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 

Most effective solutions to grow hair:

Hair fall is a common problem these days and quite distressing for those who have to face it. Here are some tips which if followed can help you have soft, long, and healthy hair.

1. Onion juice - A smelly but effective way, onion has sulphur which pumps the production of collagen tissues that assist regrowth of hair.
All you will need are two to four onions, grated with the juice squeezed out of the pulp. Use this juice to massage your scalp and leave it on for about an hour before you wash it with water and a mild shampoo. Using onion not only increases chances of re-growth of hair, but also gives a fabulous sheen to your existing sheen.

2. Potato juice - Potatoes are rich in vitamins a, b and c which are important for hair to be strong and healthy. All that you will need are 3-4 potatoes. Grate them and squeeze out the juice; massage this juice on your scalp for minimum of 15 minutes and rinse off with water.
If this makes your hair dry, you can instead make a potato mask with honey and eggs and use on your hair. This mask not only moisturises your hair, it also helps hair in growing faster.

3. Eggs - When hair falls, goes dry or gets brittle, know that it lacks protein. And one of the best sources of protein is egg. You can take a couple of eggs, mix them and apply the liquid on your scalp. This can be washed off after a hour. Alternatively, you can make an egg mask. For the egg mask, you'll need a couple of eggs, honey and olive oil. Mix them week and apply it on your scalp, covering your hair too. Wash it off after about 15-20 minutes.

4. Apple Cider Vinegar (acv) - ACV has numerous health benefits, one of them stimulating the hair follicles and helping them grow faster. It also cleanses the scalp and maintains ph balance in the hair. Add ACV into water and have a final rinse of your hair with this water, every time you shampoo.

5. Fenugreek - Fenugreek is a great remedy for hair fall. You will need to soak about 2-3 tablespoons of fenugreek seeds in water for 24 hours. Strain and use this water to rinse hair. Rinse with lukewarm water after 3 hours.

6. Ayurvedic herbs - Amla, Shikakai and Reetha are known to be beneficial for hair. They make the hair strong and long. Take 100 gms of each in 2 liters of water. Soak overnight. Boil the mixture in the morning, until it reduced to half. Cool it, mash the herbs while still inside the water and then strain it. Use this liquid to shampoo your hair.

From lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over whatsapp, facebook and other media.

Hair Loss - 5 Most Effective Hair Growth Solutions For You!

 Hives , also known as urticaria, is the outbreak of pale red, swollen bumps on the body. It can occur on any part of the body including the face, back, arms or legs. It is a type of hypersensitivity reaction in which the cause for the reaction is idiopathic (unknown). Also, it can come in various shapes and sizes. Hives can be associated with redness, itching, and a burning and stinging sensation. These can last for more than a minute or even more than that; up to days.

What causes hives?
Most of the times, hives are idiopathic, i.e. the reason that causes this type of hypersensitivity reaction is unknown. The bumps are caused by the action of histamine that makes the plasma in the blood leak out of the small blood vessels. Histamine is a substance that is released from a specialized cell and is what causes allergic responses in general. There are three types of hives- namely, acute, chronic urticaria and physical urticaria. Acute urticaria is when the hives last for less than six weeks. Chronic urticaria occurs when the hives last for more than six weeks. 

Physical urticaria refers to the condition when the hives are triggered due to causes such as heat, cold, sun exposure, sweating, pressure and exercise. Although, this condition is mainly idiopathic, there are common causes that may trigger this condition such as:

Foods such as nuts, fish, chocolates, milk and milk products
Environmental triggers such as pollen grains, dust etc
Medications such as ibuprofen or paracetamol
Insect bites
Latex
Blood transfusion
Bacterial infections including strep throat and urinary tract infection
Pet dander
Plants such as poison oak or poison ivy
What are the symptoms of urticaria?
Hives are usually self-diagnosable. The various symptoms of urticaria are:

Swollen red bumps known as weals
The red bumps can occur suddenly and subside all of a sudden as well
 Blanching which is characterized by the whitening of the swollen red part.
They occur on any part of the body and can change shapes, and sizes. It can become larger or it can reduce in size; it can also move around in the body.

