Ayurvedic management of Kitibha Kushtha with special reference to Palmo-plantar Psoriasis - A case study

About Author

Correspondence Address

DMM Ayurved Mahavidyala,Arni Road Shivajinagar Yavatmal 445001
Contact No. : 9146641554, Email : bhagwatdongare1999@gmail.com

Date of Acceptance : 10 Sep 2024

Date of Publication : 27 Sep 2024

Article ID : SD-IJAY_106

How to cite this article : http://doi.org/10.55552/SDNJAY.2024.2309

Abstract

Psoriasis is a chronic condition that impacts the epidermis on the body, including the hands and feet. It is the consequence of an overactive immune system. Psoriasis symptoms manifest as a discoloured, scaly, and itchy patch of skin on the hands and feet. These symptoms may affect the skin on the top and bottom of the hands and feet, as well as the skin between the digits and toes. Although there is no remedy for psoriasis, there are treatments that can be used to alleviate symptoms. Psoriasis is the result of an overactive immune system. The precise aetiology of the autoimmune disease remains unknown. The disease is prevalent, chronic, and expensive in terms of both financial and quality of life, with no reliable solution available worldwide. The majority of the signs and symptoms of psoriasis are similar to those of kitibh kushtha, a type of kshudra kushtha that is mentioned in Ayurveda. The presentation of kitibh kushtha is the most similar among the vatakaphaj kushtha varieties. Therefore, the law of "Vyapadeshastu bhuyasa" can be employed to establish a correlation between psoriasis and kitibha. Numerous treatment modalities have been implemented in the field of medical science; however, they are accompanied by a variety of adverse effects. In this instance, the case of Kitibha kushtha was effectively resolved through the application of Shamana and Bahirparimarjana chikitsa.Modern medicine is concerned about the increased likelihood of recurrence due to the limited treatment options available. At L.K. Ayurvedic Hospital in Yavatmal, a current case study is being conducted to assess the efficacy of ayurvedic medical treatment. A 74-year-old male with palmoplantar psoriasis presented with blackish discolouration, irritation, and fissuring on both the soles and palms. Therefore, he underwent a month of ayurvedic treatment, which encompassed Shamana and Abhyantar snehapana chikitsa. The therapeutic effects were assessed through symptomatic relief, and the response to the treatment was documented. Clinical symptoms were substantially diminished.

KEY WORDS:-  Kitibha; Kushtha; kshudra kushtha; Snehapana; shaman chikitsa, Palmoplantar psoriasis.

Introduction

Psoriasis is a hyperproliferative, chronic inflammatory skin disease. It is typically characterised by well-defined, erythematous scaly plaques that primarily affect the extensor surface, cranium, and nails, and it typically follows a relapsing remitting course. Psoriasis is a chronic, non-infectious inflammatory skin disorder that is frequently encountered in clinical settings. Psoriasis is a condition that affects up to 1% of the global population, with both males and females experiencing it equally [1]. Ayurveda has established certain codes and principles of conduct that are essential for maintaining physical and mental health. However, the modern lifestyle has undergone significant changes. Kushtha is consistently generated by Aharaj, Viharaj, Manasik, and other hetu, including Krimis hetu and Samsargaja hetu. Kushtha is a general term that can be used to describe nearly all skin diseases in Ayurveda [2].

Psoriasis is a chronic, non-communicable, painful, disfiguring, and disabling disease that has a significant negative impact on the quality of life of patients and lacks a cure.

Psoriasis on the palms is known as palmoplantar psoriasis, although it can manifest on any part of the body, including the feet. The condition is a subtype of both plaque psoriasis and pustular psoriasis, contingent upon its presentation. Palmoplantar psoriasis may manifest at any age. Despite the fact that it is restricted to the palms and soles, the fissures, tissue hardening, and hyperkeratosis have an impact on daily activities. 2% to 5% of the general population are affected by it. Three It is typically identified by the presence of white scales on keratinised lesions. [four] The clinical features of PP frequently overlap with chronic eczema, and the frequent co-occurrence of these two conditions could result in a misdiagnosis. Proper identification is crucial for a successful outcome, as these two organisms necessitate distinct treatments, despite the fact that they share certain pathological features, including epidermal hyperplasia, parakeratosis, and spongiosis [5, 6, and 7].

