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 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

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 

When you think of organs of the body, the mind goes to internal organs like the stomach, liver etc. However, the largest organ of the body is the skin. Given its size and the amount it interacts with external stimuli, the skin is susceptible to a number of infections. One of the common issues to affect skin is known as psoriasis. This is typically seen as a rash that can make the skin dry, thick and flaky. It can make the skin feel very itchy and make the person unconsciously scratch his or her skin so hard that it bleeds. Although, even modern medicine does not have a way to cure psoriasis but can manage the symptoms. In contrast, homoeopathy can help treat the factors triggering this infection and hence keep it from recurring.

Homeopathy is a holistic form of medication that treats not only the symptoms exhibited but also the issues triggering the infection. Homeopathic medicines are usually prescribed in the form of sweet pills, powders or liquids. This form of medication has negligible side effects and can be prescribed to children and adults of all ages. If needed, it can be prescribed along with other types of medication as well. However, homeopathy does not follow a one size fits all approach. This means that a remedy that suits one person may not be effective for another. This is because the ideal homeopathic prescription depends on the symptoms being exhibited by the patient, his or her overall physical and mental health, family history, personality etc.

There are a number of homeopathic remedies that may be prescribed to treat psoriasis. Some remedies can treat psoriasis that is passed on genetically from one generation to another while others can treat psoriasis caused by exposure to warm or cold conditions. Homeopathy can be used to treat psoriasis that makes the skin dry as well as psoriasis that leads to oozing lesions. It can also be used to treat chronic cases of psoriasis. In many cases, two or more remedies may be prescribed simultaneously.

When taking homeopathic remedies one must follow the prescribed schedule. Medicines must be taken half an hour before or after meals. When taking two or more homeopathic medicines, they must be spaced at least 5 minutes apart. The ideal time to take the morning dose is as soon as one wakes up. Similarly, the best time to take a night dose is just before going to bed.

Psoriasis And Homeopathy - What All Should You Know?

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

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?

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