ayurvedic management of psoriasis (ek-kustha a case …

www.wjpps.com Vol 8, Issue 9, 2019.

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Agari et al. World Journal of Pharmacy and Pharmaceutical Sciences

AYURVEDIC MANAGEMENT OF PSORIASIS (EK-KUSTHA) – A CASE

STUDY

Dr. Rashmi Agari*1, Dr. Sanjay Kumar Tripathi

2, Dr. Shweta Shukla

3, Dr. Ajit Kumar

Singh4

1PG Scholar, Dept. of Kayachikitsa, Rishikul Campus, UAU, Haridwar.

2Prof., Dept. of Kayachikitsa, Rishikul Campus, UAU, Haridwar

3Assistant Prof., Dept. of Kayachikitsa, Rishikul Campus, UAU, Haridwar.

4PG Scholar, Dept. of Kayachikitsa, Rishikul Campus, UAU, Haridwar.

ABSTRACT

The word psoriasis is derived from Greek word Psora+ Iasis. Psora

means condition. So by combining the words together, psoriasis means

an itchy condition. Psoriasis occurs when the immune system mistakes

the skin cells as pathogens and sends out faulty signals that speed up

the growth cycle of skin tissues of the body psoriasis is a multi-

factorial disease that arises due to many factors such as genetic

predisposition, local trauma, general illness, smoking alcohol,

indigestion, excessive alcohol and stress, both hormonal and

immunological abnormalities are involved at a cellular level in

psoriasis. Dysfunctional of T-cells is the primary event and then hyperkeratosis occurs in the

epidermis. According to Ayurveda vitiation of Vata and Kapha dosha by dietary and lifestyle

changes play a primitive role in the generation of chronic psoriasis. In addition to this, Ama,

a variety of exogenous environmental stressors and genetic / epigenetic factors play a

significant role in the pathogenesis of psoriasis. These vitiated Doshas and males with and

without Ama, in turn, adversely affect the skin and blood tissues as well. So in psoriasis Vata,

Kapha, and Pitta/Rakta vitiation are major contributing pathological factors in its

manifestation. Although Ek-kustha is considered as a disease of Bahya Rogmarga, but its

initiation is from Koshtha, hence diet also plays a prominent role in early pathogenesis of Ek-

Kushtha.

KEYWORDS: Psoriasis, Ek-Kushta, Ayurveda, Ama.

WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES

SJIF Impact Factor 7.421

Volume 8, Issue 9, 575-583 Case Study ISSN 2278 – 4357

Article Received on

25 June 2019,

Revised on 15 July 2019,

Accepted on 04 Aug 2019,

DOI: 10.20959/wjpps20199-14516

*Corresponding Author

Dr. Rashmi Agari

PG Scholar, Dept. of

Kayachikitsa, Rishikul

campus, UAU, Haridwar.


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INTRODUCTION

Skin is the vital sense organ of the human body.it is a vital as well as a coplex organ of the

body which usually is underappreciated in case of physical and mental health, unless a

problem or an ailment originates in it. It is the most important barrier of our outer body

against many microorganisms. It also helps in body temperature regulation, maintance of

immunity, excretion of wastes in the form of sweat an sebumand also helps in the vitamin d

synthesis in the presence of sunlight Psoriasis was described as a distinct cutaneous entity

nearly 200 years ago. Thereafter, it was recognised that the term Psoriasis included a variety

of different clinical appearances, which were collectively designated as psoriasis vulgaris. It

is a common skin condition that speeds up the life cycle of skin cells. It causes cells to build

up rapidly on the surface of the skin. The extra skin cells form scales and red patches that are

itchy and sometimes painful. Psoriasis is a chronic skin disease that often comes and goes.

the main aim of treatment is to stop the skin cells from growing so quickly. it has an equal

incidence in males and females. The disease has a polygenic trait with more than one gene

involved. When one parent has psoriasis, 8% of offsprings develop psoriasis, and when both

parents have psoriasis, 41% develop psoriasis.

Psoriasis is a non-infectious chronic inflammatory skin disease with unknown etiology and

relapsing in nature. It is characterized by well defined dry erythematous patches and covered

with adherent silvery white scales. It mostly & commonly affects extensor surfaces of

elbows, knees, scalp, nails & sacral region. It affects 1-2 % of World population. In

Ayurvedic texts, a compromised digestive system leads to an increased Vata Kapha and also

increase of Pitta Dosha in Ras and Rakta Dhatu, which leads to manifestation of Ek-Kustha.

In Charaka Samhita the Ek-Kustha symptoms are very similar to psoriasis.

“अस्वेदनं महावास्तु यन्मत्सस्यशकलोपमम ्तदेककुष्ठं” (च.नन.)

