Psoriasis is a common autoimmune disorder of the skin that results in the formation of thickened and elevated plaques of cells that remain covered by scales (loose, whitish-silver scales). In psoriasis, the skin cells multiply at an alarming rate resulting in the scaling of the skin. Though non-contagious, psoriasis can be itchy and often painful. Psoriasis mainly affects the scalp, elbow, and knees. In some, the condition may also affect the palms, feet (soles of the feet), and the torso.

As per a survey, psoriasis is known to affect approximately 2.2% of the total adult population. Psoriasis can also affect children (children under the age group of 5-8 years are mostly affected by this inflammatory skin disorder).

Psoriasis Can of Different Types

Plaque Psoriasis: As the name suggests, this type of psoriasis results in the formation of plaques of cells (thickened and elevated) on the skin surface. One of the most common types of psoriasis, plaque psoriasis affects the scalp, knees, and elbow.
Pustular Psoriasis: Pustular psoriasis mainly affects the hands and the feet of the adults whereby white blisters (pus-filled) appear on the affected area of the skin. The skin also appears red and inflamed.
Guttate Psoriasis: This type of psoriasis usually affects the legs, torso, and arms. Common in children (sometimes young adults), Guttate psoriasis results in the formation of small red spots.
Inverse Psoriasis: In Inverse psoriasis, shiny red (bright red) inflammations or lesions appear on the armpits, groyne, breasts.
Erythrodermic Psoriasis: Though rare, this type of psoriasis is marked by extreme redness of the skin. There is also shedding of the scales (in the form of sheets). The skin more or less appears sun burnt.
Symptoms:
The symptoms associated with psoriasis include

Elevated and inflamed red patches covered by whitish- silver scales (plaques).
The nails appear thick and pitted.
There is a pain in the joints followed by swelling.
At times, the affected skin may crack resulting in bleeding.
Soreness, itching and a burning sensation around the red patches.
In psoriasis of the scalp,

There may be the formation of scales (usually mild).
In severe cases, there may be crusting (the full scalp) which can spread to the forehead, ears (inside and behind), in the beard or even around the nose.
Treatment:
Though there is no definite treatment for psoriasis of the body and the scalp, the following medications may prove to be helpful

Medications like Methotrexate and Cyclosporine (immunosuppressant drugs), Retinoids, and Biologics (injected intravenously) may provide some relief.
Patients may also benefit from light therapy, anthralin, topical corticosteroids as well as vitamin D analogs.
Precaution and care
For psoriasis of the scalp

Before the treatment, it is important to remove (and soften) the scales. Medicated shampoos that contain salicylic acid can be used to remove the scales.
Use of petroleum jelly or medicated oils and ointments (as recommended by the doctor) can be helpful.
For better results, you can keep the scalp covered (preferably with a shower cap) after applying the ointment.
For Psoriasis of the Body

Avoid the skin from getting dry. You can use a medicated lotion or a moisturizer.
Drinking and smoking can worsen the situation. Avoid these vices as much as you can.
Avoid using hot water while bathing. To keep your skin moisturised, you can add oil or salt to the water (bathwater).

Psoriasis - Types, Symptoms, and Treatment

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!

Psoriasis is a durable autoimmune disease defined by patches of irregular skin. These patches of skin are usually scaly, red and itchy. Its symptoms vary greatly in severity, the coverage might be small and focused or it could spread all over the body.

Types
There are mainly five types of psoriasis:
1. Plaque- also called psoriasis vulgaris, is the most common kind of psoriasis (90% of cases). It affects the skin behind the forearms, over the navel, shins and scalp, usually presenting itself in red patches with white- colored scales over it.
2. Guttate- has lesions that are drop-shaped.
3. Inverse- red patches show up in the folds of your skin.
4. Pustular- pus-filled blisters form. They are non-infectious.
5. Erythrodermic- the rash spreads wider. In some people, even fingernails and toenails get affected as pits may form on them or their colour may change.

Causes
Anything from emotional trauma and stress to streptococcal infection can cause psoriasis. Sometimes you might carry predisposition for psoriasis in your genes and stress may aggravate it. Environmental factors may also lead to psoriasis. And then again defects in the immune system may also be the underlying cause. Even after thirty years of research, the exact cause for psoriasis remains a mystery. There is no age limit to psoriasis. It can show up from anywhere between infancy to old age.

Symptoms
Common symptoms include
1. Pink or red scaly bumps that are smaller in size, but become plaques later, show up on the skin. Although these scales can show up anywhere, they are mostly common on sites where there is much friction, abrasion or scratching.
2. Small pinpoint depressions or pits might show up on toenails and fingernails. Distal onycholysis, which refers to large brown/yellow divisions on the nails, shows up as well.
3. Sore throat may follow if it is guttate psoriasis.

