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 

Burn surgery is very common these days. Burn surgery is usually done on people who suffer from major burns. Reconstructive burn surgery is usually required in the last stages when the initial burns have healed to a certain extent. Usually reconstructive burn surgeries are done on patients who have suffered from huge accidents and have burnt their face, neck and hands to a great extent. Patients requiring this surgery usually become unrecognizable after an accident.

When is reconstructive burn surgery recommended?

If you have been involved in a household accident and the scars have not healed completely. Surgery might not totally heal the face, but it can improve your basic functions like breathing, smelling, seeing or tasting (if most of your senses are burnt and disfigured).
Reconstructive burn surgery is also very useful for acid attack victims. Sometimes, burns are not only caused by fire, but it is also caused by chemicals and acidic substances which are worse and can completely burn and disfigure your face. When hydrochloric acid, nitric acid and sulfuric acid come in contact with your skin it seeps into the skin and burns off your nose, cartilage and sometimes even causes blindness. It disfigures your face completely, reconstructive burn surgery can do miracles, though it cannot bring back your previous features and skin texture, but it does make you look more recognizable.
After a burn, facial scarring occurs which leads to the loss of eyelids, hair, nose and lips. In this case burn surgery is required.
How to take care of yourself after a burn surgery?

Regular stretching should be done, especially if the areas of your burn include your hands, legs, joints, etc. Do as much as activities as possible like getting dressed and grooming yourself. It will also make you more self-reliant and give you confidence.
Depression is very common after a burn surgery. A reconstructive burn surgery will not magically make you look the way you used to. A lot of sittings is required and remember, appearance and looks do not matter much. The wounds will fade away with time.
Itching is also very common after a burn surgery. If this problem persists, you should consult your doctor for a moisturizer.
Avoid sun exposure. Don t go out in the sun, because the U.V rays are extremely harmful and can singe your already sensitive skin; you can also get skin cancer.
Custom pressure garments should be worn to protect your skin.

Reconstructive Burn Surgery - How Can You Take Care Of It?

Schnitzler s syndrome is a very rare condition described by a reddish rash that looks like hives (urticaria) and lifted levels of a particular protein in the blood (monoclonal IgM gammopathy). Symptoms connected with the Schnitzler disorder may include increased levels of fever, joint inflammation, joint pain (arthralgia), bone agony, and different discoveries, for example, swollen lymph nodes (lymphadenopathy). It also causes weight reduction, discomfort, exhaustion, and broadened spleen and liver. This condition should be treated in terms of taking care of the symptoms so that they do not become debilitating.

Some of the other symptoms include the following:

Urticaria (hives) depicts red raised patches of the skin. These are once in a while irritated. They may last for about 12 hours to 3 days. This may become severely painful if not treated in time.
80% of such patients suffer from painful or swollen. A few patients experience bone pain as well.
High fever might be there accompanied by chills and night sweating. This can give rise to further uneasiness and is usually caused when the immune system is attacked by the ailment.
One of the main symptoms of the Schnitzler disorder is monoclonal gammopathy. This mostly means a raised level of immunoglobulin M (IgM)
Reasons behind it

The main cause behind the Schnitzler syndrome is unknown. Specialists believe that particular parts of the immune system may not work appropriately in the end because of the Schnitzler syndrome. Individuals with the Schnitzler disorder additionally have monoclonal IgM gammopathy, in which abnormal production of immunoglobins result in elevated levels of immunoglobulin M (IgM) in the body. Immunoglobulins are proteins delivered by the white blood cells. A few analysts believe that IgM antibodies accumulate in the skin (epidermis), setting off a reaction that causes the rash. At the time of diagnosis, IgM levels may just be somewhat raised and may stay stable for quite a long time.

