Ayurvedic diet plays an important role in Psoriasis patient - A Case Study

Kavita Sachin Patil; Rajan Balwant Kulkarni

Ayurvedic diet plays an important role in Psoriasis patient - A Case Study

Sachin Patil K.^1*, Balwant Kulkarni R.²

DOI:

^1* Kavita Sachin Patil, Ph.D. Scholar, Dept. of Kayachikitsa, A.S.S. Ayurved Mahavidyalaya, Panchvati, Nashik, Maharashtra, India.

² Rajan Balwant Kulkarni, Guide, Associate Professor and HOD, Dept. of Kayachikitsa, A.S.S. Ayurved Mahavidyalaya, Panchvati, Nashik, Maharashtra, India.

Prevention, treatment and management with right Ayurvedic diet exercise, mental health and proper Langhan (Fasting) in today’s environment is definitely promising to clear skin disease like psoriasis. As you know Psoriasis is a chronic inflammatory skin disease. Ayurveda is an oldest system of medicine practiced in various parts of India since many years. In Ayurveda, several herbs, formulations and advised proper Ayurvedic diet which have been used in the management of Psoriasis - Kushta Roga (skin disorders). Here, an effort was made to treat the 45 yrs female patient by applying Ayurvedic diet, with life style changes along with Ayurvedic medication, advised strictly Ayurvedic diet for one month. At the end of one month this management resulted in reduced severity score i.e., itching, redness, thickness and scaling of skin area. Also found reduction in weight and reduction in Hba1c of the patient.

Keywords: Psoriasis, Ayurvedic Aahar, Inflammation, Kshudra Rog

Corresponding Author	How to Cite this Article	To Browse
Kavita Sachin Patil, Ph.D. Scholar, Dept. of Kayachikitsa, A.S.S. Ayurved Mahavidyalaya, Panchvati, Nashik, Maharashtra, India. Email:	Kavita Sachin Patil, Rajan Balwant Kulkarni, Ayurvedic diet plays an important role in Psoriasis patient - A Case Study. J Ayu Int Med Sci. 2022;7(9):165-169. Available From https://www.jaims.in/jaims/article/view/2091

Introduction

Before we study psoriasis we should know about Kshudra Kushsta because psoriasis skin diseases come under Kshudra Kushta as per Ayurvedic literature. In Ayurveda context eleven types of Kshudra Kushta are described & Psoriasis is one of them. All type of Kushtha is Tridoshaja, so Vicharchika is also having Tridoshaja origin. Most of the Acharyas have described the Vicharchika having Kapha dominancy and comes under Raktapradoshaja Vikara and having specific involvement of Rasa, Rakta, Mamsa and Kleda (Lasika) Dushya i.e., Kapha is responsible for Kandu, Pitta is responsible for Srava & Shyava indicates the presence of Vata.^[1]

Psoriasis is an autoimmune disease. Immune system of psoriatic patient is overactive. This leads to an excessive growth of skin cells and inflammation which is a cause of the symptoms. Normally, skin cells take 21 to 28 days to replace, but, in patients with psoriasis, they take around 2 to 6 days. This causes new skin cells to develop too quickly. Which are pushed to the skin‘s surface, where they pile up. This results in the plaque formation.^[2]

As per modern view, Psoriasis is a chronic inflammatory skin disease with a strong genetic predisposition and autoimmune pathogenic traits. The worldwide prevalence is about 2%. It shows a lower prevalence in Asian and some African populations, and up to 11% in Caucasian and Scandinavian populations. Inflammation is the hallmark of psoriasis, and that leads to uncontrolled keratinocyte proliferation and dysfunctional differentiation. The histology of the psoriatic plaque shows acanthosis (epidermal hyperplasia), which overlies inflammatory infiltrates composed of dermal dendritic cells, macrophages, T cells, and neutrophils. Neovascularization is also a prominent feature.^[3,4,5]

