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 

Any surgery that requires an incision will involve sutures or staples as the last step of the procedure. This helps close the incision and keep out infections. Taking care of your stitches can help limit scarring and discomfort and speed up the healing process. Here are a few things to keep in mind.

Keep it clean and dry: For the first few days, use a washed wet cloth to clean the incision site. After a few days, you may start washing the area with soap and water unless advised else wise by your doctor. Ensure that you dry the skin thoroughly after washing it. Avoid baths that involve soaking the area in water. Also, avoid swimming. Do not use any powders, lotions, creams, deodorants etc on the wound site.
Look out for signs of infections: Avoid activities that may involve exposing your wound to dirty water, chemicals, dust etc. This increases your risk of infections. Also look out for signs f infections such as redness, swelling, pus or bleeding, fever or increased pain from the wound. In case you notice such signs, consult your doctor at the earliest.
Do not scratch: As it heals, your skin is likely to turn itchy. However, refrain from scratching so as to reduce chances of infections. Do not try and pull away from the scab but let it fall off on its own. This will also help limit scarring.
Limit contact: Avoid wearing tight clothes or anything that sticks to the skin while your wound is healing. Instead have plenty of loose, comfortable clothes easily accessible. Also, do not take part in close contact sports such as football etc until the stitches have healed completely.
Change your dressing regularly: A dressing should be changed as soon as it gets wet or soaked with blood or other body fluids. Wear clean medical gloves while changing a dressing. When putting on a new dressing do not touch the inside of the dressing or apply any creams on the stitches unless advised so by your doctor. In the case of removable stitches, the doctor will usually remove the stitches after a few days. DO not attempt to pull the stitches out on your own.
Avoid exposing the wound to sunlight: New skin that forms as the incision heals is very sensitive to sunlight and gets sunburnt very easily. Limiting your exposure to sunlight can help reduce the effects of scarring.

Stitches Post Surgery - How You Should Take Care?

What you need to know about the ring-shaped rash called lupus

Lupus is an inflammatory disease that is chronic in nature. It occurs when your tissues and organs are attacked by your body's own immunity system. The inflammation that this disease causes can affect the other parts of your body as well, like the joints, kidneys, skin, brain etc. It is often difficult to diagnose because it lacks distinct symptoms. However, one of the most identifiable symptoms of lupus is a ring-shaped rash on the face.

Lupus can be caused by a number of factors like:

1. Excessive exposure to sunlight
2. Susceptibility towards infections
3. Certain anti-seizure, blood pressure and antibiotic medicines

Symptoms

The symptoms are neither distinct nor regular. However, some common symptoms could be-

1. Fatigue and fever
2. Pain in the joints, stiffness and swelling
3. Ring-shaped facial rash
4. Skin lesions on exposure to the sun
5. Chest pain and shortness of breath

What else can lupus lead to?

Several complications may arise if lupus is left untreated. Some of them are-

1. Kidney damage and failure
2. Hallucination, seizures, strokes and several other problems associated with the brain and the central nervous system
3. Anemia, blood clotting, vasculitis etc.
4. Increased susceptibility to pneumonia
5. Increased risk of heart attacks and other cardiovascular diseases

Treatment

Lupus is a significantly dangerous disease and medical help should be immediately sought if you think that you have symptoms associated with it. Treatment depends on the signs and symptoms of individual patients.

If you would like to consult with me privately, please click on 'consult'.


What You Need to Know about this RING-SHAPED Rash on Your FACE!

Each woman has a unique silhouette and one of the characteristic elements of a woman s silhouette is the curve of her breasts. Some women who are not happy with the shape and size of their breasts may opt to undergo breast augmentation surgery. Women who feel that their breasts have lost their shape after pregnancy or as a result of weight loss or those who have asymmetric breasts may also choose to undergo breast augmentation surgery. This is a cosmetic surgical procedure through which the size of the breasts may be increased by placing synthetic implants under the skin.

This procedure is usually performed under general anaesthesia, where an incision is made under the breast, around the areolas or under the arm through which the implant may be placed. This incision is usually made such that it is camouflaged by the natural contours and creases of the breast. The implant is usually placed under the pectoral muscle or placed directly below the breast tissue above the pectoral muscle.

The placement of the implant depends on the type of implant, the degree of enlargement desired etc. the incisions are then stitched close or closed with surgical tape. The results of breast augmentation surgery should be immediately visible after surgery.

After the surgery, the patient may feel some pain and soreness around the breasts for the first 48 hours. There may also be itchiness and the patient may find it difficult to raise their arms properly. The patient may also experience slight swelling and discolouration which should resolve itself within a few days. The doctor may also advise the patient to wear a compression garment or special lingerie to support the breasts.

 When it comes to cosmetic surgery, what one person considers good looking, another may not. Hence, it is important to find a cosmetic surgeon who has a similar point of view as the patient. Before undergoing the procedure, ask to see before and after photographs of the doctor s earlier patients. If possible show your doctor photographs of what you would like your breasts to look like after surgery. This will help you achieve the results you desire.

