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 

Cellulitis is a common contagious bacterial skin infection marked by redness and swelling of the skin that feels tender and hot. It usually occurs when bacteria penetrate through a crack or a cut on the skin s surface. Although cellulitis can develop anywhere over the face or the body, it is your lower legs that are affected the most. It damages the tissues beneath the skin, spreading to the bloodstream and the lymph nodes. If left untreated, the infection might get aggravated and turn fatal.  


Prevention:
In case of a recurrence, preventive antibiotics may be recommended by the doctor. Adopting the below mentioned precautionary measures can help: 
1. Gently rinse the wound with soap and water on a daily basis, whenever you go in for a shower.
2. Apply an antibiotic ointment or a cream over the wound to get adequate protection.
3. Use a bandage to dress your wound and change it daily.
4. Watch out for signs of infections such as pain and redness and accordingly go for medical help.
5. People with diabetes often suffer from poor blood circulation. They require extra precautions in order to prevent any skin injury:
Minutely check for signs of injury, failing which you might be even more susceptible to infections. 
Moisturize and lubricate your skin daily to prevent peeling and cracking.
Trim your toenails and fingernails carefully so that they do not injure the ambient skin.
Wear appropriate gloves and footwear to protect your feet and hands.
Treat any infection developing on the skin surface at the right time because they might be contagious.


5 Tips to Prevent Cellulitis

How to control hair loss through Ayurveda?

Hair loss has a direct impact on the way you feel about yourself, your self esteem and confidence. It is also true that it is a very common problem and can be controlled and stopped completely through proper treatment. Ayurvedic treatment for hair loss has long term effects and it brings out the best results since the issues get rectified from the inside which prevents them from coming back.

Ayurveda and Hair Loss
According to Ayurveda, hair fall is associated with body type that varies from person to person and also the stability of mind-body structure. Hair is considered as a byproduct of bone formation, as stated by Ayurveda. The tissues which are responsible for the development of bones are also responsible for hair growth. Diet, yoga, meditation and medicated herbal oil massage are the ayurvedic treatments generally recommended for hair loss.

Here are some ways through which Ayurveda addresses the problem of hair fall.
1. Dietary modifications
It is important to identify the lifestyle habits that cause hair fall problems. Consumption of excessive alcohol, meat, coffee, tea and smoking are some of these habits. Hair fall can also be aggravated by indulging in intake of too much greasy, spicy, oily, sour, fried and acidic foods.
Here are some ways suggested by Ayurveda to beat hair fall:
- Hair growth can be stimulated by drinking fresh juices of Pomegranate, carrot, spinach and Kokam.
- Sesame seeds promote hair growth as they are rich in magnesium and calcium.
- Cow's Ghee is a trusted remedy to resolve all scalp problems.
- Green vegetables and fruits are rich in fiber and hence help in preventing hair fall.
- To make the roots of hair strong foods rich in vitamin C, vitamin B-complex, sulphur and zinc must be consumed, which are found in whole grains, soybeans, buttermilk, nuts and milk.

2. Yoga and meditation
Inverted asanas help in stimulating the blood flow to the head. Additionally, practicing deep breathing exercises to control anxiety, stress and keep the mind balanced is also advisable.

3. Ayurvedic herbs and medicated oil
Bhringaraja, Brahmi, Amla, Neem, Ritha and Ashwagandha are some ayurvedic herbs rich in essential nutrients that help in reducing stress and promoting hair growth. Different types of oils including coconut oil, brahmi oil, amla oil or mustard oil are useful in hair fall.

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

How to control hair loss through Ayurveda?

Vitiligo is a skin disorder that is characterized by the development of white patches on the skin. The disorder is chronic in nature; it occurs when the melanocytes (melanin production and distribution agent) which are present in the skin, die.

The area of the skin affected by this condition tends to vary from person to person. It may affect the insides of your mouth, hair, eyes and cause permanent discoloration.

Vitiligo can be classified into two types

1. Segmented Vitiligo: This type of vitiligo tends to spread fast but is stable than the other type. It is asymmetrical and affects such portions of the skin which are linked to nerves that originate in the dorsal roots along the spinal cord.

2. Non- Segmental Vitiligo: This type of vitiligo occurs in equal proportions on both sides of the body. This disorder affects the areas of the skin that are exposed to sun frequently, such as the arms, neck and the face.

Causes

There is no known cause of vitiligo; however, the likely causes are found to be trauma from a stressful event, chemical exposure and genetics. It may also result from complications in the immune system.

Symptoms:

1. The primary symptom of vitiligo is the appearance of white patches on the skin.

2. The initial patches which occur on the skin are slightly pale in color; which becomes even paler in due course of time and eventually turn white, thus making them look distinct and prominent on the skin.

3. The edge of the patches may become inflamed and cause itching.

4. Direct exposure to the skin may cause the symptoms to aggravate.

Ayurvedic View
According to Ayurveda, Leucoderma is caused due to the aggravation of Pitta Dosha. Pitta is an Ayurvedic humor which symbolizes heat or fire, and is manifested in the skin. Aggravated Pitta leads to accumulation of ama (toxins) in deep layers of the skin, leading to the condition of Leucoderma.

Pitta is of five types; one of them is Bhrajak Pitta that gives coloration to skin. In the case of Leucoderma, Bhrajak Pitta is in an imbalanced state, and therefore, the skin starts losing its color and white patches appear. Along with Pitta Dosha, deeper body tissues like Rasa Dhatu (nutrient plasma), Rakta (blood), Mansa (muscles), Lasika (lymph) are also involved in the disease.

