Psoriasis and Multipile Sclerosis- possibly related??

Hi All,

I recently had a 35 year old woman visit my clinic who has had chronic plaque psoriasis since age 8. She claims that her outbreaks started after an allergic reaction to anitbiotics. Now what is interesting to me is that she was diagnosed 5 years ago with multiple sclerosis. Since this time she has had increasing numbers of lesions found using MRI scans.
When I researched if there was any relationship between MS and psoriasis I found that they both can stem from an autoimmune problem related to killer helper- 17 (Th-17) cells and interluken-17 (IL-17) cytokines.

I would be interested to hear if anyone else has seen a correlation between these two disorders. I personally think that the two are related.

I would also be curious to hear if anyone has ever seen MS remissions happening while the patient is being treated for psoriasis, obviously using Chinese herbal medicine.

Trevor Erikson
www.skin.health-info.org
www.acubalance.ca

Hey Eran! I thought you would be the first to respond :-)

I have never seen this relationship in clinic before either, but when I did it certainly fired up my interest. From some preliminary digging I found the following research on pubmed. The basic idea I gleaned from this was that many autoimmune disorders share an over reaction of Th-17 cells and IL-17 cytokines. The newer lines of western drugs look like they will be targeting these areas.

http://www.ncbi.nlm.nih.gov/pubmed/18613831?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

I have been in discussion with my teacher Mazin Al Khafaji about this. Mazin specializes in dermatology and autoimmune disorders. He probably sees hundreds of psoriasis cases every year. From his memory he thinks he saw at least 3 cases of psoriasis where there was also MS within the past 2 years. He believes that at least 2 of the 3 saw remission in their MS symptoms while being treated for psoriasis. Interesting to say the least. Obviously not enough data to claim any significant theory yet, but the basic idea behind it is that autoimmune disorders can cross over into other body systems, this is just one example.

From a CM point of view I am curious as to the common patterns that the two disorders can obviously share in these unique cases. Obviously if MS symptoms improve while on a herbal Rx that focuses on the Blood heat, Fire Toxin, blood stasis, and wind components of the psoriasis, then Ms must have these as a common route.

I have never really worked with MS myself, so this is all just speculation on my part. Just taking note on what I observe in clinical practice.

Trevor
www.skin.health-info.org
www.acubalance.ca

I appreciate your dedication to CM as well Eran. I know you have taken it a step further by actually learning Chinese and so you have access to so much more detail and knowledge.

I always find it interesting in clinic when certain western defined diseases can have such a differing range of syndromes attached to it from the Chinese medical point of view. I have always found psoriasis to be a good example.

Psoriasis often times presents as a dry disease. It is easy to assume that this dryness is because the yin and blood are vacuous. But what I have seen in clinic and what I have been taught is that the dryness of psoriasis is most often caused by heat in the blood with fire toxin. This is easily seen when the lesion is scratched and underneath all that dry flaky scale, there will be a moist layer with pin prick bleeding underneath it (the auspitz sign).

Of course psoriasis can still be due to yin and blood vacuity and one has to always be observant of how the patient responds to treatment so that adjustments can be made if needed. It is actually quite good to know the spectrum range for a disorder so as to know what to try if what we thought was the cause doesn't respond to treatment as we assumed.

Obviously damaged fluids will lead to heat and heat can lead to damaged fluids. Sometimes it may just be a game of chicken and egg, of what caused what- first. Or more importantly, what to treat first.

My thinking when I see these cases and piece it together with western insight, is that maybe many of the symptoms of MS that appear on the surface to be from yin Xu, are in fact caused by deeper fire toxins and blood heat that are in fact damaging the yin. That perhaps attending to the fire, that is destroying the nerve mylean sheath, first, before trying to rebuild the sheath, will be useful.

What do you think? (Again I am only speculating, I really do not have a lot of clinical experience in the treatment of MS)

Trevor
www.skin.health-info.org
www.acubalance.ca

Very true points Eran.

I guess fire toxin may potentially play a deeper role in MS when there is other obvious symptoms going on, like psoriasis. But as mentioned the occurrence of psoriasis and MS appearing at the same time seems to be not very common, and so perhaps the role that fire toxin plays as part of the mechanism of MS is also rare, although significant at times?

What really matters is effective results that do the least harm and for such degenerative knotty diseases like MS, this can be challenging to say the least.

I would love to chat with you more about your experiences with MS. Perhaps you may be interested in teaching a workshop?? I think you would be a great teacher, especially with your knowledge of the classics, in conjunction with case studies from your own clinic.

Best
Trevor
www.skin.health-info.org
www.acubalance.ca

Actually Eran, we do not live in the same city. I live in the over populated and busy Vancouver, you live in rural laid back Port Moody. As far as I know, in between seeing patients, your probably out on your patio sitting in a rockin chair and playing bluegrass music on a banjo while singing in Chinese ;-)

Would love to get together. Gillian mentioned the same, as she would love to see the new family addition!

Trevor