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 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 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

Psoriasis, in general, is a persistent autoimmune condition that causes the speedy development of skin cell. This increase in the number of cells causes unhealthy scales on the surface of the skin.

Symptoms of nail psoriasis
Symptoms to watch out for are the nails cracking right from the nail bed. This, in medicinal term, is known as onycholysis and it creates space that can get contaminated by germs. Soreness or a sponge like feeling beneath the nails, pitting, warping and hardening of the nails, discoloration, painful chalk like build up beneath the cuticles which causes the nail to move upwards, are common symptoms as well. This is known as subungual hyperkeratosis. As a rule, almost everybody who is affected by general psoriasis, suffer from nail psoriasis.

Sometimes nail psoriasis may be accompanied by fungal infections. A parting amid the nail and nail bed is the perfect environment for the fungi to grow. If the symptoms you are experiencing are extremely moderate, treatment may not be required. If the discoloration, nail hardening or chipping of the nails is severe, it is probably a good time to make an appointment with a dermatologist.

Causes
A diet deficient in Calcium, Vitamin C or B12 can lead to this condition. Unhygienic habits can aggravate the condition. Psoriasis, in most cases, is acquired genetically. A weak immune system can also be a marker. Certain steps can be taken to keep the nails healthy. Keeping the nails clipped short and clean helps. Wearing gloves while working in the kitchen, during gardening or washing is another preventive measure you can always take.

Treatment
It may be hard to treat nail psoriasis; while topical medicines are prescribed, they usually don t work that well. Oral D3 supplements can be taken. D3 ointments, light or photo therapy and finally corticosteroid injections directly aimed to the nail bed may ease the situation. In very severe cases, nails may need to be removed with the help of surgery, so as to help new nails to grow back. Patience is the key word.

Nail Psoriasis - How To Know If You Are Suffering From It?

Psoriasis is a skin disease, which develops in men and women often during middle age and above. Although tests and researches are being carried out in various laboratories around the world, the exact cause of this condition is yet unknown. Psoriasis is not infectious. In other words, it does not spread by coming in contact with someone suffering from it. In case you see that you are just developing psoriasis or it is in its early stages, then you can opt for some simple and natural methods of curing it. These home remedies fall under Ayurvedic treatments and help you in getting rid of this disease before it spreads further into your body.

Moist skin: Apply lots of moisturizer on your body. This is done to keep the skin moist and supple. The more your skin becomes dry, the chances of it bleeding and causing infections increase. It is often recommended to apply body oil or sesame oil before taking a bath as it softens the skin.
Use natural body soaps: Sometimes the body soaps that you use are made of harsh chemicals. These chemicals come in contact with your body and aggravate the infection furthermore. You can use home made natural soaps, which are made of natural ingredients and are gentle on your skin.
Avoid skin injuries: Skin injuries like a cut, bleeding, blisters etc. can be harmful for psoriasis. They can aggravate the inflammation and cause more damage. In fact, it is recommended that you apply moisturizer and sunscreen every time you step out of the house in order to protect your skin from further damage.
Use medicines after consultation: Certain medicines have the ability to flare up the effects of psoriasis. Thus, when you develop this disease, it is advised that you meet a general physician and discuss your medicines with him/her in order to control the same.
Reduce stress: Stress levels contribute a lot to psoriasis. Thus, you need to relax as much as possible. You can try out yoga and meditation to keep the stress level down and in turn control this disease as well.
Wear cotton clothes: Wear clothes that you are comfortable in and those which do not cause irritation on your skin. Synthetic clothes sometimes cause a lot of irritation and rashes on the skin. It is something that should be avoided.
These are some of the quick and natural remedies to cure yourself of psoriasis as early as possible.

Psoriasis - 6 Ayurvedic Remedies That Can Help!

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