Hives - Most Common 9 Reasons Behind It!

Swollen breast tissues in men or boys caused by hormonal (testosterone and estrogen) imbalances is called gynecomastia. Both breasts or one breast, can be affected by gynecomastia. At any point in life, from birth to puberty, even in adulthood, you might develop gynecomastia. Most of the times, gynecomastia is caused by hormonal imbalances, but there might be some underlying causes as well.
Gynecomastia is normally not a serious condition, but it can be difficult to deal with the pain and embarrassment.

It can be cured with surgery or medication, if it doesn't go away on its own.

Symptoms and signs of gynecomastia include:

Enlarged glands in the breast tissue
Tenderness in the breast
The causes that trigger gynecomastia include:

Hormonal changes: Testosterone and estrogen control the sexual development in men and women respectively. Estrogen is not a hormone that only women produce; men produce it too. When the production of testosterone and estrogen are thrown out of balance, gynecomastia occurs.
Medication: Certain medications such as anabolic steroids, androgens, HIV/AIDS medicines, antibiotics and chemotherapy can cause gynecomastia.
Drugs and alcohol: Substances such as alcohol, marijuana, amphetamines, heroin and methadone cause gynecomastia.
Health condition: Certain factors, such as aging, hypogonadism (hormonal disorder), hyperthyroidism (overactive thyroid gland), tumors, kidney failure, cirrhosis, liver failure, malnutrition and starvation can lead to gynecomastia.
Herbal products: Essential oils derived from plants such as lavender or tea tree, used in lotions or shampoos, have weak estrogenic actives. They have been said to cause gynecomastia.
Gynecomastia can be cured either with medication or surgery. Surgical options for gynecomastia are, however, limited.

Treatment

There is no definitive medical treatment. The main answer for Gynecomastia is -SURGERY. It is a daycare procedure in most situations. It is done by a Surgeon, usually, a Plastic surgeon does a better job. 

Anesthesia- Either Local or General anesthesia is given to make it painless. 

Procedure-Through a small incision in the areola, the swelling is removed by both Liposuction of the Fat part and Excision (removal) for Breast gland part. As the incision is through the areola, the final scar is hardly visible. In extensive swellings, skin also needs to be removed, where in a scar around the areola border is visible. 

Recovery- usually can go back to work in 2-3 days time.

Treating Gynecomastia (Enlarged Breasts in Men) With Surgery

Washing your skin with water is something that you probably do daily, but you may not know at what temperature the water should be. Using water at the correct temperature is advantageous for the skin. Water at extreme temperatures is harmful for the skin as your skin is not designed that way.

The temperature of the water should also depend on the purpose for which it is being used. Here are some tips on how to set the temperature of the water depending on the purpose: 

1. Showering: while showering, if you are using hot water, then it may strip your skin of its essential oils and make it vulnerable to dryness. This may cause various skin complications, such as cracked and rough skin. Hence, use lukewarm water while you shower.

2. Washing your hair: using hot water to wash your hair may lead to hair damage as it rids your hair of all the essential oils and makes it limp and dull. Lukewarm to normal water is recommended while washing your hair as it will allow the hair to retain its natural oils.

3. Brushing: the right temperature of water while brushing your teeth should optimally be lukewarm. Too cold or hot water can lead to teeth sensitivity and cause oral problems.

4. Washing your face: before you apply a cleansing agent on your face, use warm water to wet the face as it helps to open up your pores. After the cleansing agent is applied, then use cold water to wash your face. Cold water helps in closing the pores after the impurities are removed from the skin.

5. Shaving: if you are going to shave, then opt for warm water as it opens the pores up and thus makes it easier for the blade to glide through the skin. This also reduces the risk of razor burns on your skin.

6. Washing your feet: wash your feet with lukewarm water as it facilitates dead cell removal and also helps in getting rid of warts.

Hot vs Cold: Which Water Temperature is Best for Your Skin

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

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