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 

Acne is a condition that affects many people including teenagers and women during their menstruation period. It is characterized by red eruptions that are usually filled with oil, secreted by overactive oil glands in the hair follicles. So what else should you know about acne? 

Here are six things you probably did not know about this condition:

1. Clogged Pores - Acne signifies clogged or blocked pores that are filled with oil and dead skin cells that have not been cleaned out completely. This mixture of oil and dead skin cells blocks the pores, and ends up creating an eruption of red sores called acne and pimples. There is a chance that bacteria may have joined these two substances as well.

2. Over Treating the Skin - The worst thing that you can do is to touch, pick or even apply too many harsh chemicals to your skin during an acne breakout. These things can actually make the problem worse, and even create scars in the long run. The constant use of cleansers and moisturizers can also have a harsh effect on the skin, due to perfume and chemicals present in such products. 

3. Exfoliation - Using a salicylic acid wash or cleanser first thing in the morning will help in exfoliation, which is a good way to clear those dead skin cells from your skin. This will speed up the process of acne treatment as well, by clearing the pores. Also at night, the use of a medicated cream that contains benzoyl peroxide will help in killing the bacteria, so that there is no infection.

4. Two Weeks Notice - Trying new products to treat acne is a great idea. But give every new product at least two weeks before you write it off. Usually, any good product will take at least that much time to affect the acne, and clear the pores in an effective way. So before you start changing cleansers and creams every other day, remember to use the two week thumb rule.

5. Menstrual Cycle - Acne, more often than not, happens about five days before and a few days after the monthly menstrual cycle. So watch out for hormonal imbalances, which can cause acne and pimples. Avoid stress around this time too.

6. Dermatologist - Visit a dermatologist if regular cleaning and over the counter creams are not working. Persistent acne may turn into infection. Remember to ask your dermatologist for an oil reducing formula too. 

Acne is a skin problem that should be treated the right way.

All About Acne

Blisters can be a very major inconvenience. Though it seems to be a good idea to pop a blister yourself as it can otherwise cause distraction or may be uncomfortable and unsightly, puncturing it often does more harm than good. Here are a few ways mentioned about how to treat blisters. Read on more to find out all about it.

1. For a Blister which has not popped
a) Try not to pop the blister as the pus if spread can affect other areas
b) Leave the blister uncovered or cover it with a loose bandage
c) Avoid putting pressure on the area of the blister. If the blister has appeared in areas where applying pressure is unavoidable like for example at the bottom of the foot, put mole skin around the blister in a circular fashion such that the mole skin gets the shape of a donut.

2. For a blister which has been popped
a) Wash the area where the blister appeared gently with warm water. Apply gentle soap in the area as well to disinfect the region. Do not by any chance use alcohol, hydrogen peroxide or iodine in the area as it would cause complications.
b) Smooth down the skin flap which remains after the blister pops. 
c) Apply antibiotic ointment in the affected area to prevent infections
d) Cover the region loosely with help of a sterile bandage or gauge.

3. When to drain a blister
a) For blisters which are painful, large or in awkward spots, it is better to drain them. Be careful and cautious while draining the blister and follow the below mentioned tips.
b) Wash the area where the blister has appeared.
c) Take a needle and sterilize it with alcohol and water.
d) Make an incision at the edge of the blister and carefully squeeze out the pus.
e) Wash the blister again and pat dry. Do not remove the skin flap which remains there after draining.
f) Smoothen the skin flap and apply antibiotic ointment in the region.
g) Wrap it up with a loose sterile bandage or gauge.

4. Follow up
a) Change the bandage on a regular basis, whenever it is wet or dirty.
b) Consult a doctor immediately if signs of infections like red streaks around the affected region, fever, or accumulation of more pus occur.

However, for blisters which have formed due to spider bites, chicken pox or such consult a doctor first.

All About Blisters and their Treatment

Plastic Surgery is a speciality that deals with reconstruction, alteration and restoration of certain parts in the human body. It improves a person's appearance and may also help in improving the functionality of various body parts. It can be classified as either re-constructive or cosmetic Surgery:

    Re-constructive Surgery: These type of surgeries are used to correct various defects in the body such as injuries as a result of trauma, physical birth defects, deformities in the ear and cleft lips.
    Cosmetic Surgery: Cosmetic Surgery is used to modify a part of the body for cosmetic reasons. The most common cosmetic surgery procedures are reconstructing the nose, removing fat from certain parts of the body and reshaping the breasts.