Breast Augmentation & Lifting - How it Can Help?

Ayurveda offers a unique and holistic approach in treating acne. It is an Indian healing system, which aims at treating pimples and acne by managing its underlying causes. Toxicity build-up and impaired digestion are targeted according to the doshas identified in an individual by an Ayurvedic practitioner. 

According to Ayurveda, the whole of the cosmos is made of 5 elements namely water, fire, air, earth and space. Doshas are aggregations of these elements and affect our well-being. If access to an Ayurvedic practitioner isn t feasible, then try cutting down on junk food as they contain additives and preservatives. Eat foods which don t have more than 4 ingredients.

Raw and unprocessed food is the best for digestion. Replace artificial skin care products with natural ones. Change your sheets and pillows regularly as they may have trace residues of acne causing organisms. Insecticides and disinfectants should be substituted for their natural counterparts, such as neem based cleaning agents.

Here are some Ayurvedic natural substances which work wonders for treating your acne:

Tulsi: An amazing way to get rid of pimples is tulsi (basil) paste when used by you on a daily basis. If access to fresh basil is difficult, then get a jar of dried basil from your neighborhood departmental store and use it with warm water. Use about 3 teaspoons so that a smooth paste can be formed and apply it on your face for over 10 minutes up to 5 times a week.
Lemon and Honey: A mix of lemon juice and honey is a simple, but effective homemade beauty remedy for the treatment of acne. Mix 1 tablespoon honey and 1 tablespoon fresh lemon juice. Apply the mix on the pimples and on the spots caused by the pimples. However, do not apply on severe pimple outburst as it can cause a severe and intense burning sensation. Keep it on your face for about 10 minutes and then wash it off. You can continue doing this 7 times in a week. You will eventually find very satisfactory results.
Cinnamon: Try dry roasting dalchini or cinnamon. Grind it finely and then make a creamy paste by adding honey to it. Apply this paste for a minimum of 5 times a week. Let its goodness soak into your skin and watch the benefits of the paste work its miracle!
Neem: Neem leaves (Indian Lilac) are the perfect natural way of treating pimples. Turn it into a paste and apply it on the areas affected with pimples. If getting fresh neem isn t feasible, try procuring some dried and bottled leaves instead and soak for about 15 minutes in hot water and use the same as a paste.
Sesame: Turn sesame seeds into a paste by soaking them overnight. Then turn into a paste. You can also use powder, which is readily available. Keep the paste on for 15 minutes and wait for the magic to work.
Potato: Potato juice or grated potato can be applied directly onto your pimples. Let the sticky potato juice sit on your face for over 10 minutes before washing it off. It lends a mild and natural bleaching glow to your skin. The same technique can be also tried with tomato juice.
Mint: Soak a few mint leaves and turn it into a fresh paste , it will act as an astringent.  Mint is also effective in making acne marks fade away if used regularly.

Acne - 7 Home Remedies for Treating it 

Moles are a common form of growth or formation on your skin that appear often in the form of small, black spots. They can develop anywhere on the body. They usually occur during adolescence or childhood and with the passage of time, they may change colour. Moles are a type of skin growth, which usually do not go away with time.

On the other hand, freckles are often described as round, flat, dark colour spots which vary in size from about 2mm to 4mm. They may result from pigment precipitation in one particular area as the skin that surrounds the dark spot is comparatively lighter in shade. Being sensitive to the sun s ultra violet rays, freckles become more noticeable during or after sunlight exposure. Although freckles are usually found in areas which are not covered from the sun s exposure, they could also occur anywhere on your body.

What causes them?
Moles are caused due to certain skin cells, known as melanocytes, grow in a very close group instead of being evenly and normally spread across the skin. Moles that occur during birth are called congenital nevi and their chances of occurring are around 1 in a 100. These moles are more prone to develop into skin cancer (melanoma) in later stages of life.

Freckles on the other hand are 

Genetically transferred, so the chance of you becoming affected are higher, if any of your parents have it.
If there s a prolonged exposure to the sunrays, then freckles may appear on your skin and they become even more prominent on a fair skin. Since the presence of melanin is less in people with fair skin the sunlight exposure causes these dark spots to surface easily
Hormonal imbalances could be yet another reason for freckles to appear as estrogen could be over-stimulate cells that produce pigment and thus become more prominent in the presence of sunlight.
Rare disorders like Xeroderma Pigmentosum (a condition leading to extreme light sensitivity and also skin cancer in certain cases) can make your skin more sensitive to the UV rays, thus resulting in freckles.
Treatment of moles and freckles

Laser Treatment: There are different types of lasers which are absolutely safe and can help reduce or lighten these dark spots effectively.
Cryosurgery: The physician would use a light freeze in conjunction with liquid nitrogen to reduce the spots of freckles. However, not every spot responds to this kind of treatment.
Retinoids: Mostly used with a combination of other bleaching creams, retinoids help reduce freckles when used continuously for a couple of months.

Moles and Freckles? How They Can Be Treated?

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