An often persistent and long-lasting condition, psoriasis interferes with the life cycle of skin cells and causes them to increase rapidly on the surface of the skin. These generally appear as dry, itchy and red patches of skin having thick, silvery scales.

Psoriasis can be subdivided into the following:

    Plaque psoriasis: The most common form, characterized by dry, red skin lesions covered with silvery scales and can be seen anywhere on the body.
    Scalp psoriasis: These appear on the scalp and may extend beyond the hairline.
    Nail psoriasis: These affect the toenails and fingernails.
    Guttate psoriasis: Characterized by blister-like appearances and are stimulated by bacterial infections.
    Inverse psoriasis: Caused by fungal infections.
    Erythrodermic psoriasis: Can cover the entire body with a reddish rash that may peel.
    Pustular psoriasis: Capable of causing chills, fever and diarrhea.

The usual signs and symptoms of psoriasis include:

    Red, sensitive patches of skin
    A silvery, scaly cover
    Dry and cracked skin that may bleed when scratched or agitated
    Tiny scaling spots (witnessed in children)
    Persistent itching, soreness or burning sensation
    Ridged, thickened or pitted nails
    Stiff and swollen joints

Possible causes of psoriasis may include:

    Skin infections or strep throat infections
    Stress
    Skin injuries, like cuts, bites or sunburns
    Smoking
    Cold weather
    Chronic alcoholism
    Certain medications such as high blood pressure medications

Risk factors

The following factors may further increase the risk of developing the disease:

    Fungal and bacterial infections
    Family history
    Obesity
    Stress
    Smoking

Ayurveda and Psoriasis

Although the root cause of the disease is yet to be identified, according to traditional Ayurveda, the vitiation of Vata and Kapha causes psoriasis. As per ayurvedic principles, Vata and Kapha are the two basic energies that uphold the balance of our body equilibrium. Strong genetic predisposition, sun deprivation, and intense streptococcal infection on the upper respiratory tract can badly aggravate psoriasis. As per ayurveda, these conditions are strong enough to create several visible pathological changes that take place are mainly due to the accumulation of dooshi vishas or low potency poisons.

Uneven and unhealthy food habits, consumption of foodstuffs in the wrong combination (Example: dairy products with fish or chicken), too much intake of yogurt, black gram, seafood, sour or salted food stuffs, etc. can trigger the psoriasis inducing pathogenesis. Other catalysts that cause psoriasis includes stress, alcohol, and tobacco consumption

Psoriasis can be effectively treated through panchakarma therapies, which include ayurvedic treatment methods for the complete detoxification of the body, and successful elimination of harmful toxins from the body fluids.

A few health tips for psoriasis patients:

    Maintain safer distance from the possible variables that cause or aggravate psoriasis
    Practice yoga regularly. Yoga can lessen the intensity of psoriasis.
    Avoid pricking, peeling or scratching your skin.
    Make sure to pat your skin dry after washing, and avoid rubbing vigorously with towel or any rough cloth.
    Avoid artificial cleansers and use gram flour (besan flour) instead.
    Use cotton clothes
    Avoid cold water bath or immediate cleaning up right after heavy work-out, long walks, or travel.
    Avoid food stuffs that can cause indigestion.
    Avoid excessive salty and acidic food stuffs, radish, urad dal, sesame, jaggery (gur), curds, fish and other sour food stuffs that can trigger psoriasis.

Psoriasis - How it Effects Your Skin?

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 

Lupus is an autoimmune disease, which is chronic i. e. Lasts for years or more than at least six weeks and may affect any part or organ of the body. The immune system fights off viruses, bacteria and germs by producing proteins known as antibodies. Autoimmune means that due to some defect, your immune system is unable to differentiate between the healthy tissues in your body and foreign invader that harms your body; thus creating antibodies that destroy the healthy tissues. This causes inflammation and damage to various parts of the bodies, leaving the sufferer in excruciating pain. 