Diagnosis

The diagnosis of the Schnitzler disorder is based upon an intensive clinical assessment, patient history, rejection of different other disorders and proof of fever, joint pain or aggravation, bone pain, discernible lymph nodes, amplification of the liver or spleen, lifted quantities of white platelets (leukocytosis), raised red platelet (erythrocyte) or anomalies, which can uncover expanded bone thickness (osteosclerosis).

Treatment: 
Anakinra is a successful treatment for Schnitzler syndrome. It is also very commonly used to treat rheumatoid joint inflammation. The following medicines and therapies have been proven to be successful for treating the Schnitzler disorder over a period of time. These are as follows:

Antihistamines
Nonsteroidal calming specialists
Systemic steroids (prednisone)
Hydroxychloroquine
Colchicine
Dapsone
Pamidronate
Thalidomide
Pefloxacin
Phototherapy
Immunosuppressive specialists (ciclosporin, methotrexate, cycloposphamide)
Biologic specialists (tocilizumab, rituximab)
The Schnitzler disorder is a long-term infection, so stopping a promising treatment can tend to cause a relapse and may cause the disease to reappear. Also, the medicines mentioned above should not be taken without consulting a doctor as they can have sever side effects, if not administered under the guidance of a physician.

Schnitzler Syndrome - Things You Must Know About It!

One of the most important functions of the skin is protection. During this process, it comes in contact with various substances including chemicals, pollen, dust, and other pollutants. While it does protect the overall body from all these, there is some damage that is inevitably done to the skin through these exposures. Different skin and different bodies react differently to these, and while some may have no reaction, others develop allergies. This is also defined by how strong the person s immunity is.

Hives is one of the most common skin allergy responses. While it is not easy to pinpoint what causes the allergy or the hives, the causative agent can be nailed by observing patterns and excluding out some of the causative agents. There are a set of regular household and surrounding items that could lead to urticaria, and working around these can help pin down the source.

Origin: When the body encounters a foreign body, it produces what are known as histamines. When they are produced, the plasma in the cell leaks out, producing a red and swollen appearance. Hives are red, itchy, raised patches on the skin. They are seen in about 20% of the population. Hives are usually allergic in nature, implying that they occur when there is a foreign substance that induces an allergic reaction. Hives can appear either due to coming in touch with some substance or due to eating some allergy-inducing substance.

Hives can be acute or chronic. Acute is when the hives appear in response to an allergic reaction. These usually disappear in a matter of days to a week at the maximum. In some people, they could be chronic and can last for months together.

Treatment: Given that they are allergic in nature, managing hives includes a combination of immediate treatment as well as preventive measures. While most are topically managed, others might require systemic intervention also.

Once the hives have developed, the following can help in the relief of symptoms and prevent from spreading further. The redness and swelling will take some time to disappear.

Avoid tight-fitting clothes
Use cool compresses on the hives
Avoid warm or hot shower
Stay in a cooler room
Avoid itching the hives
Use topical moisturizer to prevent dryness
Use topical steroid cream to manage the inflammation
Take a systemic antihistamine or an injection of epinephrine if required.
While these help in managing the hives which have occurred, preventing is via the following.

Avoid the source once identified
If the source is not yet known, record when the hives are occurring
Manage stress and see hives appear much less
Increase moisturizer use
Keep an antihistamine handy so you can take it immediately in case of suspected hives. 

Urticaria (Hives) - The Best Way It Can Be Treated!

Eczema is a skin condition that is accompanied by itchy rashes on the skin. They often bleed and give out a foul smell. Eczema usually develops during one's childhood. There are allopath medicines available to treat this condition but their action is only short-lived. These medicines provide temporary relief but fail to cure the ailment completely. However, homeopathic medicines can help an affected person recover completely owing to their ability to work at the core. Today we are going to discuss about some of the components that homeopathic medicines use to treat eczema.

