A case study of pruritic eczema treated by relaxation and imagery

Treatment of Psoriasis: A Comprehensive Review of Entire Therapies

Background:

Psoriasis is an autoimmune disease that ingeminates itself with the repeated proliferation of keratinocytes. It globally strikes a 2-5 % population on an average. Management of psoriasis remains a daunting task with various challenges influencing treatment, such as patient conformity and adherence to therapy, delicate patient profiles, psychological aspects, and skin as a barrier to topical delivery. The first part reviewed pathophysiology, triggering factors, and clinical classification. The second part reviewed all the therapies, such as topical, oral, biological, parenteral therapy, phototherapy, and the phyto-pharmaceuticals.

Methods:

The research data related to the existing and upcoming therapies for psoriasis treatment, several nanocarriers, existing marketed formulations, and detailed description of phytopharmaceuticals with their mechanism.

Results:

Topical therapy is the mainstay treatment option with limited adverse effects. Biological therapy has reformed conventional psoriasis treatment by being more efficacious and has increased patient acceptance due to decreased adverse events. Nanoformulations present an edge over conventional therapy due to improved anti-psoriatic effect and decreased side effects. Phyto-pharmaceuticals act as a complementary and alternative therapy for diminishing psoriasis symptoms.

Conclusion:

A rationalized cost-effective patient compliant therapy is required for effective management and complete cure of psoriasis.

Mindfulness-Based Cognitive Hypnotherapy and Skin Disorders

Mindfulness-based cognitive hypnotherapy integrates mindfulness, cognitive-behavioral therapy, and hypnotherapy to improve physical, emotional, mental, and/or spiritual aspects of skin disorders. Meditation, including mindfulness meditation, and hypnosis both utilize trance phenomena to help produce focalization and specific improvements in skin disorders through psycho-neuro-endocrine-immunologic mechanisms. Hypnosis, cognitive hypnotherapy, focused meditation, and mindfulness meditation are discussed with respect to improving various skin disorders including acne, acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythema nodosum, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, prurigo nodularis, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Their integration into mindfulness-based cognitive hypnotherapy is then discussed and illustrated with improvement in a patient with systemic lupus erythematosus.

Efficacy of Imagery and Meditation Techniques in Treating Psoriasis

Using a dismantled time-series design, eighteen subjects were randomly assigned to three groups: meditation ( N = 5); meditation and imagery ( N = 4); waiting list ( N = 5). Treatment lasted twelve weeks, while pre- and post-baseline periods were of four weeks. An assessment control group control was also used during baseline periods ( N = 4). The severity of psoriasis symptoms was reliably rated by dermatologists. While controlling for extraneous factors influencing psoriasis symptoms, a time-series multivariate regression analysis revealed a significant difference between the mean psoriasis ratings of treatment and control groups after treatment (partial r = .30, p < .01). No additional impact was associated with the use of the imagery technique (partial r = − .06, p > .05). Four subjects in the treatment groups, two in each condition, succeeded in clinically improving their psoriasis symptoms, and none deteriorated. The practice of mediation may be clinically effective for some patients in reducing their psoriasis symptoms.

Metaphergeleitete Hypnotherapie im Vergleich zur Imaginationstherapie

Zusammenfassung. Theoretischer Hintergrund: Juckreiz (Juckreizwahrnehmung, Kratzverhalten) und die daraus resultierenden Konsequenzen (negatives Wohlbefinden, negative Kognitionen) gehören zum Determinationskomplex des atopischen Ekzems. Mittels Imaginationstherapie und Hypnotherapie kann die Symptomatik positiv beeinflusst werden, weil sowohl diese als auch die Behandlungsmethoden in sensu fokussiert sind. Fragestellung: Unter Bezugnahme auf die Theorie der biologischen Informationsverarbeitung emotionaler Vorstellungen sensu Lang (1979) wird vermutet, dass metaphergeleitete Hypnotherapie und Imaginationstherapie unterschiedlich wirken. Methode: n = 30 Patn; unabhängige Variable: 2 Behandlungsbedingungen, 28 Tage Behandlungsdauer; davon 7 Tage Erstellung einer Baseline. Die Patn bekamen pro Woche eine Tonkassette zum täglichen Hören mit nach Hause. Abhängige Variable waren 5 Tagebuchparameter. Die Daten wurden einzelfallanalytisch und metaanalytisch ausgewertet. Ergebnisse: Sowohl im Hinblick auf die Behandlungseffekte als auch auf die Geschwindigkeit der Zielerreichung zeigt sich eine leichte Überlegenheit der metaphergeleiteten Hypnotherapie. Schlussfolgerungen: Dies wird mit der größeren Verfügbarkeit von Reaktions-Propositionen der therapeutischen Scripte als auch mit der größeren Breite von Verfügbarkeits-Repräsentationen in Verbindung gebracht.