Treatment consists of pacifying imbalanced body energies, cleansing the blood and administrating herbs that restore skin color. Poor digestion is the root cause of this disease, as it causes the build-up of toxins in the tissues. An essential part of treatment, therefore, is restoring digestion. The patient will also be advised on the correct diet and lifestyle adjustments to prevent recurrence of the disorder.

Diet & Lifestyle Advice

Increase consumption of vegetables that are bitter in taste, like drumsticks and bitter gourd.
Stay away from difficult to digest foods, sour taste, excessive salt, curd, fish, jaggery and sesame seeds.
Avoid consumption of opposite foods, such as fish and milk together.
Have sound and adequate sleep daily.
Do not over-expose yourself to excessive cold or heat conditions.

Ayurvedic Treatments For Vitiligo 

Tummy tuck or abdominoplasty is a frequently performed cosmetic procedure which is meant to improve the looks or appearance of your abdominal region. The primary goal of this procedure is to remove excess skin or fat from the abdominal region and then reconnect the tissues with sutures to get a more toned and flat look.

The requirement for abdominoplasty
The tummy tuck surgery is for someone who has folds of fat or skin on their abdominal region that results in an unsightly appearance and causes body image issues. These problems may be caused by multiple factors, some of which are mentioned below:

1. Significant weight loss: Men or women who have lost a lot of weight tend to have excess loose skin on their bodies as a result of the skin being stretched over a long period of time.

2. Pregnancy: Many women who have gone through multiple pregnancies also have similar problems as the skin in their abdominal region tends to stretch over multiple times which may result in the skin becoming flabby.

3. You have a weak lower abdominal wall: Some patients tend to generally have a weak lower abdominal wall which over the years tends to protrude and hang. This results in a misshapen body which they want to correct for body image issues. 

4. To correct scarring from C section: Many women who give birth via C-section tend to have a scar on their body and some abdominal contouring can change the shape and size of the scar, which in turn not only tightens the tummy but also hides the scars.

Considerations before abdominoplasty
Abdominoplasty isn't recommended if you fall under any of the following categories:
1. Still have to lose weight: If you have to lose a lot of weight, then it is advised that you wait till your goal weight is reached and only then consider this procedure. Abdominoplasty isn't meant to reduce weight, but to take out excess skin and flab that remains after weight loss

2. Plan on becoming pregnant again: If you are planning to become pregnant again, then the muscles and tissues in your abdomen might loosen and cause a flabby belly again.

3. If you have heart disease or other conditions: If you have heart related conditions or are diabetic, then abdominoplasty won't be considered as it might put you at high risk of complications after surgery.

Abdominoplasty - An Overview

Gynecomastia is basically swelling of the breast tissues in boys and men. This is usually caused due to an imbalance of the hormones, estrogen, and testosterone. Gynecomastia can affect either one or both the breasts, sometimes in an uneven manner. Newborn babies, boys who go through puberty along with older men might develop this condition as a result of normal changes in the levels of the hormone.
It is not necessarily a serious problem but men might find it difficult to cope with this condition. This condition can go away on its own. In case, it persists, consultations with a cosmetic/plastic surgeon can be of great help.
Before looking at the tips from a cosmetic/plastic surgeon to come out of this problem, let us briefly talk about the symptoms and causes related to Gynecomastia.

Symptoms- 
There are certain signs and symptoms, which suggest that men could well be suffering from gynecomastia. They include the likes of:

Swelling of the breast gland tissue
Pain
Tenderness
Nipple getting discharged in either one or both the breasts
Causes -
Gynecomastia is usually triggered by a decrease in the amount of the hormone testosterone compared with estrogen. Different things can alter the hormonal balance like:

1. Natural hormonal changes

2. Several medicines including:

Anti-androgens used for treating enlarged prostate, prostate cancer
Anabolic steroids
Medicines for AIDS
Anti-anxiety medicines
Tricyclic antidepressants
Antibiotics
3. Consumption of alcohol
4. Heroin and other such drugs
5. Several health conditions like Hypogonadism, Hyperthyroidism, Kidney failure, Live cirrhosis, etc.

Tips From Cosmetic/Plastic Surgeon-
Consultation with Cosmetic/Plastic Surgeon can let men have useful tips as to the treatment as well as prevention of Gynecomastia. They include the following:

Liposuction Treatment can be an ideal way to get rid of this problem. It removes fat from the breast but leaves behind the breast gland tissue in its place. The treatment involves making two or more small incisions through narrow tubes get inserted into the chest region. The tube gets moved around gently to loosen up the excess fat tissue, which is then sucked out. The treatment involves less amount of scar.
Cosmetic/Plastic Surgeon can advise patients that there are iatrogenic causes behind this problem like side-effects from any medicine or health issues like an overactive thyroid or tumor.
Mastectomy can be another effective method of treatment. It is performed endoscopically and thus has a quicker recovery time. A patient can stay at the hospital for a few hours and go back. This involves less amount of scarring.
Cosmetic/Plastic Surgeons can also go for another extremely effective method in their hands to take care of this problem of Gynecomastia. It is the Excision Technique. This is recommended where glandular breast tissue or excess skin must be removed to cure this. The patterns of incision would vary depending on the specific conditions and patients  surgical preference.


All You Must Know About Gynecomastia!

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