Psoriasis

Psoriasis

Psoriasis is one of the most commonly and frequently encountered chronic inflammatory dermal diseases, and is characterized by red plaques of various shapes and sizes appearing on the skin, covered with white scales.

The skin cells of psoriasis patients multiply up to ten times faster than normal. Psoriasis typically occurs on the knees, elbows, scalp, torso, palms and soles of the feet. Infected areas can be itchy and painful, and plaques can merge together to create bigger plaques and cover a large area. Psoriasis usually occurs in young adults, and disease conditions can last for quite a long time and recur frequently, making the disease disturbingly persistent. The cause and pathogenesis of psoriasis are still unknown at this point, but it is suspected to be related to genetic, infective, metabolic, endocrine, nervous, mental and immunological disturbance. T-cells in the body normally attack viruses and foreign bacteria, but they start attacking healthy skin cells in psoriasis patients. In response to this attack, the body starts producing more new skin cells, and these new cells accumulate on the surface of the skin before the old dead skin cells shed off, creating layers of scaly skin patches.

Main signs and symptoms of psoriasis include red skin patches covered with white scales, bleeding dry and cracked skin, itchiness and burning sensation, thickened, pitted or ridged nails, and swollen and stiff joints. There are several types of psoriasis, including:

  • Plaque psoriasis, which is the most common form of psoriasis with dry, raised, red plaques with silvery scales that can occur anywhere on the body;
  • Pustular psoriasis, which is characterized by red scaly skin on the palm and soles of the feet with tiny blisters;
  • Guttate psoriasis, which often starts in childhood or young adulthood and is characterized by small red spots mostly on the torso and limbs. This can be triggered by respiratory infections, stress, tonsillitis, etc.;
  • Inverse psoriasis, which is characterized by red and shiny lesions that appear in the skin folds, including armpits, groin area, and under the breasts;
  • Erythrodermic psoriasis, which is a rare form of psoriasis characterized by periodic, burning redness of the skin and scale-shedding in sheets. This can be triggered by severe sunburn, infection and medications.

There is no cure for psoriasis in western medicine, but depending on the severity of the patient’s conditions, doctors may prescribe medications to ease the itchiness and pain. Creams and ointments such as corticosteroids, salicylic acid and moisturisers, and medications for suppressing the immune system can be prescribed.

In TCM, psoriasis is also known as “Bai Pei” and “Song Pi Xian”, and is believed to be caused by any one or more of the following: blood heat; a combination of constitutional blood heat and invasion of pathogenic wind and heat; heat produced by exogenous wind and coldness; heat transformed from long stagnation due to stress and stagnation of qi; heat produced from stagnation due to qi dysfunction and disharmony of the spleen and stomach, typically due to excessive intake of irritating seafood; excessive heat and wind due to an accumulation of pathogenic heat in the ying-nutrient system and xue-blood system; damage of yin and blood that leads to blood deficiency and wind dryness due to blood heat gradually subsiding after a long time; obstruction of the meridians and collaterals, leading to qi stagnation and blood stasis; malnutrition of the skin due to the insufficiency of the liver and kidney, dysfunction of the Thoroughfare Vessel and Conception Vessel, and a deficiency in the Ying-Nutrient System and Xue-Blood System for females. If prolonged blood heat accumulation is attacked by pathogenic damp toxin simultaneously, then it can cause complication of heat toxin mixed with dampness. The obstruction of meridians and collaterals by exogenous wind, dampness and heat toxin can in turn affect the joints. If the excess heat toxin is not relieved to induce excessive fire toxin and flaring up of the qi and blood, then it can lead to appearance of red skin and shedding of scaly skin in the whole body. Psoriasis syndromes can be differentiated as follows:

