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 

Psoriasis is a chronic skin disease where the skin cells form a mass of scales. These patches of skin are dry, red and itchy. It is an autoimmune disease which usually occurs on the skin of the back, scalp, palms, knees, elbows and around the fingernails and toenails, but some people have the diseased patches of skin all over the body. The patches may also crack, flake and bleed. The condition has no definite cure but the symptoms can be treated and managed.

Causes of psoriasis

The following factors are proven to have contributed to cases of psoriasis:

1. Genetics
More than 32% of the cases of psoriasis have been linked to genes. In case of identical twins, if one twin has the disease, the other has a 70% chance of getting it too. There are several genes associated with the disease and most of these genes are related to the immune system. T cells (lymphocytes which affect cell specific immunity) can also cause psoriasis.

2. Hiv
Human immuno-deficiency virus adversely affects the immune system and increases susceptibility of all kinds of infections and diseases. Hiv-positive individuals have been found to have an increased risk of psoriasis than hiv-negative people.

3. Other diseases
Diseases like strep throat, chronic infections, skin infections and stress may be responsible for the condition. Other factors like obesity, alcoholism, skin dryness and smoking can also lead to psoriasis.

4. Medication
Anti-malarial, anti-inflammatory and blood pressure medicines can cause psoriasis as a side effect. The disease is also an effect of withdrawal from topical steroid creams and other steroid-based medication.

Symptoms of psoriasis

The symptoms of psoriasis may vary from patient to patient. However, if more than two of the following signs are seen, it is likely that psoriasis is the causative condition:

1. A whitish and silvery mass of scales surrounded by red patches of stinging, itchy skin
2. The appearance of blisters or rashes on the dry scaly skin and also along the nails
3. Bumps on the folded skin like back of the knees, armpits etc.
4. Diseased patches of skin can crack, peel and bleed
5. A sharp and localized pain in the joints accompanied by stiffness
6. Soreness in the throat
7. Tiny depressions in the nails or large brown patches under the nails
8. Swelling and tenderness of the limbs
9. Dental plaque
10. Muscle pain due to the swollen bands of connective tissue


Causes and Symptoms of Psoriasis

It is a chronic autoimmune skin disease, in which the skin cells form a mass of scales. Usually, these patches of skin, which are dry, red and itchy, occur on the skin of the back, scalp, palms, knees, elbows and around the fingernails and toenails. But some people have the patches all over the body. The patches may also crack, flake and bleed. While there is no definite cure, the symptoms can be managed and treated.

Symptoms of Psoriasis

The symptoms of psoriasis may vary from patient to patient. However, if more than two of the following signs are seen, it is likely that psoriasis is the causative condition:

1. A sharp and localized pain in the joints accompanied by stiffness
2. Soreness in the throat
3. Tiny depressions in the nails or large brown patches under the nails
4. The diseased patches of skin can crack, peel and bleed
5. Swelling and tenderness of the limbs
6. Dental plaque
7. Muscle pain due to the swollen bands of connective tissue
8. A whitish and silvery mass of scales surrounded by red patches of stinging, itchy skin
9. The appearance of blisters or rashes on the dry scaly skin and also along the nails
10. Bumps on the folded skin like back of the knees, armpits etc.

Causes of Psoriasis

HIV
Human Immuno-deficiency Virus adversely affects the immune system and increases susceptibility of all kinds of infections and diseases. HIV-positive individuals have been found to have an increased risk of psoriasis than HIV-negative people.

Medication
Anti-malarial, anti-inflammatory and blood pressure medicines can cause psoriasis as a side effect. The disease is also an effect of withdrawal from topical steroid creams and other steroid-based medication.

Genetics
More than 32% of the cases of psoriasis have been linked to genes. In case of identical twins, if one twin has the disease,the other has a 70% chance of getting it too. There are several genes associated with the disease- most of these genes are related to the immune system. T cells (lymphocytes which affect cell specific immunity) can also cause psoriasis.