Treatment
Psoriasis is not curable. But its symptoms can be managed with steroid creams, ultraviolet creams, vitamin d3 creams and with medicines that act as immunosuppressants. Creams alone can help control symptoms in 75% of patients with psoriasis.

All About Psoriasis

Psoriasis can be defined as a skin condition, which is caused due to autoimmune disorders within the body. This is a condition where the skin on the body develops raised and dry areas which are reddish in colour while also being bordered by silvery scales. 

Treatment of psoriasis in ayurveda
Ayurveda has a different slant to conventional medicine with regards to the treatment of psoriasis. According to ayurveda, it is the impurities in the blood, which cause the immune system to react adversely and cause this condition. Ayurveda concentrates on treating the underlying problems through the combination of changes in diet, home remedies and certain medications to treat this disorder. Some of them are mentioned below:

Changes in diet which will help purify the symptoms: 
Some advice that is usually given to patients to clean up their diet and include certain other items are as follows:
1. Avoid spicy food and try to eat food, which can be easily broken down within the digestive system
2. Inclusion of more fruits and fruit juices in your diet
3. Also include vegetables and also have a mix of boiled vegetables daily.
4. It is better to avoid animal products such as animal fats, eggs, canned and processed foods from your diet.
5. Regular consumption of butter milk and curd are known to be very good in blood purification and thus should be consumed in large quantities. 

Some ayurvedic tips and ingredients, which can help treat psoriasis: 
Other tips that can be implemented as skin applications to treat psoriasis are as follows: 
1. Use avocado oil to rub on the affected areas as it is known to be an effective treatment when applied long term.
2. Ensure that the skin is always moisturized by applying a soft, cream or gel.
3. Periodic baths in sea water if possible is also good for lessening the symptoms of psoriasis.
4. Aloe vera cream applied specifically on the patches is known to also lessen them overtime.

Few other tips to follow
1. Get into deep breathing and meditation to ensure that your body and mind are relaxed as this is very important during the healing process
2. Expose the affected areas of your skin to mild sunlight for about half an hour daily as it is known to improve symptoms. 


Ayurveda and Psoriasis

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 the condition in which the infected skin cells multiply 10 times faster than the normal rate. During this disease, the normal skin tends to get covered by a layer of dead skin cells, not allowing the skin to breathe. People who suffer from psoriasis face an increased likelihood of contracting other serious medical conditions such as cardiovascular diseases, diabetes, and psoriatic arthritis.

Psoriasis can erupt just about anywhere on the body, but it most often occurs on the scalp, chest, back, elbows, knuckles, and knees. If you have a mild case, the patches may hardly be noticeable. The worst cases produce unsightly patches almost everywhere.

Psoriasis can also affect fingernails and toenails, making them appear pitted and discolored. It can even cause significant joint pain, a condition known as psoriatic arthritis. 

Most people who develop psoriasis are initially diagnosed in their teens, twenties, or thirties. The disease follows a very unpredictable course. That first flare-up may also be the last. Or it may signal the start of a lifetime of flare-ups that come and go for no apparent reason. Fortunately, when the lesions disappear, they leave no scars. 

Here's a list of following unsafe health conditions created by psoriasis:

Cancer: People experiencing psoriasis are subjected to an increased risk of contracting certain cancers like lymphoma. A study discovered that people diagnosed with psoriasis have an increased likelihood of 40% to contract cancer than the general population. The reason for this particular risk hasn't been yet understood.
Kidney disease: According to a 2013 study, published in the British Medical journal people with psoriasis have an increased risk of encountering kidney disorders. Severe and mild psoriasis increases the likelihood of kidney diseases by 58% and 36% respectively.
Obesity: People suffering from mild psoriasis are 30% likelier to be obese than those who are not. For people diagnosed with severe psoriasis the chances increase by 80%.
Diabetes and high cholesterol: High levels of triglycerides, total cholesterol and lipoprotein are present in patients with psoriasis, and these patients are 28% likelier to have high cholesterol compared to the general masses. According to a recent study, people with the condition have a 46% increased chance of suffering from Type 2 diabetes.
Peptic ulcers and mood disorders: In some cases, peptic ulcers are also linked with psoriasis. The reason for this is attributed to inflammation. Psoriasis also leads to mood disorders like depression due to the pain and anxiety arising from the condition.

Psoriasis: Vulnerability to Health Conditions

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