Psoriasis is a chronic dermatosis characterised by an unpredictable course of remissionn & relapse. It is an non-infectious skin disaease chracterised by scaly, silvery patches mainly on the scalp and extensior surface of the body. Its exact cause is unkown. In ayurveda, it is closely resembles with ekakushta. The features of ekakushta explains in ayurveda classics resembles with the symptoms of psoriasis. Psoriasis is the challenge for modern science. There is no definite treatment for psoriasis in modern science till today. The drug available in the market use to treat psoriasis are not very effective and have local and systemic effects.

In ayurveda, vata pitta and kapha dosha is the main contributory factor for the disease. Due to vitiation of three dosha, the disease manifest and main line of treatment for psoriasis is panchkarma and internal medicine. It is considering the best approach for skin disorder in ayurveda. A case report of 42-year old male, presented with well demarcated red scaly, silvery patches mainly on both legs, hands, scalp, chest and back with itching, and also nail and joint involvement has been presented in this article.

Etiology of Psoriasis: 

Unknown but many factors have been associated-

Genetic: may be autosomal dominant

Triggers: physical trauma ,infection and drugs.

Biochemical change: like increase level of arachidonic acid and Cgmp.

Immunological factors: helper T cells PLAY A KEY ROLE.

Epidemiology: 

Roughly, 1% of population is affected. Can occur at any age and affected both sex. Most patients as worse in winters.around 7 million people are affected in developed country.

Histopathogenesis:

Increased epidermal cell proliferation.

Retention of nuclei in stratum corneum.

Proliferation of fibroblast.

Dilated and tortous capillary loops.

Shortened epidermal turnover time from normal of 60 to 10 days.

Clinical features: Usually chronic indolent lesions which persist for month. Lesions are mildly papule or plaque.erthematous plaque lesions with characteristic slivery, large, loose scales. The patients of psoriasis may also suffer from depression and low self-esteem.

In a patients with psoriasis always check for nail and joint involvement.

Nail: 10 to 15% of the patients have nail involvement. Pitting, nail plate thickening, subungual debris, discolouration of nail plate and oil spot seen in the nails.

Joints: 10% patients have joint involvement.

Sites: Scalp, pressor points & extensor. Sometimes generalised.

Chronic recurrent psoriasis is difficult to treat. Modern science treat with PUVA and corticosteroids but these drugs having local and systemic side effects like liver and kidney failure etc. So, it is the time to find out the effective and safe treatment for Psoriasis. Medicines which are used in ayurveda are safe and practised since many years. A huge numbers of drugs are prescribed in ayurveda for the treatment of kushta.

Case details: A 42-year old male patient, hindu brahman by religion, presented on 10 april 2016 with well demarcated raised red scaly, silvery patches on chest, back and both legs and hands. He complained of itching all over the body and on scraping, white powder like substances fall down and leaves a bleedy surface. On history, patients had complaints since 20 years and diagnosis of psoriasis by allopathic physician. Since 20 years he has been taking allopathy and homoepathy patients from various practioners of U.P and delhi. He is brahman and lives in well known temple of delhi and visit homes of peoples for religious ceremony. He is afraid that if the disease is spreading continously, then he is unable to work as priest because people neglect him due to disease. The disease is spreading all over his body and also involves nail and joint. Destruction of nail plates of hand and legs was also developed. For this, patients took allopathic treatment for such a long time but do not get relief.

The patients visit our clinic for the first time. He told use that his problem not solves since 20 years and spreading continuously. So, he is unable to trust us. So, we first give him counselling because reassurance and emotional support are invaluable. Physical and mental rest enhance the effects of the treatment. It is also important to tell him that the disease is not contagious and is benign.

SYMPTOMS OF THE PATIENTS :

Itching all over body

Silvery patches, especially, on legs ,chest ,back but now spreading in his hand and scalp.

Destruction on nail plates

Swelling and pain in left middle fingers and flexor deformity in proximal interphalangeal joint

Swelling in right middle metatarso phangeal joint and pain

Some blood test of the patients were done like CBC, LFT, KFT, SR, URIC ACID to assess outcome.

His general health was good and both physical and all blood test were within the normal limts.we advise patients for panchkarma and oral medication but patients refuse for panchkarma so we start his oral or internal medication. 