Ayurvedic Aahar or Pathyakar Aahar in disease condition

Ayurveda is one of the oldest healthcare systems that evolved in the Indian, Ayurveda states, diet (Aahar), sleep (Nidra), and abstinence (Brahmacharya) as the three absolute factors responsible for the maintenance of good health, physical strength, vitality of the skin and

body. Ancient ayurvedic texts such as Vimana Sthana of Charaka Samhita, have laid down rules or habits which should be followed when a diet has to be consumed, for example, it is inappropriate to eat very fast or very slow or talking too much while eating, etc., There are certain rule in Ayurveda focusing on consuming the diet are termed as Vidhi-Virudhdha-Aahara, which is responsible for many unhealthy outcomes over the body. Over the years, with the progress achieved by the humans, many new habits have been acquired by the people while eating which are considered to be wrong, for example, watching television, talking on a cellphone, standing, etc., while eating. In view of this background, the type of diet consumption among the patients with common skin diseases was assessed to study the pattern of incompatible diet/dietary mannerisms in comparison to the dietary habits of healthy individuals.^[6]

Health and Food

स्वस्थस्य स्वास्थ्य रक्षणं ।

आतुरस्य विकार प्रशमनं।। (चरक संहित सूत्र ३०।२६)

“Svasthya, “to be established in one’s self or own natural state” is optimal health according to Ayurveda. In order to achieve this, one has to have a balance of structural and physiological factors, metabolic and excretory processes, body tissues, senses, mind, and attain a state of self-awareness and contented self. Ten factors (Dasa Vidha Pariksa) are used to determine the state of health of an individual per Ayurveda namely, body tissues (Dusya), residing location (Desa), physical strength (Bala), seasons/time (Kala), digestive and metabolic processes (Agni or Anala), genetic and phenetic constitution (Prakriti), age (Vaya), mental strength or temperament (Sattva), habituation (Satmya), and food (Ahara). It is interesting to note that Sattva is said to influence health. While these are mainly used for diagnostic purposes, these can also be used to measure the wellbeing of an individual. Taste (Rasa) as an Indicator of health effects one of the ways of food classification in Ayurveda is based on Rasa. There are six major tastes according to Ayurveda, viz., sweet, sour, salty, pungent, bitter, and astringent. There are primary and secondary qualities (Guna) that increase the properties of a material. This is further augmented by potency (Virya), post digestive effect (Vipaka), and therapeutic action (Karma).

According to Ayurveda, the classification based on Rasa, Guna, Virya, Vipaka, and Karma is not only applicable to foods but also for all materials, including medicines, and is dealt with under Dravya Guna Sastra (the science of materials). Proper Metabolism is Key to Good Health.^[7]

युक्ताहारविहारस्य युक्तचेष्टस्य कर्मसु।

युक्तस्वप्नावबोधस्य योगो भवति दुःखहा।। (श्रीमद्भगवद्गीता 6.17)

Meaning of this line is addressed importance of Satvik Aahar.

To avoid Virudhanna, Ahar is good for health and it keeps person free from all disease and mostly protect from all Kshudra Roga. Recommends eating to balance the Doshas and Agni. Favors eating in accordance with your Dosha.

Ayurveda recommended diet should be accordance with season. Recommends mostly warm, cooked foods that are suitably spiced in order to stimulate digestive fire. Includes primarily foods that nourish and build the tissues and increase Ojas (immunity/vitality). Recommends eating in a calm, comfortable environment free of stress or distractions. Is taken at certain times of the day in harmony with the natural daily cycles of internal and external energies. Sattvic diet is always good for everyone.^[8] Because the Sattvic diet is based on Ayurvedic principles, people following it don’t eat many animal-based foods, such as meat, fish, eggs, and poultry. The diet also cuts a few plant foods, including garlic and onion.

Rationale for the study: Rationale behind this case study, to underline importance of the Ayurvedic Diet in the Psoriasis.

