"Effective Ayurvedic Strategies for Managing Ekakustha (Psoriasis)"– A Single Case Study

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Pragati colony sendurwafa, sakoli
Contact No. : 8788239853, Email : kapgateleena4321@gmail.com

Date of Acceptance : 12 Sep 2024

Date of Publication : 27 Sep 2024

Article ID : SD-IJAY_112

How to cite this article : http://doi.org/10.55552/SDNJAY.2024.2315

Abstract

Ekakustha, known as psoriasis in modern medicine, is a non infectious, chronic inflammatory skin disorder. It is marked by distinct, red plaques covered with silvery scales. These plaques typically appear on the extensor surfaces of the body such as the elbows and knees as well as the scalp. The condition is characterized by its long-term, fluctuating nature, with symptoms that can vary in intensity over time. The disease not only impacts the patient's physical well-being but also affects their mental and social health, as the appearance can cause embarrassment. Ekakustha, a type of Kshudrakustha in traditional medicine, presents with symptoms such as aswedanam (lack of perspiration), mahavastu (extensive involvement), yanamastyoshakalalopamam (resembling fish scales), and aruna varna (discoloration). In contemporary terms, it can be likened to psoriasis. This condition is characterized by well-defined, erythematous, scaly plaques, primarily on extensor surfaces. It is classified as an autoimmune disorder. A 64 year-old male presented with itchy, scaly lesions on his legs and was diagnosed with ekakustha, which is comparable to psoriasis. The patient received a combination of sodhana (detoxification) and samana chikitsa (palliative treatment). Remarkably, all symptoms resolved within three months without any adverse drug reaction. This case demonstrates that psoriasis patients can benefit from Ayurvedic treatments.

KEY WORDS:-  Ayurveda, Ekakustha, Psoriasis, Shodhan, Shaman

Introduction

Skin issues, ranging from minor to severe, are common experiences for many individuals throughout their lives. Ayurveda, an ancient system of medicine that originated in northern India, offers a holistic approach to health. This traditional practice is founded on the belief that optimal well-being arises from maintaining balance among the body, mind, and spirit. In Ayurveda, skin disorders are categorised under the term kustha, which results from an imbalance in the body's doshas. Kustha is considered a tridoshic disease, involving disturbances in Vata, Pitta, and Kapha doshas. These conditions are particularly common among individuals who follow an unhealthy lifestyle. According to Sushruta Acharya, Kustha can be classified based on the predominant dosha, such as Vata-type, Pitta-type, Kapha-type, and Krimi-type 3. It is also classified as one of the Ashtamahagada4 (eight major ailments), indicating its complexity and difficulty in treatment. Ayurvedic texts further divide Kustha into two main categories: Mahakustha and Kshudrakustha, with Ekakustha being a subtype of Kshudrakustha. Psoriasis presents with symptoms such as:

• Aswedanam (absence of perspiration)
• Mahavastu (widespread nature)
• Yana-mastyoshakalalopamam (fish scale-like appearance)
• Aruna varna (reddish discoloration)5

This condition commonly affects areas like the elbows, knees, and scalp. Psoriasis can be triggered by various factors, with heredity playing a significant role. If one parent has psoriasis, there is a 15% chance that their child will also develop the condition. This risk increases to 60% if both parents are affected. Modern science supports this hereditary connection, recognising psoriasis as a chronic, inflammatory, and hyperproliferative skin disease. Psoriasis is marked by well-defined, red, scaly plaques, particularly affecting extensor surfaces, the scalp, and nails. The condition typically follows a chronic pattern. Psoriasis impacts males and females equally and can occur across all racial groups. The condition is commonly diagnosed in younger individuals, typically between the ages of 16 and 20, and is often linked to a family history of the disease. For those with late-onset psoriasis, the condition generally peaks between the ages of 55 and 60.7 Previous research has also highlighted the effective management of psoriasis through Ayurvedic treatments.(8-10)