Some of the homeopathic supplements use carbon or black lead to treat eczema. Eczema often tends to develop around warm and moist areas like the folds of the elbows, behind the ears, between the toes, behind the knees. Black carbon is a primary aerosol which contains cooling agents. Homeopathy remedies make use of this quality of black carbon to heal eczema.
Eczema undoubtedly develops in areas that mostly receive less air. However, the condition can be aggravated during the winters and cause more irritation. There are homeopathic supplements that make use of a fluid extracted from the vesicle (a component of the cell) of a person affected by scabies to treat eczema. Scabies is another skin condition that occurs when the scabies mites eat into the skin and lay eggs there. This is a condition that is somewhat similar to eczema in that it leads to skin irritation and itchiness.
Petroleum extract is another homeopathic remedy to treat eczema. The medicine made from petroleum works in a similar manner as Vaseline. As has been aforementioned eczema worsens during the winter as the skin gets chapped and incessant scratching leaves lesions on the skin. The homeopathic drug controls this situation by keeping the skin moisturized.
According to the University of Michigan Health System, sulfur is a very important mineral that takes care of the connective tissues, bones, teeth, hair as well as the skin. Therefore homeopathic medicines use sulfur which acts as a sure-fire component when it comes to treating eczema.
Poison Ivy is a component that is used to treat skin conditions. The homeopathic drug made from the extract of the poison ivy plant especially treats eczema that develops on the face, scalp and around the mucous membranes. Severe eczema can also result in stiff joints. The medicine works to heal a person from such botheration.
This is an article that aims at making you acquainted with the homeopathic remedies available for treating eczema. For the best result consult a professional.

Role of Homeopathy in Treating Eczema!

Rosacea, a common skin condition, occurs due to a combination of environmental and genetic factors. This condition causes your skin to become red, and produces red, pus-filled small bumps on the skin.

Rosacea can occur in 4 forms-

Erythematotelangiectatic Rosacea- related to facial redness, visible blood vessels and flushing
Papulopustular Rosacea- related to acne-like breakouts
Rhinophyma- leads to thickening of the skin on the nose
Ocular Rosacea- affects the area surrounding your eyes
Rosacea is most commonly observed in middle-aged women with fair complexion between the ages of 30-50.

What causes Rosacea?
Rosacea is often mistaken for pimple or acne, but it is more than just that. The following factors are held responsible for causing this skin condition.

Consumption of alcohol, aerated beverages
Eating spicy food
Presence of an intestinal bacteria known as Helicobacter pylori
Over exposure to sunlight
Signs that indicate you may have rosacea-

Visible, broken blood vessels
Swollen skin
Sensitivity on the skin
Burning, stinging sensation on the skin
Rough, dry, scaly skin
Raised patches/bumps on the skin
Thickening of skin on the nose, chin, cheeks and forehead
Itchy, dry eyes
Blurred vision
Watery, bloodshot eyes
How does Ayurveda help treat rosacea?
Although there is no definitive treatment for rosacea, the symptoms of each type of rosacea can be treated with Ayurvedic herbs and medicines.

Turmeric- Packed with anti-oxidants and anti-inflammatory properties, turmeric powder helps cure various skin disorders. You can consume a teaspoon of turmeric powder daily to avoid skin inflammation, or you can have it mixed with your food or juice.
Beets and carrots- Beets and carrots contain iron, which is essential for smooth functioning of your skin. The deficiency of iron can cause your skin to become sallow and dry.
Ashwagandha- One of the most essential, powerful herbs packed with anti-inflammatory properties, Ashwagandha helps remove rosacea puss. In order to fetch best results, try applying or drinking extracts of this wonder herb every alternate day.
Fenugreek- Rich in essential vitamins like C and K, folic acid and iron, this medicinal plant helps remove dry red patches from the skin. Also, it prevents formation of rosacea puss and helps reduce itching.
Ayurvedic treatment is absolutely safe and free from side effects. These are the most preferred and effective ways to reduce symptoms and severity of rosacea.

Rosacea - Top Ayurvedic Remedies For Treating It! 

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