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 

Any surgery that requires an incision will involve sutures or staples as the last step of the procedure. This helps close the incision and keep out infections. Taking care of your stitches can help limit scarring and discomfort and speed up the healing process. Here are a few things to keep in mind.

Keep it clean and dry: For the first few days, use a washed wet cloth to clean the incision site. After a few days, you may start washing the area with soap and water unless advised else wise by your doctor. Ensure that you dry the skin thoroughly after washing it. Avoid baths that involve soaking the area in water. Also, avoid swimming. Do not use any powders, lotions, creams, deodorants etc on the wound site.
Look out for signs of infections: Avoid activities that may involve exposing your wound to dirty water, chemicals, dust etc. This increases your risk of infections. Also look out for signs f infections such as redness, swelling, pus or bleeding, fever or increased pain from the wound. In case you notice such signs, consult your doctor at the earliest.
Do not scratch: As it heals, your skin is likely to turn itchy. However, refrain from scratching so as to reduce chances of infections. Do not try and pull away from the scab but let it fall off on its own. This will also help limit scarring.
Limit contact: Avoid wearing tight clothes or anything that sticks to the skin while your wound is healing. Instead have plenty of loose, comfortable clothes easily accessible. Also, do not take part in close contact sports such as football etc until the stitches have healed completely.
Change your dressing regularly: A dressing should be changed as soon as it gets wet or soaked with blood or other body fluids. Wear clean medical gloves while changing a dressing. When putting on a new dressing do not touch the inside of the dressing or apply any creams on the stitches unless advised so by your doctor. In the case of removable stitches, the doctor will usually remove the stitches after a few days. DO not attempt to pull the stitches out on your own.
Avoid exposing the wound to sunlight: New skin that forms as the incision heals is very sensitive to sunlight and gets sunburnt very easily. Limiting your exposure to sunlight can help reduce the effects of scarring.

Stitches Post Surgery - How You Should Take Care?

4 plastic surgery alternatives for burns and wounds

The branch of plastic surgery that is generally used for the treatment of burns and other wounds is known as reconstructive plastic surgery. There are numerous surgical methods that fall under this category, which is effectively used to treat these injuries and the related issues that they cause. 

What are medical issues caused by burns and wounds?

Some of the most frequently occurring issues that stem from burns and similar wounds are as follows:

- restriction of mobility

- aesthetic disfigurement and scarring

- loss of sensation in the affected area

The different issues are caused by varying kinds of burns and injuries and, hence, each case must be approached in a different manner for remedy.

Different kinds of plastic surgeries that are used for treatment

Depending on the nature of the injury, your plastic surgeon may opt for any of the following surgical methods for treating the problem.

1. Skin grafting

In this procedure, skin is removed from one part of the body and transplanted to the affected area. This method is used for the treatment of burns. There are two types of this surgical procedure - one removes a few layers from the dermis of the donor area (split-thickness graft) while the other removes the entire dermis (full-thickness graft). Recovery time depends on the kind of procedure used. Skin grafting is occasionally used for breast and nose reconstruction as well.

2. Microsurgery

This type of surgery makes the use of a microscope in reconstructive procedures for working on minuscule veins, arteries, and nerves for repairing damaged areas. Microsurgery is often used alongside other surgical procedures for re-attaching body parts, relieving paralysis of the face and in the reconstruction of breasts.

3. Tissue expansion

This method is used to induce the growth of extra skin on the body that can be used for reconstructive purposes. This is done by inserting a balloon expander underneath the skin that slowly gets filled with saline solution and makes the skin swell. This excess skin is then used for correction or reconstruction of the affected area.

4. Free flap procedure

This procedure involves the transfer of skin, bone, muscle and blood supply from the donor area to the damaged area for repairing purposes. Microsurgery is often performed alongside this treatment method, which is used most frequently for breast reconstruction or after the removal of cancer from the neck or head.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: 6 Quick and Handy Remedies To Treat Burns

4 Surgical Alternatives for Burns and Wounds

How your baldness is completely reversible (non-surgically): part-2

I explained in part-1 about prp treatment. Dermaroller treatment follows the prp treatment.

Let's understand how does it work.

What is derma roller

Dermaroller is an instrument with multiple small needles attached to a handle, which is rolled over the treatment area, to stimulate hair follicles.

How does derma roller work?

It activates stem cells in hair bulge region and releases growth factors to stimulate re-growth. It is again a painless procedure and is usually done without anesthesia.

Any risk or side effect of derma roller?

There is no risk for using derma roller as it is used is a completely aseptic and clean environment.

Total number of treatment sessions required?

For most patients 3prp + 9 derma roller (total 12 sessions done every week over 12 weeks) are sufficient.

Are results achieved with prp + derma roller permanent?

This treatment reverses the 'hair loss stage' to 'hair growth stage' and once the bald scalp is covered with hair, the results can be maintained with just a solution. However, some patients may need prp for maintenance every 6 months to 1 year.

