more relevant sporting skills and efforts 'As a schoolboy sportsman I was once called names when going for a shower after an important game. I had made an important contribution in winning but was made to feel an outcast because I was suffering with psoriasis on my shins at the time'. Since Goffman's seminal work, there have been several collections of essays (e.g. Jones et al., 1984 Heatherton et al., 2000) that cover research on stigma from a general psychological perspective. The aim of this chapter is to review the research on stigma and stigmatisation as it relates to dermatological conditions. The work has been conducted with people with a...

About the book

Al'Abadie, M.S.K., Kent, G.G., & Gawkrodger, D.J. (1994). The relationship between stress and the onset and exacerbation of psoriasis and other skin conditions. British Journal of Dermatology, 130, 199-203. Dungey, R.K., & Busselmeir, T.J. (1982). Medical and psychosocial aspects of psoriasis. Health and Social Work, 5, 140-147. Invernizzi, G., Gala, G., Bovio, L., Conte, G., Manca, G., Polenghi, M., & Russo, R. (1988). Onset of psoriasis the role of life events. Medical Science Research, 16, 143-144. Leary, M.R., Rapp, S.R., Herbst, K.C., Exum, M.L., & Feldman, S.R. (1998). Interpersonal concerns and psychological difficulties of psoriasis patients effects of disease severity and fear of negative evaluation. Health Psychology, 17, 530-536. Winchell, S.A., & Watts, R.A. (1988). Relaxation therapies in the treatment of psoriasis and possible psychophysiologic mechanisms. Journal of the American Academy of Dermatology, 18, 101-104.

Litsa Anthis

'I remember a few months back, when I used to see his knuckles, how they were dry, cracked and bloody, and then I noticed his arm, and when I gently inquired he would retreat and change the subject. This was also before we became close. He has slowly grown more comfortable and one night, after cuddling and holding each other for a while, he asked me if I'd like to see and I said please. He took off his shirt and I saw the extent of his condition. His entire back, arms and parts of his legs were red, with patches of dry skin and blood. It struck my heart, and I suddenly felt very close to him. I wasn't shocked or afraid, and I think he sensed that because he seemed to relax a little. I reached up and touched his shoulders and lightly stroked his back. He later told me he was grateful for how accepting I was, and how he hadn't been touched in a long time. His condition does not bother me, in fact, I admire him. He has a tremendous amount of strength. We have since been intimate, and...

Conclusion

The interface between psychiatry and dermatology is multidimensional and begins in early development. The skin is a vital organ of communication and the earliest social interactions between the infant and its caregivers occur via the body, especially through touch. A disruption in tactile nurturance, for example, as a result of a skin disorder during infancy or due to childhood abuse and or neglect can be associated with serious psychiatric morbidity in later life including major depressive disorder, body image pathologies, a tendency to self-injure and dissociative states when there is significant psychological trauma present in association with the neglect. The importance of the skin in social communication is further exemplified during adolescence when the development of a cosmetically disfiguring skin disorder such as acne can be associated with depression, suicidal ideation and body image disorders including eating disorders. The role of the skin as an organ of communication...

Pandas

PANDAS, paediatric autoimmune disorders associated with streptococcal infections, overlap with chorea and tic disorders. For reviews on Sydenham's chorea and PANDAS, see Snider and Swedo (2003), Simckes and Spitzer (1995) and Shulman and Ayoub (2002). For reviews on guttate psoriasis, see Valdimarsson et al. (1995). For reviews on Kawasaki disease, see Curtis et al. (1995).

Timeline

This attribute concerns the perceived time frame for the development of the condition or threat. Time frames run through all aspects of illness representations and can be crucial with respect to the way that patients label and conceptualise the illness. A patient with newly diagnosed psoriasis may assume from the knowledge that they have gained that the condition is episodic and hence should remit in the near future. This could prompt a set of short-term avoidance behaviours designed to conceal the condition. However, a failure to repigment could result in these avoidant and concealment behaviours becoming ingrained and permanent.

Practolol

Practolol (figure 7.52) is an antihypertensive drug which had to be withdrawn from general use because of severe adverse effects which became apparent in 1974 about four years after the drug had been marketed. The toxicity of practolol was unexpected and when it occurred it was severe. Furthermore, it has never been reproduced in experimental animals, even with the benefit of hindsight. The available evidence points to the involvement of an immunological mechanism, the basis of which is probably a metaboliteprotein conjugate acting as an antigen. It seems unlikely that the pharmacological action of this drug, -blockade, is involved, as other -blocking drugs have not shown similar adverse effects. The syndrome produced by this drug features lesions to the eye, peritoneum and skin. Epidemiological studies have firmly established practolol as the causative agent in the development of this toxic effect, described as the oculo-mucocutaneous syndrome. This involved extensive and severe skin...

Identity

Variables that identify the presence or absence of the illness Skin diseases can be identified by symptoms such as pain and itching, concretely by signs like sores or bleeding and by the use of abstract labels such as eczema or psoriasis. Identity is important because the meaning and interpretation of a symptom can influence the way the person addresses the symptom. Should a patient erroneously apply the label of skin cancer to a white lesion on their skin, this could precipitate a different response than were they to attribute the lesion as a rash or an injury. This is particularly important in the domain of help-seeking.

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