Other diseases
Diseases like strep throat, chronic infections, skin infections and stress may be responsible for the condition. Other factors like obesity, alcoholism, skin dryness and smoking can also lead to psoriasis.

Psoriasis: Symptoms and Causes

When you think of organs of the body, the mind goes to internal organs like the stomach, liver etc. However, the largest organ of the body is the skin. Given its size and the amount it interacts with external stimuli, the skin is susceptible to a number of infections. One of the common issues to affect skin is known as psoriasis. This is typically seen as a rash that can make the skin dry, thick and flaky. It can make the skin feel very itchy and make the person unconsciously scratch his or her skin so hard that it bleeds. Although, even modern medicine does not have a way to cure psoriasis but can manage the symptoms. In contrast, homoeopathy can help treat the factors triggering this infection and hence keep it from recurring.

Homeopathy is a holistic form of medication that treats not only the symptoms exhibited but also the issues triggering the infection. Homeopathic medicines are usually prescribed in the form of sweet pills, powders or liquids. This form of medication has negligible side effects and can be prescribed to children and adults of all ages. If needed, it can be prescribed along with other types of medication as well. However, homeopathy does not follow a one size fits all approach. This means that a remedy that suits one person may not be effective for another. This is because the ideal homeopathic prescription depends on the symptoms being exhibited by the patient, his or her overall physical and mental health, family history, personality etc.

There are a number of homeopathic remedies that may be prescribed to treat psoriasis. Some remedies can treat psoriasis that is passed on genetically from one generation to another while others can treat psoriasis caused by exposure to warm or cold conditions. Homeopathy can be used to treat psoriasis that makes the skin dry as well as psoriasis that leads to oozing lesions. It can also be used to treat chronic cases of psoriasis. In many cases, two or more remedies may be prescribed simultaneously.

When taking homeopathic remedies one must follow the prescribed schedule. Medicines must be taken half an hour before or after meals. When taking two or more homeopathic medicines, they must be spaced at least 5 minutes apart. The ideal time to take the morning dose is as soon as one wakes up. Similarly, the best time to take a night dose is just before going to bed.

Psoriasis And Homeopathy - What All Should You Know?

What is Psoriasis? 

Psoriasis is a common skin disease characterized by thickened patches of inflamed, red skin covered with thick, silvery scales. The elbows and knees are the most common areas affected by psoriasis. It will often appear in the same place on both sides of the body. The patches can range in size from smaller than a dime to larger than a hand. 

Description of Psoriasis-

Normally, skin cells mature and shed after about a month. In psoriasis, the cell maturation speeds up, taking only three to four days. Because the lower layer of skin cells divide more rapidly than normal, dead cells accumulate in thicker patches on the skin's outermost layer called the 'Epidermis'. 

Forms & Classifications-

Psoriasis occurs in a variety of forms that differ in their intensity, duration, location, shape and pattern of scales. The most common forms are: 

Plaque Psoriasis: Plaque psoriasis is the most common form of psoriasis. It is characterized by raised, inflamed, red lesions covered with a silvery-white buildup of dead skin cells (scales). This is found primarily on the Body, elbows, knees, scalp and finger or toe nails. 
Guttate Psoriasis: Guttate psoriasis occurs most frequently in children and is characterized by numerous small, red, drop-like scaly macules that develop rapidly over a wide area of skin. This may appear following an infection, most frequently strep throat. 
Inverse Psoriasis: Inverse psoriasis occurs in the armpit, under the breast, in skin folds, around the groin, in the cleft between the buttocks and around the genitals. It is usually pink and irritated but lacks the thick scale seen in other forms of psoriasis. 
Pustular Psoriasis: Pustular psoriasis is a rare form characterized by small pustules (whitehead-like lesions) found all over the body or confined all over the body or confined to the palms, soles and other isolated areas of the body. 
Palmoplantar Psoriasis: This type of Psoriasis are most likely to show up on the palms and soles. It can also appear on the tops of your feet, backs of your hands, and on knuckles and nails. It may be triggered by an injury to the skin, an infection, or another skin condition such as hand dermatitis. It may first occur during a period of psychosocial stress. Lesions are like cuts which bleed.
 Psoriasis - Homeopathic Treatment

The patient should be encouraged to expose maximum to sunlight and avoid trauma during the active phase.

