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 

5 things that worsen your psoriasis

Psoriasis is one of the most chronic and long lasting diseases relating to the skin. Under this condition, 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. The top five things that can worsen your psoriasis are listed below.

Alcohol

There is a direct link between your drinking habits and your skin health. Drinking, in general, tends to cause harm to the overall body. Skin being no exception also gets affected adversely by alcohol consumption. If you have psoriasis, then you should immediately consult your dermatologist so that he/she can assign you a daily limit for your alcohol consumption in a manner that it does not worsen the condition of your skin.

Infections

Psoriasis also gets worsened by common infections like an earache, bronchitis, strep throat infection, and such others. It is highly recommended for you to consult your doctor if you have anybody infections along with psoriasis. So the doctor will be able to tell you the risk of the infection and how to go about managing it.

Stress

Stress has been known generally to affect the skin in an adverse manner. Stress can cause your body to have a greater incidence of inflammation on your skin which further affects your skin disease. Your doctor can help you out with the ways to manage your stress so that it does not cause any further damage to your skin.

Weather changes

Medical researchers have proved that psoriasis tends to grow in colder and drier conditions. It has reportedly been observed that people having psoriasis have smoother skin during summers than during winters.

Cuts and bruises

If there are any kinds of breakouts or irregularities in your skin, then it would further worsen your psoriasis. Your cut skin may lead to a flare which is known as the Koebner phenomenon in medical terminology.



5 Things That Worsen Your Psoriasis

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 

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

The skin is the largest external organ as well as the largest organ in general in the human body. There are many types of skin diseases that can afflict your body and they may appear anywhere. Ayurveda is a potent weapon which can be used to treat many skin diseases effectively. The natural remedies of Ayurveda are being increasingly adopted throughout the world. Let's take a look at a few of the skin diseases that can be easily cured by Ayurveda.

Eczema - one of the most common types of skin diseases, eczema is characterized by the reactions that the skin has. These reactions can manifest themselves in many forms. The most common reaction is swelling of the skin with redness. Other forms may also develop blisters, cracking of the skin, scaling or papules.

Scaly rashes - scientifically known as papulosquamous eruptions, scaly rashes are usually the result of itching which in itself is a reaction to some internal or external factors. These rashes can be mild to severely painful depending on what had caused them. Some factors behind these may be eczema, reaction to drugs, psoriasis and others.

Urticaria - these rashes differ from other ones as they persist for a short period of time and usually result in swellings on the skin. These swellings may be very sensitive and itchy. Some common examples of urticaria are nettle rashes and hives that may develop due to an external factor such as bug bites.

Psoriasis - Ayurveda has great treatments for this disease as its incidence within the population is quite high. This is a non-infectious skin condition where inflammation occurs in the affected parts of the skin and reddish scales form on the body. This problem is usually attributed to excessive cells within the body.

Pruritus or itching - another very common skin affliction which can be caused by a variety of factors, it can be a reaction to something external or be caused by internal issues that may be developing. Mostly caused by the reaction of external nerve endings they may become very painful if over stimulated.

Ayurveda has many remedies for all of the ailments mentioned above along with many other skin disorders and has gained popularity as it completely natural and devoid of side effects encountered with conventional medicine.

Common Skin Diseases That Ayurveda Can Easily Cure

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

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