by Dr. Madalene Heng MD, FRACP, FACD, FAAD

Other Types of Psoriasis

Other Types of Psoriasis

1) Guttate Psoriasis:

If you get spots about the size of a dime or nickel, without large spots, you may have Guttate psoriasis. This is usually precipitated by streptococcal infection, among other causes, such as herpes simplex infection, hepatitis, and penicillin allergy. To get streptococcal infection you need to have a specific gene present (HLA-B16). Psoriasis, in addition, is due to yet another specific gene (mapped to the distal end of the 17th chromosome). Those who have the genetic combination often develop Guttate psoriasis.

Streptococcal infection may originate from the scalp, or the throat, ears, sinuses. Keep your head down so that no water may enter the ears, as this is a common site for streptococcal infections The scalp may also be infected by Staphylococcus aureus, by a yeast called Pityosporum ovale, and aggravated by nickel from coins and keys by touching with your fingers.

If you have lesions in your groin, axilla and/or between the buttocks, you may be lactose intolerant. 95% of the Asian population is lactose intolerant (lactase deficient), 80% among Native Americans and Hispanic decent, 75% among African Americans, 50% among Mediterranean decent, and 20% among Northern European decent. The lactose in the colon causes stress to the bacteria in the colon which are trying to digest cellulose since human beings are incapable of digesting cellulose. The inflammation in the bowel causes colitis, which causes zinc deficiency, which causes proneness to yeast and bacterial infection. In the scalp and face, the yeast is Pityosporum ovale; elsewhere (groin, axilla, between the buttocks, between the fingers and toes etc, the yeast is Candida albicans.

  • Go on a lactose free diet (including cheese, ice cream, yoghurt, cream soups containing milk, pastry containing milk, sauces containing milk etc). Substitute soy products and goat cheese instead. You probably will need calcium and vit D supplements. You may also benefit from zinc supplements (40-60 mg daily).
  • Oral antibiotics to treat your streptococcal infection and Staphylococcal infection. Oral Keflex® 500 mg, two capsules twice daily until clear i.e. 4 months.
  • Oral antiyeast treatment e.g. oral Diflucan® 200 mg tabs - one tablet per week until clear i.e. 4 months.
  • Clobetasol solution 0.05% in the mornings - massage between the hair roots. Psoria-Gold ® curcumin gel at night after a shower, and after drying your hair. Wet the scales with a little rubbing alcohol, and while the scales are still wet, massage curcumin gel into the wet alcohol in order to get the curcumin gel to penetrate under the scales. You may do this for the trunk/limbs as well at night after the shower.
Trunk and Limbs
  • Use a combination of clobetasol cream 0.05% mixed with ketoconazole cream 2% on the palm of your hand, and then apply to the patches on the trunk and limbs. Do this morning, and if possible during the day as well.
  • After a shower at night, apply Psoria-Gold® curcumin gel, massaging it into the wet alcohol to get the gel to penetrate the psoriatic scales.

2) Psoriatic arthritis

Psoriatic arthritis is aggravated by factors that lead to the formation of antibodies in the blood stream - called circulating immune complexes. Streptococcal infection is the most common cause of circulating immune complexes that worsen psoriatic arthritis. See “guttate psoriasis” for details on the source of streptococcal infection, its prevention and treatment.

Other factors that may lead to the formation of cirulating immune complexes include herpes simplex infection, penicillin allergy and hepatitis. The condition is also worsened by a tendency to lupus erythematosus. This condition is more difficult to treat with topical medication. Please see your doctor.

You may refer to the National Institute of Health website for more information on the drugs mentioned above. 

You may refer the National Institute of Health website for a printed guide on Curcumin as Alternative medicine.