Investigation Done :

CBC(Complete Blood Count)

LFT(Liver Function Test)

KFT(Kidney function Test)

Sr. Uric Acid

Investigation was done to rule out any other pathology. Investigation were within normal limit.

Internal Medication :

Medication are given into two phase. In First Phase, we are given panchsakara churna - one spoon two times daily for anulomana and pachan, Panchnimba churna- one spoon two times daily with luke water, panchtikta ghrita gugulu - two tab two times daily, and one oil for local application containing jyotishmati,bakuchi, and chakramad for five days. We told patient to apply the oil firstly only on legs for 5 days. Patient taking the same for 5 days and come on 5th day, we see the fabulous result, the rashes which are developed within 4 to 5 months just disappear and other rashes are also subsiding.

After 5 days, in second phase, we continue the same treatment and also added haridra khand - one spoon two times daily, gugulu tiktam kashaya - three spoon two times daily (one hour before food for 15 days). The patient came back on 20th day, with great result, the rashes were almost 60 % subsiding and pain and swelling in finger and ankle also reduce to great extent. Now, patient is not taking any pain killer for pain. Patient also get improvement in nails of legs.

We prescribe the same medicine for one month that time and ask him to do some physiotherapy additional for finger deformity. After that patient came with 70 to 75 % relief in symptoms and patients also tell that during the treatment, he will not develop any additional rashes.

During the treatment, we also told the patients to follow some dietary changes and live according to the rules of Ayurveda.

Result: Psoriasis is a disease with unkown etiology and triggered by many factors. In modern science, treatment of psoriasis is a challenge. They do not have any safe and proper medicine for psoriasis. But, ayurveda treatment gives satisfactory results as well as the quality life to the patients. Ayurveda removes toxin out of the body and corrects the formation of aama. Ayurveda gives the prevention as well as the treatment. So, by following the dietary and lifestyle change we prevent the reoccurrence of the disease.

Ayurveda For Psoriasis 

Do you know that enlarged breasts, which are observed in many men are caused because of a health condition? This is known as gynecomastia and involves enlargement of the breast tissues in men. The condition is commonly called man boobs. It is usually not something serious and is not always permanent.

Causes
During the puberty stage, gynecomastia is quite common and normal. It occurs because of natural changes in oestrogen and testosterone, the sex hormones. The condition is also likely in men of old and middle age because of ageing and hormonal shift. Certain medicines such as antibiotics, heart medicines, AIDS medicines, drugs for heartburn and anti-anxiety medicines may also be responsible for this condition. Drinking alcohol in excess and taking marijuana, and other recreational drugs also increase the chances of gynecomastia. Breast size may also get enhanced by the use of herbal products containing lavender oil and tea tree oil.

Symptoms
Men affected by gynecomastia are featured by having a rubbery mass underneath their nipple region. It is less in amount and is usually tender. Fluid discharge is also an indication in some cases.

Diagnosis
For the diagnosis of gynecomastia, you should visit a plastic surgeon, who deals with cases of hormone imbalances. Blood or hormone tests may be required if your physical examination shows that your breasts are larger than usual, the lymph nodes are swollen, or when the lump is sore.

Treatment
Commonly, gynecomastia can not be cured with medicines. Surgery is compulsory. In the case of teenagers, the breasts become of normal shape within two to three years. Surgery is the only option for restoring your chest shape and improving your self-image. In the surgery for treating gynecomastia, a small cut is made on your breasts and extra breast tissues are removed. This makes your breasts smaller and flatter. The nipple may also need to be repositioned. Liposuction is another procedure which is carried out for this purpose, in which extra fat is sucked out from under your skin. Among the different modes of treatment for gynecomastia, surgery is meant for long term results. However, you need to undertake a healthy lifestyle in order to maintain your new chest shape. Gaining weight and taking drugs may cause gynecomastia to reoccur.

Gynecomastia - What You Need To Know About It!

Depending on the way you look at it, a mole can be a beauty spot or a blemish. For most people, facial moles are undesired. Moles can be described as clusters of pigmented skin cells. They appear in the form of dark spots on the skin that vary in size, color and texture. Apart from the face, moles appear commonly on the arms and legs but can affect any part of the body. In most cases, moles are harmless but in some cases, they may turn precancerous and need to be removed. However, most moles are removed for only cosmetic reasons. Moles can be removed through home remedies, surgery or laser treatment.

