Is Psoriasis genetic?

Q: I have recently developed psoriasis in patches on my elbows and knees. My mother and father both suffered from it for years, and my sister shows signs of developing it as well. Does it run in families? Is there any cure? M. B., Sheffield.

A: Psoriasis is a chronic skin condition that supposedly affects about l per cent of the population. As you know, it's characterized by silvery red scaly patches on the knees, elbows, the scalp, the folds of the skin and on some victims, the entire body when the skin cells multiply about l0 times or more faster than they ought to. Although it isn't dangerous, it can be disfiguring, itchy and hellish.The standard medical line is that there is no known cure for psoriasis. The usual treatments consist of coal tar preparations, mild steroid creams and specialized treatments with ultraviolet light. Some coal tar preparations warn that users shouldn't spend much time in the sun even though doctors usually suggest that the sun will improve the condition. As mentioned several times in these pages (see p 5) steroids can cause a thinning of the skin, raised blood pressure, osteoporosis and muscle weakness, retarded bone growth in children, delayed wound healing, alterations in fat metabolism, hypertension, chemical imbalances in the body and symptoms of psychoses, to name a few symptoms. Ultraviolet treatments of male sufferers has been associated with a higher incidence of genital cancer (see WDDTY, Vol. l, No. 6).

Although we're not exactly sure what causes psoriasis, several interesting theories have been put forward. The first, mentioned in Nutritional Medicine by Stephen Davies and Alan Stewart (Pan, l987) theorizes that the metabolism of certain derivatives of dietary oils has somehow subtly changed. In that case you might be able to improve matters by changing your diet. Nutritional Medicine suggests that you reduce intake of animal fat, eat plenty of fresh vegetables and fruits, and take high doses of zinc (30-40 mg a day), possibly with other supplements. Nevertheless the authors caution that because of the potential adverse effects with high doses of zinc, this treatment should never be embarked upon without supervision.

Recently, several theories concern a relationship between the onset of psoriasis and a low level of essential fatty acids. Recent reports published in the medical literature have reported improvements in patients given fish oils such as MaxEPA. Again, this kind of therapy should never be embarked upon without medical supervision.

Perhaps most provocative is the work carried out by E. William Rosenberg, Professor of Dermatology in the Departments of Medicine and Pathology at the University of Tennessee College of Medicine in Memphis. He believes that an inherited fault in the body's antigen-antibody response to foreign organisms, particularly the yeast Candida albicans, brings on psoriasis. Hence its tendency to run in families.

He and Dr Sidney M. Baker, Medical Director of the Gesell Institute of Human development in New Haven, Connecticut, published information about their success in treating psoriasis patients with an anti-candida approach. Our own panel member Dr John Mansfield reports similar success with about 50 of his patients, some of whom had severe psoriasis.

Dr. Mansfield uses the standard anti-candida treatment, which combines medication (an anti fungal agent like Nystatin, Fungizone or the new preparations like Sporanox) with a restrictive diet. The diet initially avoids sugar, all refined carbohydrates (those made with white flour) and all yeasted food. Some doctors also recommend limiting daily carbohydrate intake to 60-80 grams and taking certain vitamin supplements to boost the immune system. These include essential fatty acids, zinc, vitamin C and magnesium, among others. Again, we encourage you to find an experienced doctor before launching on this kind of regime.