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 

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, 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 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

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 an inflammatory skin disease in which the skin cells multiply at a rate higher than the normal. It can even be 1000 times compared to the normal rate. It worsens every winter as the skin becomes itches and even starts bleeding after scratching. However, psoriasis is not contagious meaning that it cannot spread from one person to another. In fact, psoriasis is not an infectious disease. It does not occur due to infection of any sort. That is why it does not spread from one person to another.

Treatment
The general belief is that Psoriasis is incurable. However, this is not true. Homeopathy is far more effective in the treatment of psoriasis and these homeopathic medicines are completely natural and do not contain any chemical compounds at all unlike allopathic medicines. The homeopathic remedies do not intend to suppress this inflammation. In fact, they intend to correct the cause that has resulted in this indiscriminate cell division and also the inflammation. Once these two things are set right, the symptoms disappear on their own.

Homeopathy does require some patience on the part of both the patient and the doctor to get good results in the homeopathic treatment of psoriasis.
Remedies for the homeopathic treatment of psoriasis

Graphites is one of the best homeopathic remedies for psoriasis with constipation. In such cases the patient cannot tolerate cold easily. There may be thick sticky discharge from the eruptions. In some cases, eczema may also be present with psoriasis. In female patients, there may be disturbance in the menstrual cycle too.
Mezereum is helpful in case of psoriasis on the scalp. In such cases thick and leathery crusts cover the head and there is pus beneath these crusts.
Arsenic Iodatum is given in case where patches of psoriasis occur with multiple colours. The scales are usually large in size.
Sepia is recommended for psoriasis with foul odour from the eruptions and the affected area of the skin. It is a deep acting medicine and should not be repeated often.
Thyroidinum is considered one of the best homeopathic medicines for psoriasis with obesity. In such cases the itching gets worsened at night. It is a remedy for chilly and anaemic patients suffering from dry impoverished skin along with cold hands and feet.
Arsenic Album is an excellent psoriasis remedy in which psoriasis gets worsened by cold and better by warmth.
Sulphur is considered helpful in various skin manifestations
Kali Brom is helpful in case of syphilitic psoriasis whose symptoms include skin cold, blue, spotted corrugated, large, indolent, painful pustules.
Kali Ars is given in case of patches on back, arms and elbows and scaly itches.
Radium Brom is helpful in treating psoriasis of penis, itching eruptions on face oozing and patchy erythema on forehead.
Other natural and alternative remedies can also be resorted to including Naturopathy, Herbal medicine, Yoga, Ayurveda, Acupressure etc. In case you have a concern or query you can always consult an expert & get answers to your questions!

Psoriasis - 10 Homeopathic Remedies For It!

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