Mole removal depends on the type, size and location of the mole. When treated with lasers, layers of the mole are removed one by one by evaporating the affected cells. This does not cause any sort of bleeding and does not disturb healthy tissues adjacent to the mole. It is also considered to be a largely pain-free procedure but you may feel a slight tingling sensation. After the laser procedure, a scab forms over the affected area which later falls off. You may also notice slight swelling and redness in the area for a few days after the procedure.

Laser treatment for mole removal has a number of advantages.

As it is a non-invasive procedure, there are minimal chances of infection
Multiple moles can be treated in a single session
Laser beams can reach parts of the face, nose and ears that may be difficult to reach through other procedures.
There are minimal disturbance and injury to the adjacent healthy tissues
Healing is much faster than with other procedures
There is a very low chance of scarring
However, one of the biggest disadvantages of laser therapy is that it can only be used to treat surface moles as the laser beam cannot penetrate deep into the skin. Also, laser treatment, if not recommended in cases where the mole may be considered precancerous as the laser beam will destroy the mole leaving nothing that can be used for a biopsy. Lasers are also seldom used to treat large moles or birthmarks. The cost of removing a mole with laser treatment depends on the size, location and number of moles. In some cases, more than one session may be required and this too could influence the cost of the procedure.

Moles - How Laser Treatment Can Help You Get Rid Of Them?

6 ways to minimize visible pores on your skin

Pores are openings in the skin through which your body's natural oil, called sebum, is released. They appear larger when they are clogged with dirt or oil, and are home to hair follicles. Dead skin cells and sebum which, put together, form a pimple can stretch out pores. Aging and exposure to the harmful UV rays of the sun also contribute to the appearance of pores on your skin. Pores can be controlled with the right skin care. 

Here's how:
1. Choose your skin care products wisely 
Zinc and magnesium help to maintain your skin's oil balance and clear pores. Products with softening ingredients like rosemary and lavender may soothe your skin and prevent pores from stretching out. You should use products with salicylic acid as an ingredient since it unclogs pores, exfoliating your skin. 

2. Maintain cleanliness
Washing your face temporarily stops your pores from holding extra oil or dirt. Exfoliating two to three times a week can also control the cropping up of pores on your skin. However, these are temporary methods because you will have large pores naturally if your skin is oily.

3. Applying sunscreen
Exposure to the harmful UV rays of the sun for too long can make your pores look bigger. Applying sunscreen on the face and on exposed areas of your skin with SPF 30 can minimize your pores. Also, wear a broad-brimmed hat and withdraw stepping out in the sun between 10 A. M. To 4 P. M.

4. Treating the spot
Oily skin tends to have larger and more noticeable pores. Some areas of your face may be oilier making the pores visible. A clay mask can be used for spot treating if the pores on your nose, cheeks or forehead are large. Apply a thin layer of the mask on your skin and rinse it off with water after a few minutes. The clay extracts the extra oil out of your clogged pores so that the skin looks sleek. Using blotting paper on your oily areas can also be effective. 

5. Maintain a proper diet
Avoid food that is oily and high in fat because unhealthy oil can agitate the skin leading to clogged pores. You should eat low-fat foods like fruits and vegetables instead of munching on chips, cookies and candies. 

6. Remove makeup before going to bed
One of the biggest blunders that you can do is to leave your makeup on and go to bed. Leaving makeup on clogs your pores, stretching them out over time. Even if you forget to wash off your makeup at the sink due to some reasons, make sure that you at least remove it with face wipes. 





6 Ways to Minimize Visible Pores on Your Skin

Men also suffer from breast enlargement, medically called gynecomastia. This usually happens when the levels of female sex hormones, in the affected male, overshadow the male sex hormone levels.

Gynecomastia is different from fat accumulation in the male upper chest. It is typically characterised by an increase in the glandular tissue, which can produce milk.

Lots of adolescent boys suffer from male breast enlargement due to the adolescent hormonal surge, though, the condition can present in men at any age. Adolescents lose the breast enlargement typically in periods ranging from 6 months to a year. Beyond this period, a man with enlarged breasts has to seek medical intervention for treatment.