The skin serves as a protective barrier, shielding the underlying tissue from physical, chemical, and biological toxicants. The external appearance of patients is the primary concern of skin diseases, which can significantly disrupt their daily routines. In the context of general clinical practice, skin disorders are among the most prevalent categories of health issues. Kushta is a comprehensive term that encompasses the majority of cutaneous diseases in Ayurveda. In general, Twak Vikaras are primarily impacted by an altered lifestyle, a lack of physical exercise, poor hygiene, mental stress, and improper food practices. Kushta is further subdivided into Maha Kushta and Kshudra Kushta. Kitibha Kushta is one of the Kshudra Kushta. Tridosha, Rasa, Rakta, Mamsa, and Ambu are all impacted. Rakta Dusti is the primary cause of Twak Vikaras. Alpadosha Nirharana is significantly influenced by Shamana Chikitsa. This paper emphasises a case study of Kitibha Kushta, a Raktavahasrotodusti Vikara that was treated with Ayurvedic principles, specifically shamana chikitsa.Eight

Blackish discolouration, hardness, dryness, and harshness to the touch are symptoms that can indicate the predominance of Vata. An indication of Kapha predominance is the presence of itchiness as a cardinal symptom. Nine

Psoriasis is currently managed by modern science through the use of corticosteroids, methotrexate, and retinoids. However, the disease recurs and induces severe adverse effects, including liver, kidney, and bone marrow depletion. Consequently, Ayurveda serves a critical function. The objective of the current investigation is to develop a safe and effective treatment for psoriasis.

Discussion

Action of Snehapana

Mahatiktaka ghrita [10]: The ingredients of Mahatiktaka have tikta rasa, ruksha, and laghu guna. It acts mainly on kled, meda, lasika, rakta, pitta, and kapha, which help in balancing the vitiated dosha and dhatu. It has properties like Deepana, Pachana, Strotoshodhaka, and Raktashodhaka. Raktaprasadaka, Kushtaghna, Kandughna, and Varnya. The Ghrita's lipophilic action helps to carry drugs to the target organs; it enters to its cellular level and delivers to mitochondria and the nuclear membrane. It maintains the normal texture of skin.

Gandhak Rasayana

Madhur amla and kashaya rasa are effective in treating skin conditions such as psoriasis. [11] and properties such as Krumighna, Twachya, Kandughna, Dahaprashaman, Raktashodhak, Vranaropak, and Kushtaghna. It possesses antibacterial, antiviral, and antimicrobial properties.Many types of skin conditions can be treated with refined sulphur. It enhances digestion and skin appearance, reduces infection and irritation. It can be used to treat skin conditions both internally and externally.[12]

Sariva

Daha and Vaivarnya are two of the symptoms and signs, respectively, of Kushtha Vyadhi. Charak has described Sariva in Dahaprasahamana [13] (refrigerants) and Varnya (complexion promoting) Mahakashaya. It also works as Raktapachaka as described by Charak.

Manjishta

Charak has described Manjishtha in Varnya [14] and Vishaghna [15] Mahakashaya and in Pitta Shamana Mahakashaya by Sushrut. As it has Tikta Kashaya Madhura rasa, it works as Kaphapitta shamaka, which gets vitiatated in KitibhaKushtha and Kushthaghna also. In Pachansansthan, it acts as Krumighna.

Khadira

Khadira has kushtaghna [15] property according to Charak. Also, it’s tikta, kashaya, and shitvirya, making it pitta, kaphaghna, and kandughna. It works great in Kushtha disease.

Mode of action of Dermocare oil: - Dermocare oil is useful in skin diseases like psoriasis, itching, and eczema due to its Kushtaghna property. Ingredients of Dermocare oil Pacify Tridosha moisturise the skin and improve skin complexion. [16]

Conclusion

With the help of both Snehapana and Shamana Chikitsa, the patient got relief. Clinically, patient 70% improved.

References

1. Fauci, Braunwald, Hauser, Longo, Jameson, Loscalzo; Harrison’s Principal of Internal Medicine. Vol-1; U. S. A.; 17th edition; McGraw Hill Companies; page no. 315.