  1. Blood Heat and Excessive Wind Syndrome Main symptoms include the sudden onset and frequent appearances of fresh red patches covered with a thick layer of scale, obvious hemorrhage, and appearance of new affected areas due to excessive scratching. Symptoms can be accompanied by vexation, dry mouth, dry stool, brown urine, along with reddened tongue with yellowish coating, and wiry and slippery or rapid pulse. For this type of syndrome, it is best to remove excess heat, dissolve toxin, cool blood and expel wind.
  2.  Blood Deficiency and Wind Dryness Syndrome Main symptoms include prolonged disease conditions, light-colored patches with a decreasing amount of scales, slight itchiness, and can be accompanied by pale tongue with thin and whitish or little coating, and thin pulse. For this type of syndrome, it is best to nourish the blood, replenish yin, expel wind and moisten dryness.
  3. Qi Stagnation and Blood Stasis Syndrome Main symptoms include dark red thick blisters that last for a long duration, with purple dark tongue or purple patches and spots on the tongue, and hesitant or fine and slow pulse. For this type of syndrome, it is best to promote qi flow, dissolve stagnation, activate blood and clear out obstructions in the collaterals.
  4. Syndrome of Dysfunction of Thoroughfare Vessel and Conception Vessel This syndrome occurs in females, and main symptoms are light-colored papules with few scales that are relieved or disappeared during pregnancy, but can recur or aggravated after delivery. This syndrome is common in females who have had a history of irregular menstruation, and symptoms are accompanied by pale tongue with thin and whitish coating, and soft and thin pulse. For this type of syndrome, it is best to replenish qi and blood, regulate Thoroughfare Vessel and Conception Vessel.
  5. Syndrome of Obstruction of Collaterals by Wind and Dampness Main symptoms include extensive amounts of papules over the whole body, with swelling and pain and limited movement in the joints, mostly the joints of fingers and toes. The joints can be deformed after a long time with difficulty to extend them straight. For severe cases, the large joints of the knee, ankle and spine can also be involved. Symptoms are accompanied by pale tongue with thin white and greasy coating, and wiry and slippery or soft pulse. For this type of syndrome, it is best to disperse wind, expel dampness, dissolve toxins and clear out obstructions in the collaterals.
  6. Syndrome of Mixture of Heat-Toxin and Dampness In addition to erythema and desquamation, main symptoms of this syndrome include recurrences of dense patches of blisters with various sizes, erosion on the skin surface and shedding of the skin over the whole body, mostly on the palms and soles of the feet. Symptoms can be accompanied by fever, excessive thirst, dry stool and little urine in severe cases. Reddened tongue or gray and black tongue with yellowish and greasy coating, and slippery or slipper and rapid pulse can be observed. For this type of syndrome, it is best to remove excess heat, cool blood, dissolve toxin and remove dampness.
  7. Excessive Heat-Toxin Syndrome Main symptoms include diffuse and wet red skin lesions over the whole body with burning sensation and large amounts of scales on the skin surface. Symptoms can be accompanied by fever or high fever with excessive thirst, dry stool, brown urine, along with crimson tongue with cracks and little or no coating, and wiry, slippery and rapid pulse. For this type of syndrome, it is best to clear away fire, dissolve toxin, cool blood and protect yin.

It is recommended to take antibiotics for patients who have an infection in the upper respiratory tract along with psoriasis symptoms. Psoriasis patients should avoid beef, lamb, alcohol and other irritant food in their diet, and avoid getting injuries. It is also essential for patients who apply external creams or ointments to start from a low concentration of the cream or ointment.

Herbal formular such as Tu Huai Yin, Yang Xue Run Fu Yin, Tao Hong Si Wu Tang, Si Wu Tang, Du Huo Ji Sheng Tang, Huang Lian Jie Du Tang and Qing Wen Bai Du Yin can be used to treat psoriasis. Please feel free to consult with a Registered Acupuncturist or an intern student of the college clinic about psoriasis syndromes.

Dep. of Dermatology

Dr. Benny Xu, Director, Department of Dermatology

Dr. Benny XuWith over 20 years of clinical experience in the City of Calgary, Dr. Benny Xu is highly regarded in the community and well respected in the acupuncture and Chinese medicine profession.

Dr. Benny Xu is the founder of Alberta College of Acupuncture and Traditional Chinese Medicine (ACATCM). Dr. Xu graduated from the Liaoning University of Chinese Medicine, and has been practicing acupuncture and Traditional Chinese Medicine in Calgary since 1992.


Dr. Xu is:

  • a former member of Acupuncture Committee, Alberta Health and Wellness;
  • a former vice president of Alberta Traditional Chinese Medical Science & Acupuncture Association;
  • a former president of the Alberta Association of Acupuncturists and Chinese Medical Doctors;
  • a recipient of the Alberta Centennial Medal in 2005 for his significant contribution in TCM and Acupuncture education;
  • a member and presenter of the Beijing 2006 International Forum on Innovation and Development Situation of Traditional Medicine,
  • a presenter of the Beijing 2006 International Forum on Education of TCM and Traditional Medicine;
  • a former member of the Advisory Committee of The Integrated Health Institute at Mount Royal University.

Dr. Benny Xu was the president of ACATCM from 1997 - 2013, and is a recipient of the Alberta Centennial Medal (2005) for his significant contribution in TCM and Acupuncture education. Dr. Xu has been actively involved in the local community and has been practicing acupuncture and Traditional Chinese Medicine in Calgary since 1992.