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, 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 long lasting disease characterized by patches of scaly, itchy and red skin. It can be restricted to a small areas or can even spread to the whole of your body. When the underlying infection reaches the surface of your skin, the healthy cells die. This causes red and itchy plaque covered with white scales. It mostly occurs on the elbows, knees and scalp. Sometimes these scales itch and also bleed. In severe cases the red skin grows and merges with another patch.

Conditions of psoriasis:
1. Finger nails get discolored and pitting is noticed. The nails begin to crumble and in severe cases detach from the nail bed.
2. Scales and crust start to develop on the scalp.

Types of psoriasis:
1. Guttate psoriasis- It is characterized by small red spots which occur on the torso and limbs. It usually starts in young childhood or adulthood. It triggers respiratory infection, tonsillitis and strep throat.
2. Inverse psoriasis- In this condition bright red and shiny abrasion occurs in the groin area, in the armpits and under your breasts.
3. Erythrodermic psoriasis- It is characterized by periodic redness of the skin and shedding of the skin. It also causes severe sunburn and infection.

Cause of psoriasis:
Many factors can cause psoriasis. Factors such as, trauma, infection or emotional stress can trigger this condition. Some abnormalities in the system also cause psoriasis. People who have a flare up of psoriasis are usually affected by emotional stress or some trauma like the death of a loved one or loss of a new job. These tensions may intensify because of problems in your internal system.

Ayurvedic treatments for psoriasis:
1. Consuming medicated ghee.
2. Herbal medicines or herbal concoctions can also be consumed.
3. Basthies are medical and herbal enemas which should be taken for 8days.
4. You should avoid having meat and only consume vegetarian dishes to reduce psoriasis. Also avoid yogurt, black gram, salty food products and chilies.
5. You can also remove impurities from your body by means of vomiting and purging.
6. You can also cure psoriasis by covering your entire body in a paste of mud.
7. Consume turmeric and Neem daily to treat psoriasis.

Some medicine like arogya vardhini vati, kutaki, ras manikya, Giloy ghan vati must be taken after consulting an Ayurvedic expert.

7 Best Ayurvedic Medicine for Psoriasis Treatment

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 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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