Discussion

Triphala Churna is a traditional Ayurvedic formulation made from a blend of three fruits: Amla (Emblica officinalis), Haritaki (Terminalia chebula), and Bibhitaki (Terminalia bellirica). It is widely used in Ayurveda for various health conditions, including skin diseases. It helps to remove toxins from the body, reducing their impact on the skin. It reduces inflammation, neutralises free radicals, protects skin cells from damage, and supports a youthful appearance. Enhances digestion and nutrient absorption, leading to better skin nourishment balances doshas, particularly Pitta, which is linked to inflammatory skin issues.
Cap Grab Each capsule contains Vranapahari Rasa (Classical Prepn) 100 mg, Triphala Guggulu (Classical Prepn) 300 mg, Gandhaka Rasayana (Classical Prepn) 75 mg, Arogyavardhini Vati (Classical Prepn) 25 mg, Guduchi Guduchi(Tinospora cordifolia) Q.S., and Manjistha (Rubia cordifolia). Triphala Guggulu gives Shodhana (detoxifying, cleansing), Rasayana (rejuvenating), and anti-inflammatory action. Vranapahari Ras content Sudha Paradha Sudha Gandhaka Sudha Haritala Sudha manasila Sudha Guggulu Sudha Triphala. Vrnapahari ras can be considered as one and only formulation required for internal administration in management of vrana due to the special combination developed by ancient sages of Ayurveda. It exerts its effects by accelerating wound healing and also treats infections primarily caused by pyogenic microorganisms in the bloodstream. Arogyavardhini Vati helps in balancing these doshas, particularly Pitta, which is associated with inflammation and heat in the body. Improving digestive health is crucial for managing psoriasis. Gandhak Rasayan is a polyherbal drug, which is RaktaShodhak (blood purifier), Kandughana, and Rasayan, mainly indicated in Kushtha Rog. It has antifungal and antibacterial properties. Thus, it reduces features of Raag, Pidika with Rakta Shodhak, and Kushthaghana propertie11. Broad spectrum Grab Has Putigna (prevents foul smell), Kandugna (prevents itching), and Lekhana (cleansing) properties, thus being very effective in wound healing. Grab possesses antimicrobial and anti-inflammatory properties that are beneficial in treating infectious disorders.12

Tab Sorawin contents Kutaja, Manjishta, Katuki, Khadira, Bakuchi, Nimba, and Rasamanikya Ras offer a comprehensive approach to treating both the underlying causes and symptoms of psoriasis and other skin conditions. Its active ingredients work synergistically to alleviate symptoms such as plaques by inhibiting excessive cell proliferation in the epidermis. Rasamanikya helps balance both Vata and Kapha doshas while pacifying Pitta dosha. It effectively eliminates excess toxins from the body and provides relief from pain, inflammation, and swelling. Reduce redness and itching in affected areas. Additionally, the healing properties of its herbal components support the repair of rashes and cracked, ulcerated lesions, promoting normalisation and improved skin health in the affected regions.13
Panchatikta Ghrit, having ingredients Nimba (Azadirachta Indica), Guduchi (Tinosporia cordifolia), Patola (Trichosanthes dioica), Kantakari (Solanum Xanthocarpum), and Vasa (Adhatoda Vasica), is a traditional Ayurvedic formulation used primarily for its therapeutic benefits in various conditions. These bitter herbs, like Neem (Azadirachta indica), Kutki (Picrorhizakurroa), and others, are known for their strong anti-inflammatory properties,

reducing inflammation and swelling. This is particularly beneficial for conditions characterised by inflammation, such as psoriasis and eczema. Support liver function and detoxification processes. By enhancing liver function, Panchatikta Ghrit helps in the elimination of metabolic wastes and toxins (ama), which can otherwise contribute to skin issues and systemic imbalances. Panchatikta Ghrit's bitter taste and the specific herbs used in balancing Pitta dosha is associated with heat and inflammation-reducing symptoms like redness, heat, and irritation, which are often seen in conditions like psoriasis. Ghee acts as a carrier for the herbs and provides nourishment and hydration to the skin. The fatty acids in ghee help maintain skin moisture, improve barrier function, and promote healing of the skin. This is beneficial for managing skin conditions like dryness and scaling in psoriasis. By supporting and modulating the immune system, Panchatikta Ghrit may help in managing autoimmune responses, which are involved in conditions like psoriasis. The bitter herbs in Panchatikta Ghrit also have blood-purifying effects that help in reducing the manifestation of skin conditions that are linked to toxic blood or metabolic waste. Shankh Vati helps balance Pitta and Vata doshas, addressing imbalances that can lead to digestive issues and discomfort.14
In psoriasis, Raktshodhak Kwath is used to remove toxins from the bloodstream, which may contribute to skin flare-ups. Supports skin regeneration and can alleviate symptoms like redness and scaling. Aids in reducing systemic inflammation, which is a key factor in psoriasis.