Aswedanam means- absence of sweating, Mahavastu means- extensive localization and

Yanmatsya Shakalopamum means – resembles the scales of fish.

As per ancient Ayurveda text, the Samprapti of psoriasis can be described as vitiated Vata

and Kapha Doshas which adversely affect the Jala Mahaboot of the affected skin region,

resulting in its appearance as whitish colour and scaly & thin skin tissues. These vitiated

Doshas dries the water content of skin and promote abnormal rapid proliferation of skin

tissues. Vitiated Kapha Dosha and accumulated Malas cause itching in the skin and the blood

vitiated by Vata Kapha and Malas alters the normal healing process and hence these vitiated


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Doshas permeate further and become deeply rooted in tissues. Ek-Kustha is one of the

Shudra Kustha Roga which is caused by both dietary imbalance and Ama Dusti which leads

to Raktadusthi.

MATERIAL AND METHODS

Case report

The present case study is a successful Ayurvedic management of Ek-kushta. A 18 year female

patient came to OPD of Kaya-Chikitsa, Rishikul Campus, Haridwar, UAU, Dehradun on

24/12/2018 with chief complaint of red erythematous lesions with severe itching as well as

scaling of skin over both legs, back of palm and back, abodominal region, face, since 2-3

years. which is aggrevated during winter season.

History of present illness

According to the patient, she was asymptomatic 3 year back. One day she noticed some

papules over lower legs with watery discharge and itching. She took allopathic medicine for

this but got no relief. Her condition worsens day by day. The papules spread and become red

patches with scaly skin and spread over to both legs, back of palm and back, face, and

abdominal region. Now she wants to take Ayurvedic treatment along with purification of

body through Panchkarma procedure. So, she came here for better management.

Past History

No previous H/O any other severe illnesses.

Personal history

General condition – average Nadi – Pitta Pradhan Vata (76/Min)

Mala – Saam Mutra – Samanya Gandh, Varna.

Temperature – 98.40f Agni – Vishamagni

Blood pressure – 110/70 mmHg Shabdh – Samnaya

Drika – Samanaya Akriti – Madhyam

Bala – Madhyam Jihva – Niraam

Addiction- tea Nidra- disturbed

Treatment History

Patient took allopathic and local medication for present complaint but could not get

satisfactory relief.

Surgical History

No H/O any surgery.


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Family History

Family history was negative for similar condition or skin disorder and no H/O severe

illnesses.

Investigation

All routine investigation (Hb, TLC, ESR, RBS etc.) done and were within normal range.

Hb % 11.5gm%

TLC 7200/cmm

ESR 30mm/hr

Urine (routine&microscopic) normal

RBS 95mg/dl

Differential Diagnosis

According to modern science, based on the symptoms of Ek-Kushta, it can be co-related with

Palmo-planter Keratoderma, Palmo-planter Psoriasis Palmo-planter Xerosis, Palmo-planter

Dermatophytes.

Treatment Given

Ayurveda emphasizes on three fold therapeutic management of the disease viz: Sanshodhana

(biopurification), Sanshamana (pacification) and Nidana-Parivarjana (avoiding causative

factors) for almost all type of disorders including dermatological disorders. Sanshodhana

(Virechana) followed by Sanshamana Aushadha (to subside remaining Doshas after

Sanshodhana) is the backbone of present study in the management of Ek-Kushta (Psoriasis).

Schedule of therapy

Therapy Drug Matra (dose) Duration Anupan

Deepana Nagarmotha churna+

Ajmodadi churna 3gm +2gm

Twice a day

For 3 days Koshna-Jala

Snehpaan Panchatikta-Ghrit

Gugglu

25 ml On 1st day Koshna- Jala

50ml 0n 2nd

day Koshna- Jala

75ml On 3rd

day Koshna- Jala

100ml On 4th

day Koshna- Jala

125ml On 5th

day Koshna- Jala

150ml On 6th

day Koshna- Jala

175ml On 7th

day Koshna- Jala

Abhyanga 777 oil ----------- Next 2 days ------------

Swedana

(sarvanga )

Vaspasweda

(hot fomentation) ----------- Next 2 days ------------

Virechana Trivrit-Avleha

+Triphala Kwatha 80gm + 50ml Koshna- Jala


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Sansarjan

krama

Mand (rice water) According to

appetite 1

st day ------------

Boiled rice According to

appetite Next day -----------

Khichdi According to

appetite Next day ------------

Daal and roti According to

appetite Next day -------------

Sanshmana

aushadh

Nimbadi churna+shudh

gandhak+ras manikya

3gm

+250mg

+75mg

Twice a day

Koshna Jala

Mahatiktak ghrit One tab.twice a

day Koshna Jala

Gomutra arka 1tsf twice a day Koshna Jala

Triphala gugglu 2tab. Twice a

day Koshna Jala

Mahamanjishthadi

kwath 40ml Twice a day

777 oil L/A Twice a day

OBSERVATION AND RESULT

The improvement in the lesions of Ek-Kushta before Shodhana, after Shodhana and during

Samshamana Chikitsa is as shown in figures.

