PSORIASIS

INTRODUCTION

The skin is one of the five sensitive organs which is responsible for touch sensation; therefore, it plays a great role in physical and mental wellbeing of any individual. The unbroken skin is the nature’s dressing over the body. It acts as an effective barrier against the entry of diseases and its damage results in whole host problems.

Psoriasis is one of the most common dermatologic diseases, affecting about 2% of the world population. The rate of psoriasis varies according to age, gender, region and ethnicity. A combination of environmental and genetic factors is thought to be responsible for these differences. It usually occurs before the age of 40, most commonly between the ages of 15 and 25 years; affects equally in men and women. The aetiology of psoriasis is still poorly understood, but there is clearly a genetic predisposition. It has been found in large surveys that one third of patients have a positive family history. Evidence has accumulated and clearly indicating a role of T- cells in the patho- physiology of psoriasis.

Psoriasis can be a very persistent complaint. It does not kill but it is responsible for great deal of unhappiness feeling of depression. Hence, psychological aspect of psoriasis is most important in the etiopathogenesis and management of psoriasis.

DEFINITION

Psoriasis is a non-infectious chronic relapsing inflammatory skin disease characterized by well-defined dry scaly erythematous patches and covered with adherent silvery white scales. The eruption is usually symmetrical and most commonly affects extensor surfaces of elbows, knees, scalp, nails and the sacral regions. Psychological stress is emphasized as one of the major triggering factor in the exacerbation of the disease.

CLASSIFICATION

Clinically psoriasis can be classified as:

•   Plaque psoriasis
                Involving palms & feet       Scalp involvement       Nail involvement
• Guttate psoriasis
• Flexural psoriasis
• Pustular psoriasis
• Erythrodermic psoriasis

PLAQUE PSORIASIS: Also called as psoriasis Vulgaris is the most common form of Psoriasis. It is presented with dry, slightly elevated, red patches called as plaques that are covered by a layer of silvery white scales.   

When plaques are localised in the palms of the hands and soles of the feet are called as PALMO-PLANTAR Psoriasis.

The lesions effecting the scalp dermis, may spread to the ears, forehead, and the back of the neck may or may not be presenting with the hair loss, without the involvement of the rest of the body surface is called as scalp psoriasis.

50% of the patients suffering from the psoriasis presents with the changes in the nails which include, severe thickening of the nail, shallow or deep holes (pits) in the nails, discoloration of the nail either yellow or brown, separation of the nail from the bed.

GUTTATE PSORIASIS: 

This presents as small reddish dots simulates the rain drop like lesion. Typically seen in the upperbody, legs, and arms, but also can occur in any other part of the body.

FLEXURAL PSORIASIS:This type of psoriasis appears in the skin folds which are smooth, red patches devoid of scales as seen in plaque psoriasis. It may appear in the genitals, under the breasts, and in the armpits. 

PUSTULAR PSORIASIS: This appears as small, white, fluid filled blisters (pustules) surrounded by swollen, reddish skin. It can occur anywhere in the body and may result in the fluid imbalances and infection associated with the raise in temperature.

ERYTHRODERMIC PSORIASIS:This covers the entire body; skin appears bright red with extensive fine scaling. It may be a quite painful conditionassociated with severe itching. There may be requirement of hospitalisation in case of protein and fluid loss, and decrease in body temperature.

One of the complications of the illness is the development of the Arthropathy in about 5% of the psoriatic patients. Symptoms may simulate the presentation of rheumatoid arthritis. The tests for rheumatoid arthritis will be negative and rheumatoid nodules will be absent.

Modern medical science treats psoriasis with PUVA and corticosteroids. But these therapies give serious side effects like liver and kidney toxicity, bone marrow depletion etc. Hence it is the need of time to find out an alternate safe and effective treatment for Psoriasis.

TREATMENT IN AYURVEDA

Psoriasis is one of the most common dermatologic diseases and still stands as a challenge to different medical systems. Many research works have been done on psoriasis in Ayurveda and modern medical science but no drug has yet been claimed to cure psoriasis completely. Psoriasis can be better managed by the following Ayurvedic principles:  

Ø  NidanaParivarjana(Avoiding the cause factor)

Ø  Shodhana Therapy(Purification Therapy)

Ø  ShamanaChikitsa(Pacification Treatment)

In Ayurveda, Psoriasis can be correlated with‘Ekakustha’ due to very much similarity in their symptoms. The unique treatment modality of Ayurveda provides long lasting results and a better life to patients through its three basic principles of treatment.

PANCHAKARMA – The purificationtherapy is a unique type of treatment for various chronic, auto-immune, hormonal, degenerative disorders etc, where other sorts of treatments have no satisfactory answer as well equally beneficial for the promotion and preservation of health. In addition, the “Shamana” (internal medicines)& External Application (Lepan) of drugs is administered after taking the proper course of “Shodhana” (Panchakarma) then it provides additional relief and thus helps in eradication of the diseases (psoriasis) completely.

“Kitibha” is a type of “kshudrakushtha” described in different Ayurvedic classics. It is a “Vata-Kaphaja” disorder. The clinical symptoms of “Kitibha” described in Ayurveda resembles with the clinical symptoms of Psoriasis. The clinical features of Kitibha described by Kashyapa represent remission, relapse and seasonal variation, which is present in Psoriasis. It is one of the most common dermatological problems of unknown aetiology. It is a chronic, genetically determined, inflammatory and proliferative disease characterized by dry, well-circumscribed, silvery scaling papules and plaques of various sizes with spontaneous remission, relapse and seasonal variation.

Medicines which are used in Ayurveda are safe and being practiced since thousands of years. A large number of drugs are described in Ayurveda for the treatment of Psoriasis,

Psoriasis Treatment in Namami

NAMAMI, the holistic health retreat, situated in Kochi, Kerala, basically relays on integrating the best of Ayurveda, Yoga, Meditation and Naturopathy in treating such chronic skin issues.

We have formulated certain special combinations and treatment protocols to cure psoriasis and reduce the relapses. “Takradhara”, “Snehapanam”etc are some of the unique treatments practised at NAMAMI. We have also got expert Ayurvedic consultants visiting our centre to handle such patients with various skin disorders.

Namami is an Ayurvedic wellness resort integrating the ethos of Ayurveda, Naturopathy, Yoga and meditation and is situated by the banks of River periyar near Cochin International Airport.

By

Dr.Bejoy, B.A.M.S,
RMO, Namami Purnagram