Psoriasis Treatment
Ancient history: Lepra, psora, psoriasis
The roots of the identification of psoriasis lie in Ancient Greece. The Greeks, who pioneered the field of medicine, divided skin disease into the categories of psora, lepra and leichen [2]. Psora referred to itch, while lepra was derived from the Greek words lopos (the epidermis) and lepo (to scale) . Hippocrates (460–377 BC) was one of the first authors to write descriptions of skin disorders. He utilized the word lopoi to describe the dry, scaly, disfiguring
eruptions of psoriasis, leprosy, and other inflammatory skin disorders.
Similar to Hippocrates’ works, the Old Testament also lumped together many cutaneous disorders. The biblical term tsaraat, or zaraath, described a range of skin conditions including leprosy and psoriasis. Lepers were often ostracized because they were considered divinely punished, and cruelty was imposed upon those who suffered from psoriasis and leprosy alike.
Many historians credit the Roman thinker Celsus (ca. 25 BC–45 AD) with the first clinical description of papulosquamous diseases. Celsus described impetigines and specified that the second species of impetigo was characterized by red skin covered with scales. This description suggested a type of papulosquamous disease, such as psoriasis.
Galen (133–200 AD) first utilized the term psoriasis, but his description was not consistent with the disorder that we now call psoriasis. He described psoriasis as a pruritic, scaly skin disease of the eyelids and scrotum. Although he used the term psoriasis, his description is now believed to most likely represent seborrheic dermatitis. Indiscriminate grouping together of all inflammatory skin diseases led to stigmatization of patients with psoriasis. For centuries, patients with psoriasis received the same cruel handling as lepers. They were required to carry a bell or clapper to announce their approach, and had to wear a special dress. In addition, they could only touch or dine with others considered lepers. In 1313,
Phillip the Fair of France ordered that they be burned at the stake.
Distinguishing psoriasis as a distinct entity
In 1809,Willan built on Celsus’s description of papulosquamous conditions by detailing features of what we now know as psoriasis. However, he described modern psoriasis under the term lepra vulgaris, which perpetuated confusion of psoriasis and leprosy. Lepra vulgaris was described as enlarging, sharply marginated erythematous plaques with silvery-white scale that occurred most frequently on the knees, and were associated with nail pitting.
For decades after Willan’s description, some authors favored using the term psoriasis , while others chose the term lepra. Physicians lacked clarity regarding the word psoriasis and the ability to distinguish psoriasis from diseases with similar cutaneous manifestations.
Finally, Gibert and Hebra matched Willan’s description with the term psoriasis, ending much confusion. Psoriasis was now finally acknowledged as a distinct disease, leading to improved perception of psoriatic patients.
In his books, Gibert (1797–1866) used the term psoriasis, recognized secondary syphilis as a contagious entity, and established pityriasis rosea as a clinical syndrome. Gibert’s pivotal publications included thorough accounts that made important distinctions between papulosquamous diseases. In 1841, shortly after Gibert’s works, Hebra further distinguished the clinical picture of psoriasis from that of leprosy. Only 165 years ago, this differentiation
set the stage for psoriatic patient’s freedom from extreme persecution. The distinctions made by Gibert and Hebra were essential to accurately diagnosing patients and developing tailored therapies.
Psoriasis Treatment
Ancient history: Lepra, psora, psoriasis
The roots of the identification of psoriasis lie in Ancient Greece. The Greeks, who pioneered the field of medicine, divided skin disease into the categories of psora, lepra and leichen [2]. Psora referred to itch, while lepra was derived from the Greek words lopos (the epidermis) and lepo (to scale) . Hippocrates (460–377 BC) was one of the first authors to write descriptions of skin disorders. He utilized the word lopoi to describe the dry, scaly, disfiguring
eruptions of psoriasis, leprosy, and other inflammatory skin disorders.
Similar to Hippocrates’ works, the Old Testament also lumped together many cutaneous disorders. The biblical term tsaraat, or zaraath, described a range of skin conditions including leprosy and psoriasis. Lepers were often ostracized because they were considered divinely punished, and cruelty was imposed upon those who suffered from psoriasis and leprosy alike.
Many historians credit the Roman thinker Celsus (ca. 25 BC–45 AD) with the first clinical description of papulosquamous diseases. Celsus described impetigines and specified that the second species of impetigo was characterized by red skin covered with scales. This description suggested a type of papulosquamous disease, such as psoriasis.
Galen (133–200 AD) first utilized the term psoriasis, but his description was not consistent with the disorder that we now call psoriasis. He described psoriasis as a pruritic, scaly skin disease of the eyelids and scrotum. Although he used the term psoriasis, his description is now believed to most likely represent seborrheic dermatitis. Indiscriminate grouping together of all inflammatory skin diseases led to stigmatization of patients with psoriasis. For centuries, patients with psoriasis received the same cruel handling as lepers. They were required to carry a bell or clapper to announce their approach, and had to wear a special dress. In addition, they could only touch or dine with others considered lepers. In 1313,
Phillip the Fair of France ordered that they be burned at the stake.
Distinguishing psoriasis as a distinct entity
In 1809,Willan built on Celsus’s description of papulosquamous conditions by detailing features of what we now know as psoriasis. However, he described modern psoriasis under the term lepra vulgaris, which perpetuated confusion of psoriasis and leprosy. Lepra vulgaris was described as enlarging, sharply marginated erythematous plaques with silvery-white scale that occurred most frequently on the knees, and were associated with nail pitting.
For decades after Willan’s description, some authors favored using the term psoriasis , while others chose the term lepra. Physicians lacked clarity regarding the word psoriasis and the ability to distinguish psoriasis from diseases with similar cutaneous manifestations.
Finally, Gibert and Hebra matched Willan’s description with the term psoriasis, ending much confusion. Psoriasis was now finally acknowledged as a distinct disease, leading to improved perception of psoriatic patients.
In his books, Gibert (1797–1866) used the term psoriasis, recognized secondary syphilis as a contagious entity, and established pityriasis rosea as a clinical syndrome. Gibert’s pivotal publications included thorough accounts that made important distinctions between papulosquamous diseases. In 1841, shortly after Gibert’s works, Hebra further distinguished the clinical picture of psoriasis from that of leprosy. Only 165 years ago, this differentiation
set the stage for psoriatic patient’s freedom from extreme persecution. The distinctions made by Gibert and Hebra were essential to accurately diagnosing patients and developing tailored therapies.
Psoriasis Treatment
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