Unani is an ancient medical practice of the Middle East that people sometimes use to try to help alleviate conditions of psoriasis. It involves incorporating a special diet, use of herbal compounds and other additional supportive medical practices.

What is Psoriasis?
It is a common immune-mediated skin disease that is characterized by chronic and inflammatory scaly deposits on the skin called plaques. The dry flakes and skin scale deposits occur due to rapid build-up of skin cells. It has a substantial impact on the quality of life with reported impairment in physical and mental functioning.

Causes and symptoms of psoriasis
Heredity is a crucial factor when it comes to psoriasis. There is no definite cause of this skin condition, but consuming opposite foods, trauma on the skin like bruises, cuts, skin irritants, excessive smoking/drinking and mental stress can be some reasons causing it.

Here are some common symptoms of psoriasis:
  Silvery scales on skin
  Itchy and burning skin
  Pus-filled skin bumps
  Dry skin patches and skin redness
  Blisters
  Bleeding patches in skin
  Restricted joint motion
  Inflammation and pain in skin

The Unani view
There are several topical drugs, phototherapy and systemic medications available for psoriasis. However, according to studies, almost 50% of the patients were dissatisfied with their treatment. In the absence of satisfactory cure in modern medicine, the traditional system of Unani medicine is highly beneficial in treating Psoriasis. According to the Unani view, psoriasis occurs due to burnt melancholic humour that has an irritant nature. As a result, it destroys the skin and produces intense itching, roughness and scaling. The unique formulations of Unani aims to eradicate the skin disorder.

How can Unani help treat psoriasis?
Under the banner of the Unani system of medicine, physicians emphasize to apply emollient over the affected part in the form of ointment (Margham) or oil (Rogham). In addition to this, they also advise avoiding sweet or sour items in the diet. Herbal formulations and natural ingredients are used in these topical applications. When applied to the skin lesions over a prescribed course of time, it eases the skin and gets rid of psoriasis.

Risk and safety considerations
There are several studies undertaken to prove the effectiveness of Unani medications to treat Psoriasis, most of which are positive. The Unani medicines have not shown much side effects and can be taken for a prolonged period of time to yield positive results.

Unani medicine has been proven to have a positive effect on the PASI score of the patients, which assesses the severity of psoriasis. A proper diagnosis at an early stage followed by the appropriate treatment under Unani medicine yields remarkable results.

Effective Unani Medicine for Psoriasis Treatment 

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?

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, 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 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 

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

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