Jalokavacharan, or leech therapy, is used in Ayurveda to manage various skin conditions. Leeches help in detoxifying the blood by removing stagnant, impure blood and enhancing the circulation of fresh, oxygenated blood. This detoxification can be beneficial for skin diseases that are believed to be caused or exacerbated by the accumulation of toxins. Leeches release enzymes like hirudin and other bioactive compounds that have anti-inflammatory properties. This can help reduce redness, swelling, and irritation associated with many skin conditions. By improving circulation and reducing inflammation, leech therapy can accelerate the healing of skin lesions and wounds. This is particularly useful for chronic skin conditions that involve ulceration or slow-healing lesions. The therapy can provide pain relief by reducing local inflammation and improving blood flow, which can be helpful for conditions like psoriasis or eczema that involve discomfort and itching.15

Conclusion

Psoriasis is a chronic skin condition that is challenging to manage, even with contemporary medical treatments. Recent research indicates that Ayurvedic medicine may offer promising results for individuals struggling with this condition. Although this study is based on a single case, it lays the groundwork for further research. Expanding these findings to include a larger patient population could provide valuable insights and advance our understanding of alternative treatments for psoriasis.

References

1.Sukla AB, Tripathi RD, Charak Samhita of Agnibesh Vol I, nidanasthana 5/3, Chaukhamba Sanskrit Prakasan: 2015. P-513

2.Sukla AB, Tripathi RD Charak Samhita of Agnibesh Vol I, nidanasthana 5/3, Chaukhamba Sanskrit Prakasan: 2015. P-493

3.Sharma AR, Sushrut Samhita of Maharsi Sushrut vol I, Nidansthana 5/6, Chaukhamba Surbharati Prakasan, Vanarasi: 2017. Pp 494

4.Sharma AR, Sushrut Samhita of Maharsi Sushrut vol I, Sutrasthana 33/6, Chaukhamba Surbharati Prakasan, Vanarasi: 2017. P- 259

5. Sukla AB, Tripathi RD, Charak Samhita of Agnibesh Vol I, chikitsasthana 7/21, Chaukhamba Sanskrit Prakasan: 2015. P-184

6.Stuart H Ralston, Ian D Penman, Mark W J Strachan, Richard p Hobson, Devidsons principals and practice of medicine, Dermatology 29, Edinburgh: Churchill Livingstone/Elsevier, 23rd edition 2018: p-1247

7. Kumar, P. J., & Clark, M. L. (2002). Kumar & Clark clinical medicine. Edinburgh: Saunders Skin disease 24, 8th edition 1012, P-1207

8. Parekh D, Makwana S, Patgiri B. Chronic psoriasis (Ek Kushtha) treated with Shodhana and Shamana Treatment: A Single Case Study. International Journal of AYUSH Case Reports, 2019;3(1), 50-59.

9. Parida AN, Bhatt NN, Dave AR, Shukla VD. A Comparative Study of Vamana & Virechana karma in Ekakushtha w.s.r to Psoriasis. AYU 2009;30(3):255-259.

10. Masooda N, Mahapatra AK, Rajgopal S. Ayurveda treatment protocol for the management of Ek-Kushtha (Psoriasis)- A Single Case Report. International Journal of AYUSH Case Reports, 2020’3(4), 290-297.

11. Kaushik H, Singh Tomar B, Kumar Chawla S Role of Gandhak Rasayan in Kshudra Kushtha - A Review Article .Journal of Ayurveda and Integrated Medical Sciences 2024;9(3)

12. https://greenremediesindia.in/product/grab-tablets/

13. https://sahasrayogam.com/products/branded-medicines/sorawin-tablet/

14. SHRI GOVINDDAS SEN Bhaishajya Ratnavali Chaukhambha Sanskrit Prakasan 2023 Kustha Rogadhikar Prakarana 54 (Shlok 251-254)

15. Dr. Naveen Kalra* 1 , Prof. Ram Kishor Joshi2 and Dr. Ajay Kumar Sahu3 Effect of the jalaukavacharana andayurvedic formulation in the management of eka kustha (psoriasis) - a case report world journal of pharmaceutical and medical researchwjpmr, 2024, 10(2), 79-82