The efficacy of hypnosis in the treatment of pruritus in people with HIV/AIDS: a time-series analysis

Pruritus, or generalized itch, is a source of serious discomfort and distress in a significant minority of people living with AIDS. Anecdotal reports suggest hypnosis might be a useful treatment, leading to reductions in distress and improvements in the condition. But empirical examination of the question is notably lacking. This time-series study reports results of a 6-session self-hypnosis treatment (relaxation, deepening, imagery, and home practice) for 3 HIV-positive men suffering from pruritus, related to disease progression and/or HIV medications. Posttreatment, all 3 patients reported significant reductions in daily itch severity and extent of sleep disturbance due to itch. One patient also evidenced significantly less itch distress. Another also experienced significantly less time bothered by itch. For the 2 patients on which 4-month follow-up data were available, treatment benefit across variables was stable or further improved.

Hypnosis in a case of long-standing idiopathic itch

OBJECTIVE

This article presents the results of a brief hypnosis treatment of a woman with chronic, idiopathic vaginal and anal itch.

METHODS

The patient was referred after 3 years of unsuccessful outcomes with standard topical and oral treatments prescribed by her family physician and three dermatologists. Treatment consisted of five sessions of self-hypnosis training in techniques of relaxation, deepening, and imagery, and home practice with an individualized instructional tape.

RESULTS

After treatment, the patient reported substantial tissue healing, confirmed by her treating physician, that coincided with significant reductions in her scores of itch intensity, itch-related sleep disruption, and distress from pre- to posttreatment. These improvements continued at 4 months of follow-up, and the patient reported complete resolution of physical symptoms.

CONCLUSIONS

The fact that these changes coincided with only minor improvements in general anxiety scores suggests that the resolution of the patient's itch condition was treatment-specific rather than the result of methodological artifact, participant reporting bias, or a general sense of feeling better. These findings suggest that hypnosis is a cost-effective treatment for idiopathic itch conditions, especially those that are unresponsive to standard medical treatments.

Hypnotherapy as a treatment for atopic dermatitis in adults and children

Eighteen adults with extensive atopic dermatitis, resistant to conventional treatment, were treated by hypnotherapy, with statistically significant benefit (P < 0.01) measured both subjectively and objectively, which was maintained at up to 2 years where results were available. Twenty children with severe, resistant atopic dermatitis were treated by hypnosis. All but one showed immediate improvement, which was maintained at the following two clinic appointments. In 12 children, replies to a questionnaire at up to 18 months after treatment, showed that 10 had maintained improvement in itching and scratching, nine in sleep disturbance, and seven maintained improvement in itching and scratching, nine in sleep disturbance, and seven maintained improvement in mood.

Relaxation therapies in the treatment of psoriasis and possible pathophysiologic mechanisms

Psychologic factors play a role in many dermatologic disorders, giving rise to the possible use of psychotherapeutic modalities in treatment. Regarding psoriasis, emotional factors have a strong correlation with onset and flare-ups. The psychophysiologic mechanisms involved are not known; however, stress and its effect on the autonomic nervous system and the immune system may play a significant role in the onset and course of psoriasis. Relaxation and mere suggestion also affect the autonomic nervous system and the immune system and therefore may affect the course of the skin disorder. A few case studies have documented successful treatment of psoriasis with hypnosis and biofeedback. Further study of this process is needed, and the role of stress in dermatologic diseases must always be given consideration.