Typically, gynecomastia occurs due to certain medications like for renal failure and hypertension. It can also be caused due to conditions like hyperthyroidism or kidney failure, liver cirrhosis or problems with testes which causes changes in hormones in the male body.

Treatments-

Whatever be the reason, gynecomastia is a deeply distressing condition for men of all ages. Treatments are available, both surgical and medicinal and they help especially surgery.

Male Breast Reduction Surgery- Facts

Surgery for male breast reduction can be performed safely and successfully on teenagers and adult men alike.

In male breast reduction surgery, the surgeon makes an incision around the nipple and removes the excess glandular tissue and fats causing the appearance of the breast. This is the only effective treatment for gynecomastia that has long-lasting, if not permanent, results. Male breasts may also appear due to excess fat in the upper chest. Liposuction is generally very effective in treating this. The surgeon removes fats and some glandular tissue and then sculpts a new chest contour that looks natural for your body.

More severe cases of gynecomastia may require more than this. The surgeon has to then go for something called  surgical tissue excision  to achieve optimal results. Older males with gynecomastia with sagging skin also require tissue excision. This technique allows the surgeon to remove a major chunk of glandular tissue and/or skin that cannot be successfully removed by mere liposuction.

If you are planning to go for breast reduction surgery, find the best cosmetic surgeon. This will go a long way in you getting the best results and minimise scars.

Also be prepared for the after-effects of the surgery. Even though it is typically performed as an outpatient procedure using general anaesthesia or local anaesthesia with sedation, you must be prepared for soreness and swelling. Recovery time is usually a week and a patient is often given a compression garment to wear for the first few weeks after surgery to support the healing breast tissue. Also, be prepared to be off exercise for a month or so after surgery.

Can Surgery Help Reduce Enlarged Breasts In Men?

The first thing anyone notices about you is your face and often people find themselves wishing for things like a slimmer nose, fuller lips etc. This is where facial cosmetic surgery comes in. Facial cosmetic surgery can address areas like your eyebrows, nose, cheeks, chin etc to give you the facial structure you've dreamed of.

Take a look at some of the common types of facial cosmetic procedures:

Brow lift: Frown lines and creases that develop across the forehead, between the eyes and over the nose bridge can be addressed through this procedure. This surgery is performed mainly to combat signs of aging and involves raising eye brows that may be sagging over the eyelid.
Eyelid surgery: Puffiness in the upper eye lids may be caused by excessive fat deposits. When combined with sagging skin, it can disturb the contours of the eye and in some cases cause vision problems. Blepharoplasty or eye lid surgery removes this excess skin and corrects fine lines, wrinkles and bags under the eyes.
Nose: A rhinoplasty is used to reconstruct the nose. The nasal skin is separated from the tissue and cartilage structure underneath which is then reshaped as desired and then sutured together again. Rhinoplasty is of two types; open rhinoplasty and closed rhinoplasty.
Ears: An octoplasty is a facial cosmetic surgery aimed at correcting protruding ears or large outer ears and correcting ear deformities such as a lop ear, cupped ear or shell ear and torn ear lobes. This surgery is usually performed on children between the ages of 4 to 14.
Chin: Surgery on your chin can reshape it to make it look smaller or bigger as desired. This can be done by reshaping the jaw bone or inserting an implant. In some cases the procedure may be combined with liposuction.
Forehead: Signs of aging on the forehead, frown lines or heavy brows triggered by stress and hereditary furrowed lines above the nose can be addressed with a forehead lift. This procedure is often performed along with a facelift or eyelid surgery.
Facelift: As we grow older, our skin loses its elasticity. This triggers the development of wrinkles and deepens creases along the nose and cheek. Facelifts address these signs of aging by tightening skin and strengthening the muscles beneath it. Facial cosmetic surgery can also be used to correct congenital defects such as cleft lips and to treat scars.
Surgery to repair a cleft lip or cleft palate not only enhances appearances but also enhances the quality of life by improving functionality. Scar revision surgery involves the injecting or application of steroid medication to lighten the scar and make it less obvious. To treat burns that leave behind prominent scars, a procedure called Z plasty may be used.

Facial Cosmetic Surgery - Which Type is Suitable for You?

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