Case Report

A 45-years-old female patient presented with a history of psoriasis since 4 years to it outer side of the ankle joint c/o itching, redness scaling and thickening, significant embarrassment. Received treatment from allopathy that is Emollients, Keratolytics, Topical steroids, Vitamin-D derivative and Dithranol. The patient gets good result initially, but after 5-to-6-month condition become as it is. Undisciplined time of meals taking spicy, oily food and salty food consumption was more, Divaswap source diet, no exercise, noted and overweight noted. BP was recorded 142/90 HR-96/min volume good, weight 61 kg and height 149 cm.

No DM HTN. HBA1C was 6.4 before treatment and below Hetus were noted.

1. Atichankraman 2. Abhighat 3. Divaswap 4. Viruddha 5. Ahar 6. Vihar 7. Snigdha Padarth Sevan 8. Guru Padarth Sevan and 10. Adhyashan 11. Virudh Ann Seven.

On Examination

C/O Itching, numbness, discoloration of the skin, roughness thickening, constipation, Obese

Pallar +

Appetite - sometime extreme, sometime lost.

BP - 142/96

PR - 88/min

RR - 18/min

Temp - 98.3°F

RS - Clear,

CVS - NAD

CNS - NAD

Prakruti - Kaph - Pitta

Body region - Lower limbs

Local examination - Redness thickness

Diagnosis - Diagnosis was confirmed as per Ayurvedic concept Psoriasis

Differential Diagnoses: Shudra Kshustha, Mahakustha, Adult Blepharitis, Atopic Dermatitis, Atopic Keratoconjunctivitis (AKC), Cutaneous Squamous Cell Carcinoma, Diaper Dermatitis (Diaper Rash), Dry Eye Disease (Keratoconjunctivitis Sicca), Gout and Pseudogout, Lichen Planus, Lichen Simplex Chronicus, Mycosis Fungoides, Nummular Dermatitis (Nummular Eczema), Onychomycosis, Pityriasis Alba, Pityriasis Rosea, Pustular Eruptions, Reactive Arthritis, Seborrheic Dermatitis, Sicca Keratoconjunctivitis, Subcorneal Pustulosis, Syphilis, Tinea in Emergency Medicine.

Management and Treatment Plan
1. Ghandhak Rasayan

2. Arogyavardhini

3. Mahamanjisthdi Kadha

4. Mahatikta Ghrut Bahya and Abiyantara

Advised Ayurvedic Diet
Duration: For one month

Apathya: Virudh Aahar, Sour, oily, salty, heat producing items like pepper etc.; curd, milk, jiggery, meat of marshy, animals, sesame seeds, black gram are contraindicated; sexual intercourse and alcoholic drinks are to be avoided.

Pathya: Old rice, barley, green gram, bitter vegetables and meat of wild animals are wholesome. Laghu Aahar, Satvik Aahar and Langhan (fast) one time Ashvasan Chikita.

Vihar: life style changes advised for one month i.e., Daily aerobic exercise

Treatment Outcome: At the end of month improvement found in psoriatic area and drastic improvement in severity score i.e., Scaling, Thickness, Redness, itching. Treatment Management with Ayurvedic diet found most effective. The patient gets relief from the above mentioned symptoms. Reduction in weight was one of the outcomes of this study HBA1C comes normal 5.9%. Patient’s appetite/Agni become normal. Patient feels energetic after one month. At the end of one month patient had no Constipation. Patient improved her quality of life.

Table 1: Treatment outcome

Picture 1: Before treatment
Picture 2: After 1 month of treatment

Weight before applying Ayurvedic Diet (30 Jan 2021)	61
Weight after applying Ayurvedic Diet and Exercise (3 March 2021)	54

Before starting Ayurvedic diet - Severity Score
1. Scaling,	Moderate
2. Thicness	Moderate
3. Redness	Moderate
4. Itching	Moderate
After one month
Scaling	Mild
Thickness	Mild
Redness	Mild
itching	No
Lab Test (30 Jan 2021)	Moderate
HIV	Sero negative
Initial HbA1c	6.4
After one-month HbaA1c	5.7 %
Initially Appetite	Appetite some time extreme, sometime less
Appetite after one month	Normalize
Initially Bowel habit	Constipation
After one Month- Bowel habit	Regular one time
Initial Blood Pressure	142/96 mm of hg
After one month Blood Pressure recorded	130/90 mm of Hg

