PSORIASIS: HOW TO MAKE A HAND DIAGNOSIS VIA 'MULTI-PERSPECTIVE PALM READING'!
How to make a Palm Reading Assessment for PSORIASIS?
Key-elements of the hand in Psoriasis in a nutshell: multiple skin problems (scales or plagues are typical), often featured with multiple nail abnormalities (nail pitting + onycholysis are most common).
[Phantom picture for Psoriasis will become available soon]
An advanced hand diagnosis for Psoriasis requires a person to have multiple significant hand markers that follow the MAJOR REQUIREMENT + the additional requirements described below:
MAJOR REQUIREMENT: The person requires to have significant hand markers for Psoriasis that relate to SKIN QUALITY (= hand perspective 6) + one of the other dimensions of the hand
- ADDITIONAL REQUIREMENT A: The person requires to have at least 3 hand markers that relate to SKIN QUALITY (= hand perspective 6)
- ADDITIONAL REQUIREMENT B: The person requires to have at least 2 hand markers that relate to FINGERNAILS (= hand perspective 2), MOTORICS (= hand perspective 7), or FINGER MORPHOLOGY (= hand perspective 3).
- ADDITIONAL REQUIREMENT C: The person requires to have at least one hand marker in the palm (or back of the hand) + at least one hand marker in the fingers.
(More specifications will follow soon)
IMPORTANT: Even when all above REQUIREMENTS are fullfilled, then one can speak of a 'confirmed' hand diagnosis for Psoriasis - NOTICE: most cases of psoriasis are diagnosed clinically!
Some of the 24 significant hand markers for Psoriasis that are listed below became known in medical science as a 'physical minor anomaly' (such as the simian crease).
But in general most of these individual hand markers can usually be described as harmless body characteristics - except for the markers described for perspectives 2, 6 and 7.
- List of 24 hand markers for Psoriasis -
• Hand perspective 1 - HAND SHAPE:
- (No elements identified yet)
• Hand perspective 2 - FINGERNAILS:
- Nail pitting: 20 pits in one person is typical (more than 60 pits per person is unlikely to be found in the absence of psoriasis);
- White color due to air bubble/detachment from nail bed (onycholysis);
- Horizontal ridging;
- Horizontal transverse lines (Beau lines);
- Nail deformation: nail plate weakening, crumbling (onychodystrophy);
- Discoloration: yellow, yellow brownish (oil drop), salmon patch;
- Red spots in lunula;
- Splinter hemorrhages;
- Thickening of the nail plate due to fast nail growth;
- Thickening of the hyponychium (subungual hyperkeratosis);
- Fungal infection (onychomycosis);
- Nail fold infection (paronychia).
• Hand perspective 3 - FINGER MORPHOLOGY:
- Sausage finger: inflammation of entire digit (dactylitis).
• Hand perspective 4 - MAJOR LINES:
- Simian crease.
• Hand perspective 5 - DERMATOGLYPHICS:
- (No elements identified yet)
• Hand perspective 6 - SKIN QUALITY:
- Thickened skin;
- Red skin;
- Skin scales;
- Skin plagues: skin scales larger than 1 cm in diameter - typically manifesting on bony areas, or in the palm (Psoriasis Vulgaris);
- Punctate bleeding spots below skin scales (Auspitz's Sign);
- Formation of skin scales around injured skin (Koebner Phenomenon);
- Blisters surrounded by red skin (Pustular Psoriasis);
- Tripe palms (acanthosis palmaris).
• Hand perspective 7 - MOTORICS:
- Pain due to nail changes: resulting in restrictions during daily activities;
- Problems related to the distal interphalangeal joints.
NOTICE: About 1% to 3% of the world population has psoriasis.
THE FAMOUS 'SIMIAN LINE' (SINGLE PALMAR CREASE) IS ONLY A MINOR KEY-ELEMENT FOR THE HAND IN PSORIASIS
Hand Diagnostics: the Simian Line & Psoriasis!
Various studies around the world have proven that the simian line is more often seen among diabetics than in the general population (about 3% of the healthy population has a simian line in at least one hand).
This implicates that the simian line is much more important in the genetic syndromes (e.g. Down syndrome & Fragile-X syndrome) than it is in psoriasis.
Therefore a simian line can only play a role in a hand diagnosis for Psoriasis if multiple significant hand markers are seen in two other perspectives (MOTORICS + FINGERNAILS).
This raises the question: 'how can the simian line serve as a diagnostic marker specific for Psoriasis?'
'Phantom picture' of the hand in Psoriasis.
NOTICE: Later the author will present a comprehensive 'phantom picture' for the most typical hand-characteristics in Psoriasis.
HAND SIGNS & DIAGNOSTICS:
