Psoriasis is a chronic dermatosis characterised by an unpredictable course of remission & relapse. It is a non-infectious skin disease characterised by scaly, silvery patches mainly on the scalp and exterior surface of the body. Its exact cause is unknown. In Ayurveda, it closely resembles with 'ekakushta'. The features of 'ekakushta' in ayurveda resembles 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 uses 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.
Roughly, 1% of population is affected. Can occur at any age and affected both the sexes. Most patients as worse in winters.around 7 million people are affected in developed country.
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 practitioners 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 of nail plates
Swelling in right middle metatarsal phalangeal 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 was within the normal limits. The patients are advised to opt panchakarma therapy, specifically 'Raktmokshan'. Raktmokshan has two type - Leech therapy and Siravedh (bloodletting through veins puncture). Raktmokshan can cure psoriasis very quickly as compared to other Ayurvedic remedies.
Leech Therapy: Leech therapy has shown drastic result in patients with eczema, psoriasis and all other types of skin infections. Leeches are 'worms' with suckers on each end. According to Ayurveda, Leech at first bite only sucks impure blood from the skin and only the pure blood is left so it is a blood purification therapy. Later, when it starts sucking pure blood, the patient feels pain. Raktamokshana can be done in four different ways:-
Raktmokshan is a curative therapy.
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