Indications :
Psoriasis, Psoriasis arthiritis, Pustular psoriasis of the palms & sole, Parapsoriasis disorders, a topic dermatitis ( neurodermatitis), Ichthyosis vulgaris, Mycosis fungidis (1-11), Lichen planus, localized scleroderma ( morphea ), Uvitis, joint disorders, Ankylosing spondylitis ( Bechterev ), and Osteoarthiritis (Degenerative joint disease), Eczema , Eczema– Atopic Eczema.

The average treatment period is three weeks. The treatment is not recommended for patients with sun over sensitivity.
Patients, on cortisone-medications, should consult their physician to stop medication four weeks prior to treatment.
The recommended treatment period for Psoriasis arthropatica is between May and September and for . Pustulosa between October and April.
The preferred treatment period for patients suffering from heart and circulatory decompensation is between September and April.

Psoriasis is a fairly common skin disorder, which effects about 2-3 % of the world population. It occurs equally in men and women and can effect people at any age. Although the lesions are unsightly and may sometimes be embarrassing, the disorder is not catching and, with proper treatment, can be brought under control.

Even though the exact cause of psoriasis is still unknown, it appears that some people are more inclined to develop the disorder than others do. Many patients are able to think of some one else in the family who has psoriasis, but it is thought that people with a family history of the disorder only get it themselves if some other factor starts off.

One of these factors could be a throat infection. Of those patients who had psoriasis during childhood, half developed the condition after having a sore throat.

Stress is another factor, which could bring about psoriasis for the first time, but it can also be responsible for relapse after on. It is very important to understand that if you are anxious or under pressure increase the possibility of developing psoriasis, and you should attempt to control this by understanding that the stress and anxiety are themselves important factor.

PSORIASIS

Psoriasis is a chronic non- infectious inflammatory dermatosis characterized well – dermacated erythematous plaques topped by silvery scales.

Psoriasis effects 2% of the population in Europe and North America, but is less common in Africa and Japan. In sex incidence is equal. The condition may start in any age, even in the elderly but the peak outside is in the 2nd and 3rd decade. It is unusual in children less than 8 years old.

Inherited polygenic factors predispose to the development of psoriasis. About 35% of patients show a family history and identical twin studies show a concordance of 80%. There is a 25% probability that a child with one parent who has psoriasis will be similarly affected but this increases to 60% if both parents have psoriasis.

Eczema is a non-infective inflammatory condition of the skin. The term ‘eczema’ literally means ‘to boil over’ ( Greek ), and this well describes the acute eruption in which blistering occurs.
Eczema represents a reaction pattern to a variety of stimuli, some of which are unknown.
Eczema and dermatitis mean the same thing and may be used interchangeably. However,  to patients, the term ‘dermatitis’ often implies an industrial causation.

A division into endogenous ( due to internal or constitutional factors ) and exogenous ( due to external contact agents ).A further division into acute and chronic eczema can be made in many cases according to the morphology of the eruption.

Acute eczema

Chronic eczema
 

Contact dermatitis may effect any part of the body, although the hands and face are common sites. The appearance of dermatitis at a particular site suggests contact with certain objects.
For example, an eczema on the wrist of a woman with a history of reacting to cheap earrings suggest a nickel allergic response to a watch strap buckle. Diagnosis is often not easy as a history of irritant of allergen exposure is not always forthcoming. Knowing the patient’s occupation, hobbies, past history and use of cosmetics or medicaments helps in listing possible causes.
Nickel sensitivity is the commonest contact allergy, affecting 10% of women and 1% of men. Usually it only causes an inconvenient eczema at jewellery or metal contact sites, but an industrial dermatitis can result, e.g. in nickel platers.

Definition

Atopic eczema is a chronic pruritic inflammation of the epidermis and dermis, often associated with a personal or family history of asthma, allergic rhinitis, conjunctivitis or atopic eczema. Uncontrollable scratching is prominent and the course is remitting.
 
‘ Atopic ‘ defines an inherited tendency present in 15-25% of the population, to develop one more of the aforementioned disorders and to produce high levels of circulating IgE antibodies, commonly to inhalant allergens ( e.g. housedust mite ). Excessive IgE production is not the primary abnormality but is the result of more fundamental imbalance of immune function.

About 12–15% of infants are affected. It usually starts within the first 6 months of life, and by 1 year, 60% of those likely to develop it will have done so. Two-thirds have a family history of atopic. Remission occurs by the age of 15 years in 75% , although some relapse later.

Babies develop an itchy vesicular exudative eczema on the face and hand, often with secondary infection. Less than half continue have eczema beyond 18 months.

After 18 month, the pattern often changes to the familiar involvement of antccubital and popliteal fossae, neck, writs and ankles. The face often shows erythema and infraorbital folds.
Lichenification, Schoolchildren with eczema may be teased or rejected by their classmates.

The commonest manifestation in adult life is hand dermatitis, exacerbated by irritants, in someone with past history of atopic eczema. However , a small number of adults have chronic severe form of generalized and lichenified atopic eczema which may interfere with their employment and social activities. Stressful situation, such as examinations or marital problems. often coincide with exacerbations.

General measures in the management of atopic eczema include explaining the disorder and its treatment to the patient and the parents, stressing the normally good prognosis. A child should wear loose cotton clothing and avoid wool ( which irritates ) and excessive heat. Nails should be kept short. Cats and dogs cause exacerbation in some patients and are best kept away. The exclusion mite from the home environment is difficult. Careers advice is also important. Wetwork jobs ( e.G. nursing, hairdressing, cleaning ) and industrial work with exposure to irritant oils should be avoided

Emollients

Emollients such as aqueous cream and emulsifying ointment should be used regularly on the skin and as soap substitutes. They moisturized the dry skin, diminishing the desire to scratch and reducing the need for topical steroids. Bath oil emollients may also help.

Coal tar or ichthammol paste

Wet dressings

Systemic therapy

Dietary manipulation

Some children with atopic eczema give a history that suggests food allergy ( e.g. urticaria of the mouth on contact with the food, or gastrointestinal symptoms ) and its clear that offending food should be avoided. Otherwise, dietary treatment is reserved for a minority who have not improved with standard therapy. Diets free from cow’s milk or eggs may be tried but must be supervised by dietician to ensure exclusion and prevent nutritional deficiencies.