Acupuncture Treatment for Psoriasis Present on the Soles

: Psoriasis is a chronic autoimmune skin disorder. Psoriasis manifests as itchy and sore plaques on the skin, mostly located on the knees, elbows, scalp, palms or soles. Psoriasis affect people in all age groups, equally male and female. It is controlled by the type of white blood cells - T cells, which protect the body against infections and disease. In Traditional Chinese Medicine (TCM) psoriasis is considered as a Blood heat disorder. The treated patient is a 43 years old woman with psoriasis manifested on the both feet (soles). The psoriasis was present more than 20 years, but the last year patient’s soles were in the worst condition. The patient was treated with acupuncture treatment, in our clinic for TCM and acupuncture. The positive outcome was achieved after 13 treatments. Treatments were done once weekly, indoor, with duration of 35-40 minutes. The aim of the treatment was to correct the Yin defect, therefore were treated points located on the meridians of Spleen, Liver, Kidney, Ren Mai and Ashi (trigger) points on the soles. Acupuncture as part of the TCM is very helpful treatment in treating psoriasis as it can reduce the inflammation, itching and pain and improve the overall health of the patient.


Introduction
Psoriasis is a chronic and inflammatory skin disease that result in red, thickened, flaky patches of skin, covered with whitish scales. [1] Psoriasis can occur anywhere on the body, but most commonly on the elbows, knees, soles, palms and scalp and may also affect the toenails, fingernails and soft tissues of the genitals. Psoriasis can causes significant physical discomfort, depression, social isolation and other personal issues. Patients with psoriasis may also have risk of psoriatic arthritis, hypertension, cardiovascular disease. [2] Currently, there is no Western medicine therapy available that has long lasting effect and it's safe, beyond immunosuppressant drugs. Western medicine offers corticosteroids, phototherapy, vitamin D analogs, retinoids, biologic immune modifying agens and other similar therapies in the treatment of psoriasis.  [5] The most common pattern seen in patients is Heat in the Blood. [6] The goal of the treatment is to find out the specific imbalance (the root) that causes psoriasis and treat it completely. [7]

Case Report
The treated patient is 43 years old women with psoriasis manifested on her feet (soles) for more the 20 years. Psoriasis was manifested with redness on the skin, plaques and occasionally itching. The patient has done 13 treatments once weekly and after every treatment she felt better and the results were obviously good and satisfying. During the treatment the patient wasn't taking any tablets. The patient is also sports active person. The treatments started on 7 th February, 2017 and until 16 th of May, 2017 were done 12 treatments. The 13 th treatment was made after 3 weeks on 26 th of July, 2017. Acupuncture treatments were done in a clinic for TCM and acupuncture in Skopje, by a doctor specialist in acupuncture. During the treatments were used fine, sterile, disposable acupuncture needles size 0.25 x 25mm produced by Wuijuiang City Medical & Health Material. The aim of the treatment was to correct the Yin defect, therefore were treated points located on the meridians of Spleen, Liver, Kidney, Ren Mai and Ashi (trigger) points on the soles.

Discussion
The treated patient in the beginning of the treatments had typically pale red lesions and yellow scales which were thicker. In the beginning of the treatment there was no particularly significant progress in the condition. The improvement was slow, gradual and steady, which resulted with positive outcome and great results.
Skin is the largest organ on the body and also the most visible and defenseless organ. According to TCM the main sources behind skin disorders are believed to be heat and dampness. The term heat refers to distress in the body. The dampness in the body can be caused by insufficient flushing of waste and toxins from the body, water retention and moist environment. [8] Psoriasis may also be caused by spleen and digestive system deficiency which can't supply enough nutrition to the lungs and prevent the normal work of the liver. [9] Psoriasis is chronic disease on the skin from autoimmune nature. This diseases are group of disorders in which the immune system attacks the body and destroys its tissues. According to TCM (Traditional Chinese medicine) autoimmune disorder appears when there is some imbalance in the body, which comes from deficiency of Yin and Yang that disrupts the flow of Qi energy through the body. Acupuncture as a treatment is used with aim to help the body restore the balance and to treat the root cause of the disorder. Acupuncture can cause physical response in the nerve cells, the pituitary gland and other parts of the brain. Acupuncture also affects the body temperature, the blood pressure and the immune system. [10]

Conclusion
Acupuncture as part of the TCM is very helpful treatment in treating psoriasis as it can reduce the inflammation, itching and pain and improve the overall health of the patient.