Symptoms:
1. Fatigue: most of the people suffering from lupus experience weariness and fatigue. People usually take afternoon naps to remedy this. However, this may lead to insomnia. Talk to a doctor to successfully cure this symptom.
2. Unexplained fever: if you suffer from recurrent fever that hovers around 99 to 101 degrees fahrenheit, visit the doctor as soon as possible since this is a sign of infection or inflammation.
3. Hair loss: one of the most prominent symptoms of lupus is hair loss or thinning of hair. You may find your hair looking brittle, thin and ragged, including the hair on your eyebrows, eyelashes and other parts of the body. 
4. Lesions or skin rash: another prominent symptom is the butterfly rash that covers both the cheeks and the bridge of the nose and appears right before a flare up. This rash may occur all of a sudden or when exposed to the sunlight. Lupus also causes lesions and discoloration on various parts of the body due to exposure to sunlight or artificial light.
5. Pulmonary issues: lupus causes pleuritic chest pain due to painful inflammation in the lungs as well as the areas surrounding it such as diaphragm and lung blood vessels. This affects the patient's breathing process. Moreover, lupus is also known to decrease the size of the lung also called the" vanishing lung syndrome" that is identified by shortness of breath and chronic chest pain.
6. Kidney inflammation: most individuals suffering from lupus tend to develop nephritis that is inflammation in the kidneys. It is imperative to visit the doctor if you have symptoms of nephritis as it may cause end-stage renal disease (esrd) if untreated.

Symptoms of Lupus

A common skin condition, which causes the discoloration of your skin in patches across the face, melasma is more of a social embarrassment and cause for distress rather than being a serious condition. Although it affects men as well, studies have shown that over 90 percent of patients are women. It is also known as the mask of pregnancy as many pregnant women develop this skin condition.

Causes of Melasma
Primary causes of melasma have been attributed to various hormonal changes within the body. Let's look at some of the factors that may cause this disorder:
1. Pregnancy: This is often attributed as the leading cause of melasma, the primary cause has often been attributed to hormonal changes that a woman may experience due to pregnancy.

2. Treatments that may change hormonal balance: Women on contraceptive pills or who have implants such as intrauterine devices may also develop this disorder. This is due to the balance of estrogen and progesterone being changed within the body.

3. Sun exposure: Continued sun exposure may also lead to melasma. This is due to the activation of melanocytes within the body which start producing more melanin.

4. Stress: Long periods of stress on the body can also trigger hormonal changes and cause melasma.

5. Thyroid problems: If someone suffers from Hypothyroidism or low levels of the thyroid hormone, it can trigger other hormonal changes and also cause this skin disorder. 
It has also been noticed that people with generally a darker skin tone tend to get melasma and it is less common in people with fairer skin.

Certain characteristics of Melasma
Melasma develops in certain patterns which can be easily diagnosed either as spots on the skin similar to freckles or brown patches of skin that grow bigger. Some of these patterns are:
a. Malar pattern: This grows on the nose and cheeks
b. Mandibular pattern: Starts growing around the jaw line
c. Brachial melasma: This grows on the upper arms and shoulders
d. Lateral cheek pattern: Grows on the cheek on both sides of the face
e. Centrofacial pattern: Nose, upper lips, forehead and cheeks

Treatment of Melasma
Most women who develop melasma during pregnancy report that it goes away after childbirth. However certain forms of melasma may appear in non-pregnant women due to hormonal changes. Treating the underlying hormonal changes usually resolves the problem. However certain other methods may be required to resolve the issues such as skin creams, chemical peels, dermabrasion and microdermabrasion.

All About Melasma

Stretch marks, as the name suggest; appears when the skin is over stretched. These marks can also appear when the body loses its ability to stretch (use of certain steroids). Both the conditions affect the skin elasticity. As a result, white, red (turn pale over a period of time) or purple streaks appear on the buttocks, armpits, stomach, thighs and chest.

Many factors influence the appearance of stretch marks, also known as striae distensae
1. Elevated levels of cortisone hormone (produced by the adrenal gland) play a pivotal role in the appearance of stretch marks.