Before treatment


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After Virechana


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After 1 month treatment

DISCUSSION

In the present case, Shodhana Chikitsa (Virechana) and Sanshaman Chikitsa (drugs) are

selected for the treatment of Ek-Kushta (Psoriasis) because of their ability to pacify the

involved Doshas (Vata &Kapha) and to provide relief in symptoms. Shodhana Chikitsa

(Virechana) is targeted to expel increased Pitta Dosha as well as Kapha Dosha out of the

body. Along with this, Shamana drugs which were given are proved drugs for skin disorders.

Because of Tikta, Kashaya Rasa, Laghu Guna, Sheeta Veerya and Katu Vipaka, Nimba

powder possesses Pitta Shamaka, Kaphaghna, Vrana Ropana, Krimighna, Kandughna, Daha

Prashamana and Rasayana properties. Because of its Anti-inflammatory, Anti-bacterial and

Anti-fungal properties, it is useful in treatment of skin diseases. Gandhaka also have the

property of wound healing. As Psoriasis is an auto immune disorder. Therefore, the

combination thus used has various effects like Vranaropaka, Vranashodhaka as well as acts

as blood purifier. The effect of Maha manjishthadi -Kwatha has Tridosha-shamaka as well as

Blood purifier action

The Probable mode of action of the treatment given is described below:

Chikitsa Mode of action

1- Deepana Enhances appetite and pacifies vitiated

Vata Dosha.

2- Snehapana ,abhyanga, swedana Expels vitiated Dosha from Shakha to

Kostha and also pacifies the Vata Dosha.

3- Virechana To expel increased Pitta & Kapha Dosha

out of the body.


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4- Sansarjana Krama Improve digestion and increases appetite

5- Sanshamana Aushadh To subside remaining Doshas after

Shodhan

CONCLUSION

This case study demonstrated that in Skin diseases, Ayurvedic management (Virechana as

Shodhana therapy and Sanshamana Aushadha) seems very effective. On the basis of the

result obtained in present study, it may be concluded that the addition of Virechana Karma

prior to administration of Sanshamana Aushadha increases the cure rate of Ek-Kushta

(Psoriasis).

REFERENCES

1. Lee Goldman and Andrew I. Schafer; Goldman’s Cecil medicine. 24th

Edition; Elsevier

Saunders. Eczemas, photodermatoses, Papulosquamous diseases. Pg. No. 2517.

2. Pt. KashinathShastri& Dr. G.N. Chaturvedi, CharakaSamhita, “Vidyotini”

Uttarardha/Part-2, Hindi Tika, Sutra Sthana 7/21 Chaukhambhabharti Academy,

Varanasi, (India), Reprint, 2011; 252.

3. Prasad Mamedi, Kshama Gupta, Ayurvedic management of Palmoplanter psoriasis:

Acase report; Journal of pharmaceutical and scientific innovation, 04/08/2016;

www.jpsionline.com (ISSN: 2277-4572).


Uttarardha/Part-2, Hindi Tika, Chapter Charakasiddhi1/7 Chaukhambhabharti Academy,

Varanasi, (India), Reprint, 2005; 960.


Purvardha/Part-1, hindiTika, Chapter Matrashitiya-adhyaya,5/85-86 Chaukhambhabharti

Academy, Varanasi, (India), Reprint, 2005; 128.

6. YadavajiTrikamajiAcharya; Nyayacandrika&Panjika Commentary and

ShriDalhanacharya, NibandhaSangraha Commentary on SushrutaSamhitā,

ChaukhambaOrientalia Varanasi, (India), 7th Edition, chikitsa-sthan, chapter 32/21-23,

2010; 175.

7. Pt. KashinathShastri& Dr. G.N. Chaturvedi, CharakSamhita, “Vidyotini” purvardha/Part-

1, hindiTika, Chapter 25/40, Chaukhambhabharti Academy, Varanasi, (India), Reprint,

2005; 468.


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8. Pt. KashinathShastri& Dr. G.N. Chaturvedi, CharakSamhita, “Vidyotini” Uttarardh/Part-

2, hindiTika, Chapter Charak siddhi1/11 Chaukhambhabharti Academy, Varanasi,

(India), Reprint, 2005; 961.

9. Dr. Ravi DuttTripathi, Astang-Sangrah, “Saroj” Hindi commentary, SutraSthana,

chapterVaman-Virechan-Vidhi-Adhyaya, 27/5, Chaukhambha Sanskrit pratisthana, Delhi

(India), reprint, 2005; 482.

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