Title: Koebner effect on normal Plaque Psoriasis
Post by: Nick on June 09, 2003, 11:47:52 AM
Koebner effect on normal Plaque Psoriasis
I have been pondering about this for a little while and I thought I would share my thoughts and see what everybody else thinks.
Part 1.
A few years back a doctor by the name of Koebner came up with this theory that in Psoriasis patients: If a Psoriasis sufferer was to damage a part of normal skin then there was a chance that during the healing process that skin would become psoriatic skin. It seems to be proven when sufferers get cut or graze their skin, but it doesn’t always happen.
So basically he was saying “Damage your skin ….. whoosh! Psoriasis hits the damaged area”.
Part 2.
I noticed that when I suffer a flare I get flaky. I guess that applies to many of us Psoriasis members. Then I noticed that if I try peeling or scraping off the plaques, especially for my facial psoriasis, the flare takes a lot longer to fade and there have been times when it just hasn’t eased off at all. Yet, there have been times when I have made the conscious decision not to peel or scratch off the flakes and even though it may look hideously crusty I just let the flakes fall naturally or with the least amount of encouragement.
Now in my experience I have found that allowing the flakes to form and fall off on their own has quite dramatically eased the effect of the flare-up. The flare doesn’t seem to last as long.
Scalp psoriasis seems to act the same way for me. If I forget myself I can suddenly find that I have been having a really good dig at the plaques on my scalp without even realising it. The next thing I know is that the scalp Psoriasis has taken a hold again and seems to get worse the more I scratch and dig.
My theory.
Could it be that the Koebner effect actually is a part of the normal lifecycle of a psoriasis flare-up? Maybe Koebner was more right than he realised in that not only does Koebner Effect work on damaged skin but also works on skin that is already psoriatic.
Here’s where I’m going with this.
If we flare up as part of a normal Psoriasis attack do we actively encourage the Koebner Effect on our skin by scratching or removing the flakes? Does our skin think that it is damaged even more than it really is and so makes our immune system go into overdrive which in turn only makes the psoriasis attack even worse?
My feelings on this are that maybe we are doing even more damage to ourselves when we go scratching off the flakes, even if they do look terrible. I can only speak from my own history so I’d love to hear from others if they have ever found anything similar.
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Title: Re:Koebner effect on normal Plaque Psoriasis
Post by: fishs on June 09, 2003, 12:38:14 PM
:hi:
Nick .
Very interesting .. I am not altogether ok with the damaged skin idea .. I can understand your thinking though.. It is logical .. It is a bit like the old cause and effect theory .. analyse the effects to provoke the cause is not a bad way to approach things ..
I agree re the immune system .. As you know I have just completed an extensive article on immunisation and innoculation re kids and I researched that for nearly 8 months before I finished the article and no doubt about it you can certainly trick the immune system .. and your theory is certainly plausable ..
I am going to think about this one for a few days..
Fish.. |
Title: Re:Koebner effect on normal Plaque Psoriasis
Post by: juliep on June 09, 2003, 08:11:04 PM
I have never developed psoriasis on any clear skin that has been 'damaged' but I agree Nick, that the more you scratch the plaques the longer they take to heal. I wonder though if this is just the super-accelerated response of normal skin - ie if you scratch normal skin you dislodge skincells and the body automatically goes into repair and renew mode so if you scratch a plaque it does the same only at a hugely accelerated rate.
Some time ago I was diagnosed as having leukoplakia on my tongue - it looks and acts quite like a p plaque - and I have noticed that if I chew the side of my tongue in my sleep (my worst habit and soooo hard to stop, can manage to do it even with a gumshield) then the plaque increases in size and becomes sort of flaky, so there is definately something in your theory Nick
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Title: Re:Koebner effect on normal Plaque Psoriasis
Post by: peterb on June 09, 2003, 09:19:04 PM
A little article I found----
· Patients may recognize that new lesions appear at sites of injury to the skin.
(This isomorphic phenomenon (Koebner reaction) typically occurs 7-14 days after the skin has been injured and has been found in 40-80% of patients with psoriasis.
In some patients, so-called reverse-Koebner reactions may be noted in which preexisting psoriatic plaques will clear after injury or trauma to the skin.
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Title: Re:Koebner effect on normal Plaque Psoriasis
Post by: Alison on June 10, 2003, 08:10:42 PM
hmm yeh u got me thinking now :-\ ???
i reckon u might be onto something there nick , p left alone does clear up/calm down alot quicker than if u sit n pick at it all night.
vicious circle to break |
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