The next case history illustrates the time between an onset of symptoms of psoriasis and an actual diagnosis.  It began with a young man noticing dandruff when combing his hair.  The flakes of “dandruff” started to get larger and look like the scales of a small fish.  There were also more of them than there were of regular dandruff, and they shook out quite easily.  A shake of the head would result in a circle of little crumbled flakes on his shoulders and the collar of his shirt.   As time went on, the amount of crumbled flakes that fell continued to increase, and so his wife stocked a number of different dandruff shampoos.  These did minimize the scales to some extent, but after awhile each shampoo would lose any useful effect that it might have had.

Friends suggested various remedies, such as shaving the head and applying lotion to it for several weeks.   Again, there was some minimal improvement that did not last.  Others suggested various combinations of herbs to be applied topically to the scalp, but again nothing changed.  In addition to this lack of success, sometimes small bits of blood or greasy drops fell out when he combed his hair.

Finally, after more than a year, the characterized inflamed red areas of psoriasis began to appear.  Those began in the scalp area, but spread farther to the neck area, so that other people could easily see a few of the inflamed areas.  One of his co-workers mentioned that it might be psoriasis.  However, the lesions were still localized and not highly noticeable, and so he continued to ignore it until another lesion showed up on his trunk a few months later.   Even with this red and itchy area it took another few months and a good deal of prompting to get to a consultation with a doctor.

The first doctors he visited examined the areas and prescribed various ointments, but did not return with a diagnosis of psoriasis.  He was given several ointments, none of which helped the lesions at all.  Finally, another friend convinced him to have a consultation at a clinic associated with a university, and was finally diagnosed with psoriasis after nearly two years after the first flare up of the disease.

The lesions on his skin resisted most traditional treatment, for though sometimes there was some improvement, it was only for a short period of time.  He also tried homeopathic remedies, usually in the form of small pills to be taken orally.   These did seem to have any effect on the lesions.  Finally, he embarked on a several month long program of detoxification to remove metals and toxins from his body, and the lesions have decreased markedly.

The next case history is of a young man who has started an Internet version of a discussion group for those who suffer with psoriasis.  He had his first flare up of plaque psoriasis at age eight, but his physician diagnosed it as eczema and gave him a topical cortisone cream.  The lesions continued for over a year, and then disappeared for several years.  As a teenager the lesions returned and covered a large part of his body and were put on Trimacinilone ointment, which worked well for a number of years.   At this point the topical steroid simply stopped working, the lesions of plaque psoriasis returned, and he also showed the lesions of guttate psoriasis.  One of the few advantages is that though guttate looks terrible, it does not have the flaking of plaque, and so often has far less itching associated with it.

This return of a very severe outbreak cast him into a deep depression and he stayed inside most of the time.  At age twenty-two this is not much of a life for a young man, and he used the internet frequently to find and talk to other people who suffered with various forms of psoriasis.

With treatment the guttate psoriasis cleared, the plaque psoriasis remained, and he exhibited symptoms of psoriatic arthritis.  In order to treat this new complication, a specialist suggested the use of Enbrel, one of the medications described above.

After six months on Enbrel and using a topical foam, he became symptom free for over a year.  The battle is ongoing and some symptoms have returned, but the time without symptoms has allowed him to get a number of friends to support him as he continues to fight this battle.  The main point of this case history is that persistence is of great value, both in continuing to try treatments, and continuing to find other people for support in any future battles in life.

Accupuncture

The next case history is to illustrate the use of acupuncture and other forms of traditional Chinese medicine in the treatment of psoriasis.  Again, inclusion of these cases does not imply that this is either useful or not useful in helping the symptoms of psoriasis, rather they are included for completeness.  The first patient is a lady in her thirties whose first outbreak of psoriasis was in her childhood.  She had noticed that her worst flare-ups were related to times of great stress, and these were complicated by cold weather.  She had areas of inflammation on her scalp, elbows, knees, and back, and these areas were relentlessly itchy.  Using a combination of herbal products and acupuncture, the lesions became less inflamed and shrank in size.  Though initially she came to the acupuncture practitioner for problems in menstruation, the improvement of her psoriasis was marked.   

A second case was a middle-aged man with a moderate case of plaque psoriasis that had areas of inflammation that had lasted for many months.  A series of acupuncture treatments over about eight months gave significant relief of the pain of the lesions, and decreased their size by more than fifty percent.

Hypnosis

Another alternative method of treating psoriasis is with hypnosis.  These cases are included here just as an indication of another method of therapy for psoriasis. The first case is a twenty-seven year old man with plaque and guttate psoriasis over forty-five percent of his body.  He had previously tried steroid creams, and Chinese herbal and acupuncture.  Neither of these choices had made a difference in the lesions of psoriasis on his body.  He had also tried the UVB treatment and this was somewhat effective in helping his inflammation.  

During the session of hypnosis he remembered that he was bullied quite severely at the age of eight, and shortly after this he had his first flare up of psoriasis.   The flare up continued for three months before his teachers finally pushed his parents to take him to the doctor.  After suggestion therapy and NLP reframing, his inflammation gradually decreased until after two months all of the lesions of psoriasis were gone.  After a few additional sessions he has remained symptom free for more than four months.  His maintenance therapy is to listen to a self-hypnosis CD once a week.

The second case that used hypnosis to treat psoriasis was a forty-four year old woman who had plaque psoriasis on her elbows, knees, and ankles.  These symptoms began at the age of thirty-nine.  She had tried both a UV phototherapy treatment and a steroid cream, and neither had given any improvement.  At the time of hypnosis treatment for psoriasis she was using the E45 cream.  Her history revealed that the flare-ups of psoriasis began immediately after her father died suddenly of a heart attack.  She was not able to return for the funeral, and felt guilty that she was not able to say goodbye.  Under hypnosis she was able to let go of her guilt, and do some confidence strengthening.  She had four sessions of hypnosis, and the lesions of psoriasis lingered for seven weeks.  They started clearing at that point and after three months she was entirely free of any psoriasis flare-ups, and has remained so for the several months after that.

For this particular practitioner of hypnosis, approximately one half of his patients that have psoriasis respond extremely well to the treatment, and he recommends that this option be explored for many patients with psoriasis.