Homeopathic treatment of psoriasis   Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach.

This is the only way through which a state of complete health can be regained by removing all the signs and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat psoriasis but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned; several well-proved remedies are available for psoriasis treatment that can be selected on the basis of cause, location, sensation, modalities and extension of psoriasis. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person.

Homeopathy For Psoriasis!

An often persistent and long-lasting condition, psoriasis interferes with the life cycle of skin cells and causes them to increase rapidly on the surface of the skin. These generally appear as dry, itchy and red patches of skin having thick, silvery scales.

Psoriasis can be subdivided into the following:

    Plaque psoriasis: The most common form, characterized by dry, red skin lesions covered with silvery scales and can be seen anywhere on the body.
    Scalp psoriasis: These appear on the scalp and may extend beyond the hairline.
    Nail psoriasis: These affect the toenails and fingernails.
    Guttate psoriasis: Characterized by blister-like appearances and are stimulated by bacterial infections.
    Inverse psoriasis: Caused by fungal infections.
    Erythrodermic psoriasis: Can cover the entire body with a reddish rash that may peel.
    Pustular psoriasis: Capable of causing chills, fever and diarrhea.

The usual signs and symptoms of psoriasis include:

    Red, sensitive patches of skin
    A silvery, scaly cover
    Dry and cracked skin that may bleed when scratched or agitated
    Tiny scaling spots (witnessed in children)
    Persistent itching, soreness or burning sensation
    Ridged, thickened or pitted nails
    Stiff and swollen joints

Possible causes of psoriasis may include:

    Skin infections or strep throat infections
    Stress
    Skin injuries, like cuts, bites or sunburns
    Smoking
    Cold weather
    Chronic alcoholism
    Certain medications such as high blood pressure medications

Risk factors

The following factors may further increase the risk of developing the disease:

    Fungal and bacterial infections
    Family history
    Obesity
    Stress
    Smoking

Ayurveda and Psoriasis

Although the root cause of the disease is yet to be identified, according to traditional Ayurveda, the vitiation of Vata and Kapha causes psoriasis. As per ayurvedic principles, Vata and Kapha are the two basic energies that uphold the balance of our body equilibrium. Strong genetic predisposition, sun deprivation, and intense streptococcal infection on the upper respiratory tract can badly aggravate psoriasis. As per ayurveda, these conditions are strong enough to create several visible pathological changes that take place are mainly due to the accumulation of dooshi vishas or low potency poisons.

Uneven and unhealthy food habits, consumption of foodstuffs in the wrong combination (Example: dairy products with fish or chicken), too much intake of yogurt, black gram, seafood, sour or salted food stuffs, etc. can trigger the psoriasis inducing pathogenesis. Other catalysts that cause psoriasis includes stress, alcohol, and tobacco consumption

Psoriasis can be effectively treated through panchakarma therapies, which include ayurvedic treatment methods for the complete detoxification of the body, and successful elimination of harmful toxins from the body fluids.

A few health tips for psoriasis patients:

    Maintain safer distance from the possible variables that cause or aggravate psoriasis
    Practice yoga regularly. Yoga can lessen the intensity of psoriasis.
    Avoid pricking, peeling or scratching your skin.
    Make sure to pat your skin dry after washing, and avoid rubbing vigorously with towel or any rough cloth.
    Avoid artificial cleansers and use gram flour (besan flour) instead.
    Use cotton clothes
    Avoid cold water bath or immediate cleaning up right after heavy work-out, long walks, or travel.
    Avoid food stuffs that can cause indigestion.
    Avoid excessive salty and acidic food stuffs, radish, urad dal, sesame, jaggery (gur), curds, fish and other sour food stuffs that can trigger psoriasis.

Psoriasis - How it Effects Your Skin?

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