Outlined below are 5 facts about plastic surgery:

    Liposuction is popular among males: The most common plastic surgery among men is liposuction. So far, out of the 1 million plastic surgeries that men have undergone, most have been liposuction. The other popular cosmetic surgeries for men are face lifts and Rhinoplasty.
    35-50 year old undergo the maximum number of plastic surgeries. In 2014, over 4 million procedures were performed on people whose ages were in the range of 35-50 years. The most common concerns were sagging skin and fine lines. Liposuction was the most popular surgery in this age group.
    Most women opt for breast augmentation: Breast augmentation often requires correcting various issues such as post-op sagging and various other tweaks like modifying the size of the implants. The number of revisions in breast surgeries has actually gone up compared to the initial breast surgeries.
    Asian double eyelid surgery: A surgery where the eyelids are altered to make your eyes look bigger and attractive. It is a popular surgery among Asian women.

5 Facts You Never Knew About Plastic Surgery

Liposuction is very popular as a relatively quick and safe cosmetic surgery to get rid of excess fat. At one time, the procedure was even touted as a better alternative to healthy diet and exercise. Regardless of such myths, liposuction is an important development in cosmetic surgery. Indeed in certain cases (of extreme weight gain) liposuction is the first surgical procedure performed on the patient. Like all surgeries, liposuction has a few do's and don'ts, and they are:

Do's
1. Keep your weight at a healthy level before surgery. The more the amount of fat is removed from your body, the greater is the risk involved in surgery, which is why controlling your weight pre surgery is important. Losing a large amount of weight leaves a lot of loose skin in your body, which can make your skin look saggy.
2. Wear your compression garments. Compression garments help your skin compress over the area where the fat used to be, leaving smooth, tight skin.
3. Continue exercising (with the go ahead of your doctor) after the procedure and follow a healthy diet to maintain your body.
4. Maintain gentle activity for two weeks after the procedure. This will help in removing fluid deposition in the surgical area and prevent complications.

Don'ts
1. Do not take anti inflammatory medicines like aspirin or ibuprofen as these medicines may cause bleeding complications. They also harm the body's immune system, which is detrimental to recovery.
2. Do not smoke or drink while recovering as Nicotine disturbs normal skin growth, which may lead to permanent scars, while alcohol interferes with the effect of some medicines.
3. Don't lift heavy objects or bend down immediately after the surgery. Your doctor will give you a more specific timeline as to when you can pursue such activities.
4. Don't expect results from day one. You will see results after you have recovered from the surgery.
5. Do not opt for liposuction specifically for weight loss. Liposuction is chiefly a procedure for shaping and contouring the fat in your body to give you that shape you always desired.

Do's and Don'ts of Liposuction

Vitiligo or White patches is medically referred as Leucoderma. It is a disease that causes loss of skin colour resulting in white patches. It can affect the skin on any part of the human body. It occurs when the melanin-forming cells called melanocytes which produce melanin die or stop functioning. The condition is not life threatening or contagious, but it is stressful and makes one feel bad about oneself.

The main sign of vitiligo is loss of skin pigment which produces light or white patches on skin. The discoloration is first visible on sun exposed areas like the hands, feet, arms, face and lips. It can also be coupled with premature greying of hair below the age of mid-thirties, colour loss of retina and inner lining of the mouth.

Vitiligo has no cure, but homeopathic treatment help to stop or slow the process of colour loss and brings back some colour to skin. The failure of melanocytes can be attributed to disorder in which immune system attacks and destroys them. It can also be triggered by sunburn, stress or exposure to industrial chemicals. People with vitiligo are at risk of Social or psychological distress, loss of hearing, sunburn and skin cancer, inflammation of the iris and dry skin.

Homoeopathic treatment enhances the natural production of pigments and Vitiligo is considered as a manifestation of an inner disturbed state of the body. The patient is analysed on mental, physical and familial attributes. The medication is then based the results. Arsenic Sulph Falvus, Arsenic Album, Baryta Mur and Baryta Carb are known to give good results in Vitiligo. Vitiligo is a chronic disorder and it takes a long time even with the best of the homoeopathic treatment.

Calcarea Carb is prescribed to patients of Vitiligo with milky white spots on skin. It is prescribed to free perspiration over the head, neck and chest and persons with intolerance to cold weather.
Arsenic Album is useful remedy for vitiligo in persons prone to dry, rough skin. The skin complaint coupled with asthma is a strong contender for using homeopathic medicine Arsenic Album.
Sepia is prescribed for vitiligo in persons showing unresponsive attitude towards family and life
Silicea is prescribed for vitiligo in patients with pale and waxy skin, tendency to excessive perspiration. If the main mind symptom are timidity and an under-confident nature, then Silicea is a good choice. It is known to work on patients who seem under-confident, fear public speaking.
Sulphur is considered the best for vitiligo treatment as it goes deep inside the basic root cause to exterminate the disease. The persons requiring homeopathic medicine Sulphur show a mind constantly occupied with various theories and plans due to which they suffer from mental fatigue and absent mindedness.

Homeopathic Medicine for Vitiligo or White Patches Treatment

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