Discussion

Atichankraman, Abhighat, Divaswap, Viruddha Ahar Vihar, Snigdha Padarth Sevan, Guru Padarth Sevan, Adhyashan & Virudh Anna Seven these Hetus leads to aggravation of Pitta and Kapha which in turn produced psoriasis and we found these sign and symptoms Scaling, Thickness, Redness itching. The Dosha combine, different innumerable conditions will arise, and treatment should be selected based on the particular Doshas involved Dhatus. Langhan also played vital a role in this case and we think this is the first steps towards the balancing Tridosha. As this is chronic disorder taking long period to treat but, after applying strictly Ayurvedic Diet to the patient, we will get successful results while treating Psoriasis.

Conclusion

In this case study, the overall effect was found near 50%. The effect of Ayurvedic diet directly fall on quality-of-life (QOL) of the patient. We found effect of this Ayurvedic diet on vitals parameter i.e.,

Blood Pressure & HBA1c of the patient become normal after one month. At the end of one month this management resulted in reduced severity score (i.e.) Itching, redness, thickness and scaling of psoriasis skin area. Also found reduction in weight and reduction in Hba1c of the patient.

Reference

1. Agnivesa, Charak Samhita, By Revised By Charak & Dradhabal with the Ayurveda Dipika commentary of Chakrapanidatta edited by Vaidya Jadavaji Trikamji Acharya. Chaukhambha Prakashan, Varanasi. reprint 2009; Chikitsa sthana, 7/34 Page no.452

2. National Institute of Arthritis and Musculoskeletal and Skin Diseases. October 2013. Archived from the original on 8 July 2015. Retrieved 1 July 2015.

3. Dermatological Manifestations In Ayurveda: A Review EJPMR 2019,6(2), 277-293, Apr 7, 2019

4. Eczema and Vicharchika: A Review from Western and Ayurvedic Perspectives' A Review of the Literature by Jessica Houghton. 2015.

5. Rendon A et al. Psoriasis Pathogenesis and Treatment. 2019 Mar 23. doi: 10.3390/ijms20061475, PMCID: PMC6471628: 2019 Mar; 20(6): 1475.

6. Kulkarni M, et al. “A cross-sectional study to assess the incompatible dietary behavior of patients suffering from skin diseases: A pilot study” Ayurveda Integr Med. 2016 Apr-Jun; 7(2): 113–118. Published online 2016 Jul 19. doi: 10.1016/j.jaim.2016.06.001 :PMCID: PMC4969308; [PMID: 27450757]

7. Payyappallimana U, et al. “Exploring Ayurvedic Knowledge on Food and Health for Providing Innovative Solutions to Contemporary Healthcare” Front Public Health. 2016; 4: 57. Published online 2016 Mar 31. doi: 10.3389/fpubh.2016.00057; PMCID: PMC4815005, PMID: 27066472

8. Bhagavad Gita: Chapter 6, Verse 1

9. Agnivesa, Charak samhita, Revised By Charak & Dradhabal with the Ayurveda Dipika commentary of Chakrapanidatta edited by Vaidya Jadavaji Trikamji Acharya. Chaukhambha Prakashan, Varanasi. Reprint 2009; Chikitsa sthana, 30/26

10. Jacquiline Habash J, et al. “Psoriasis Differential Diagnoses” Updated: Sep 14, 2022, Medscape

11. Guidelines of http://ccras.nic.in/sites/default/files/ viewpdf/faq/PSORIASIS.pdf

Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2022-08-25	2022-08-27	2022-09-03	2022-09-10	2022-09-17
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	19%

Case Report

Psoriasis

Journal of Ayurveda and Integrated Medical Sciences