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 

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 disorder which is characterized by rapid multiplication of skin cells on the skin s surface. These extra skin cells develop into silvery scales, which are often dry and itchy. It may also lead to formation of painful red patches on the skin. This disorder might produce symptoms, which flare up and reduce periodically. There is no cure for psoriasis; treatments however can make the symptoms manageable. 


Symptoms
The symptoms of psoriasis include red patches on the skin and scaly and dry skin. The red patches might be itchy and one might often experience a burning sensation around the area. The joints in your body may also become stiff and swollen. 


Causes
The exact cause of psoriasis has not been ascertained. The accepted theory is that psoriasis occurs when the immune system attacks the healthy skin cells. There is a type of white blood cell called the  T cell , whose function is to combat harmful virus or bacteria in the body. With Psoriasis or any other autoimmune disorder, these T cells start attacking the healthy (skin) cells. 


Overactive  T Cells  may trigger other responses in the body, thus, leading to excess production of skin cells and white blood cells. The excess cells move to the skin surface and end up causing the red painful patches.


Treatment options to manage psoriasis
Although there s no cure for psoriasis as such, the symptoms can be controlled. The treatment options for psoriasis are:
1. Topical treatments: Topical treatments involve application of creams and lotions. They have been mentioned below:
I. Corticosteroids: Corticosteroid creams or lotions reduce the excess skin cell production, thus, reducing inflammation. They are generally not used as a long term treatment as they cause skin thinning.
II. Vitamin D analogues: A synthetic form of Vitamin D, it helps in slowing down skin cell growth. 
III. Salicylic acid: This treatment is used to reduce scaling on the skin, caused due to psoriasis. It is usually administered along with other medications.


2. Light therapy: Light therapy involves using sunlight or artificial light to reduce inflammation and scaling. It helps in reducing the activity of T cells in the body. 


3. Oral medications
In case of severe symptoms, oral medications are prescribed. Medications such methotrexate helps in reducing the excess production of skin cells. Cyclosporine is a drug that is used to suppress the erroneous immune system response. 

Psoriasis - 3 Easy Ways You Can Get them Treated

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

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 condition in which rapidly multiplying skin cells cause the area affected to become rough, scaly and itchy. The affected area becomes red and sometimes painful and while the disease can t be cured, it can be managed by limiting the rapidly multiplying cells. The immune system is thought to be compromised in psoriasis which leads to Infection by opportunistic bacteria such as streptococcus. 

Till very recently, psoriasis was thought to be idiopathic, but studies show emotional imbalance or triggers such as cold and infections might lead to activating an inherently present gene. Even though it is usually limited to the skin, it can affect the joints and nails too. This autoimmune disorder occurs in patches where the scaly formation might become irksome, especially if it is in uncommon areas such as the mouth and genitalia. Psoriasis is also thought to be a result of alcoholism or medication such as lithium which is used to treat epilepsy or bipolar disorder.

Common homeopathic remedies
When treating psoriasis, homeopathy is a trove of invaluable resources and treatment options. Medication is customised for the patient after taking into account their personal medical history.
Homeopathy acts by trying to manage the root cause of psoriasis which is an immunocompromised state of being. The added advantage of homeopathy in treatment is the lack of side effects.

Here are some of the most feasible treatments for treating psoriasis with homeopathy:

Kalium Bromatum: It is the first line of treatment in a lot of cases of psoriasis, especially when the red patches are covered with silver scales. It is also used in syphilitic psoriasis.
Kalium Arsenicosum: It is an effective treatment for psoriasis that develops on the back and the arms.
Sulphur: It is best suited for skinny people or those who tend to be forgetful.
Calendula: It helps soothe and provide temporary pain relief for affected areas, especially if they are inflamed, but it doesn t address the underlying cause of the disease and hence doesn t treat it.
Kalium Sulphuricum: It is best used for papular psoriasis, especially when sebaceous secretions are also involved.
Arsenic Album: It is used for cases of psoriasis which improve on the application of warmth on the affected areas.

Psoriasis - 6 Homeopathic Treatments For it!

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