Advantages of i-prp


	
	Simple, effective and non-surgical procedure
	
	
	Completely safe, as your own blood is used.
	
	
	Hair regrowth with i-prp gives best cosmetic appearances.
	
	
	It gives a natural density. Number of hair strands is in lakhs as compared to a maximum of 6000 hair follicles that can be grafted when a hair transplant treatment is done.
	
	
	The hair growth direction remains same (giving a completely natural look), which is not the case with hair transplant treatment where the hair growth direction changes (giving an odd look).
	
	
	Cost of i-prp is much less compared to hair transplant
	


If you would like to consult with me privately, please click on 'consult'.


How Your HAIR LOSS or BALDNESS is Completely Reversible (Without Surgery):  PART-2

Corns and calluses are areas of stumpy skin caused by friction or pressure. They usually hurt when you wear shoes or walk.
Calluses generally develop on your feet or hands, and most of the time, don t require treatment.
Corns have a hard or soft inner core. Soft corns are mostly found between the toes, while hard corns form on the top of the toes. Corns that are caused by ill-fitting shoes often reduce on wearing the right shoes.
Causes-
Repeated friction or pressure causes corns and calluses on areas of skin. The pressure leads to the death of the skin, which develops a protective, hard surface. Soft corns develop in a similar fashion. Corns and calluses are not formed due to viruses and are not harmful. They can be formed due to:
Regular usage of any object that puts strain on the hands, such as sports equipment (badminton racquet) or tools (hammer or gardening hoe), usually leads to calluses on the hands.
Pressure from wearing the wrong footwear usually leads to corns and calluses on the feet. Calluses can also form by walking barefoot.
Abnormal structures on the foot, such as hammertoe or bone spurs, can cause calluses and corns.
Repeated pressure from playing certain sports can also cause calluses on the feet.
Symptoms-
Corns and calluses on the feet are easy to spot. A callus is thick, hard and dry, and may appear yellowish or grey in colour. When touched, it will feel bumpy and more insensitive than the skin around it. A hard corn is thick and firm, while soft corns look like an exposed sore. The hard corn may have a grey centre with a light yellow ring around it.
Corns and calluses don t hurt, but it does become painful when you are wearing shoes or walking. Fitting your feet into shoes gets more difficult due to them. Touching or squeezing the corn or callus can also be painful.
Treatment-
Corns and calluses don t require treatment normally, but if they hurt, here s what you can do:
Wearing well-fitting shoes that are roomy with deep and wide toe boxes (the area covering the toe).
Protective paddings, such as moleskin, toe separator, toe sleeves, etc., can alleviate pain.
Soaking the corn or callus in hot water, and then gently wear down the dead skin by using a pumice stone.
Salicylic acid can be used to soften the corn or callus.


All about Calluses and Corns

When it comes to a man's physique, enlarged breasts can be quite embarrassing. This is a condition known as gynecomastia or men boobs or  enlarged breast in men and affects more men than you would imagine. It may affect one or both breasts. It can result in terrible embarrassment, teasing, and social trauma. Many will try to hide it with thick loose shirts, avoid bare chest activities like swimming, exercises etc and withdraw from public exposure.Though it does not pose a significant health risk, it can affect a man's psychological health and lower his self-confidence. The good news is that men suffering from this condition do not need to live with it. 

Male breast reduction surgery or gynecomastia surgery, aims at reconfiguring the contours of a man's chest by removing excess breast fat & if needed extra gland tissues. The only permanent solution to this condition is surgery. This is because fat tissues are not solely responsible for enlarged breasts. Often glandular tissue is present in excessive amounts as well. Patients need careful evaluation by Plastic Surgeon & sometimes if needed by endocrinologist to determine the source of their breast enlargement. 

Gynecomastia surgery is usually a daycare procedure. It is performed by Plastic Surgeons under local anesthesia with liposuction being the most preferred procedure. This procedure begins when the surgeon makes a small incision on each side of the chest. These incisions are usually placed along the natural contours of the body, around the edge of the areola or near the armpit so as to reduce the visibility of scars. Excess fat and glandular tissue are then sucked out of this incision. Simultaneously, the surgeon sculpts the other tissues in the chest to redefine chest contours. Patients are usually advised to wear a compression garment after the surgery to support the healing tissues and minimize swelling. 

Results of this procedure are visible almost immediately. Recovery from gynecomastia surgery is usually quick and many men find themselves back to their normal routine within a few days. However, vigorous exercising and heavy lifting should be avoided for a few weeks after the surgery. The patient may also experience slight soreness and minimal pain that can be relieved with over the counter pain killers. 

The results of this procedure are generally permanent if there are no hormonal abnormalities. It is important to maintain a healthy lifestyle and avoid drugs that influence your testosterone levels. Regular exercise can also help tone the chest muscles and maintain the achieved good shape of chest. It is really a very simple but rewarding surgery for the male & it definitely boosts his confidence, body image & self-respect.

Enlarged Breast In Men - Causes And Treatment 

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Consult for Blepharoplasty - Online and Easy!

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