2. Stretch marks are common during pregnancy. As the foetus grows in size, the skin tends to stretch more and more. This stretching provides sufficient space to the developing foetus. A hormonal imbalance can also mark the appearance of stretch marks during this period. In some, the stretch marks appear after pregnancy.

3. Stretch marks are sure to appear when a person experiences a sudden change in the body weight (weight gain or loss). These marks can also be seen in children who are in their growing phase (teenagers).

4. Use of corticosteroids (steroid hormones produced by the adrenal cortex) can leave your body with the unwanted stretch marks. It is advisable to use corticosteroids (pills or cream) under medical supervision.

5. Stretch marks may be an outcome of some genetic disorders such as ehlers-danlos syndrome and marfan's syndrome. Striae distensae can appear in people with cushing's syndrome (the adrenal gland produces the hormone, glucocorticoids in excess)

Stretch marks often affect person's confidence. Most people find stretch marks extremely annoying and embarrassing. They try every possible trick under the sun to camouflage and get rid of the unwanted marks. The stretch marks are generally harmless and can be treated.

1. Drink plenty of water. It is important to keep the skin hydrated. Bio oils, vitamin e enriched oils, certain creams, can effectively fades the appearance of stretch marks. Use of moisturisers containing cocoa butter and shea butter will speed up the fading process.

2. Loss or breakdown of collagen protein (fibrous protein) can result in stretch marks. For stretch marks that are not very old, tretinoin cream comes across as a huge relief. Application of tretinoin cream helps in the restoration of collagen protein. For pregnant women, it is best to avoid this cream.

3. In case the stretch marks are a little older, a person can go for microdermabrasion.

4. Another great technique is the pulsed dye laser therapy. This therapy works by enhancing the growth of elastin and collagen protein.

All the preventive measures and treatments can help to fade the stretch marks. However, none can guarantee complete disappearance of the marks.

Stretch Marks - Causes and Prevention Tips

Burn surgery is very common these days. Burn surgery is usually done on people who suffer from major burns. Reconstructive burn surgery is usually required in the last stages when the initial burns have healed to a certain extent. Usually reconstructive burn surgeries are done on patients who have suffered from huge accidents and have burnt their face, neck and hands to a great extent. Patients requiring this surgery usually become unrecognizable after an accident.

When is reconstructive burn surgery recommended?

If you have been involved in a household accident and the scars have not healed completely. Surgery might not totally heal the face, but it can improve your basic functions like breathing, smelling, seeing or tasting (if most of your senses are burnt and disfigured).
Reconstructive burn surgery is also very useful for acid attack victims. Sometimes, burns are not only caused by fire, but it is also caused by chemicals and acidic substances which are worse and can completely burn and disfigure your face. When hydrochloric acid, nitric acid and sulfuric acid come in contact with your skin it seeps into the skin and burns off your nose, cartilage and sometimes even causes blindness. It disfigures your face completely, reconstructive burn surgery can do miracles, though it cannot bring back your previous features and skin texture, but it does make you look more recognizable.
After a burn, facial scarring occurs which leads to the loss of eyelids, hair, nose and lips. In this case burn surgery is required.
How to take care of yourself after a burn surgery?

Regular stretching should be done, especially if the areas of your burn include your hands, legs, joints, etc. Do as much as activities as possible like getting dressed and grooming yourself. It will also make you more self-reliant and give you confidence.
Depression is very common after a burn surgery. A reconstructive burn surgery will not magically make you look the way you used to. A lot of sittings is required and remember, appearance and looks do not matter much. The wounds will fade away with time.
Itching is also very common after a burn surgery. If this problem persists, you should consult your doctor for a moisturizer.
Avoid sun exposure. Don t go out in the sun, because the U.V rays are extremely harmful and can singe your already sensitive skin; you can also get skin cancer.
Custom pressure garments should be worn to protect your skin.

Reconstructive Burn Surgery - How Can You Take Care Of It?

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