E-ISSN:2456-3110

Case Report

Scalp Psoriasis

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 10 October
Publisherwww.maharshicharaka.in

A single case study on Ekakustha (Scalp Psoriasis) with Ayurvedic Management

Tilavat Y1*, Unadkat N2
DOI:10.21760/jaims.8.10.37

1* Yogita Tilavat, Associate Professor, Department Of Agad Tantra, Netra Chikitsa Ayurved College, Amreli, Gujarat, India.

2 Nirav Unadkat, Associate Professor, Department of Roga Nidana, Noble Ayurved College and Research Institute, Junagadh, Gujarat, India.

Ekakustha (Psoriasis) is non-infectious chronic inflammatory disease of skin characterized by well-defined erythematous plaques with silvery scale which have a preference for extensor surface and scalp and by chronic fluctuating course. The disease not only disturbs the patient physically but also interrupts the mental and social health of the patient. 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, excessive alcohol, indigestion, and stress. 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 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. Here a 32 years old male patient came with complain of Shiro Kandu (itching on scalp), Kesha Patana (Hair falling), Darunaka (Dandruff), Vibandh (Constipation). He was diagnosed with Ekakustha (psoriasis). All the symptoms were resolved in 2 months. Psoriasis patient can get benefits from Ayurveda treatment like Takra Dhara and Shaman Chikitsa.

Keywords: Scalp psoriasis, Ekakustha, Ayurvedic management

Corresponding Author How to Cite this Article To Browse
Yogita Tilavat, Associate Professor, Department Of Agad Tantra, Netra Chikitsa Ayurved College, Amreli, Gujarat, India.
Email: 		Tilavat Y, Unadkat N, A single case study on Ekakustha (Scalp Psoriasis) with Ayurvedic Management. J Ayu Int Med Sci. 2023;8(10):231-234.
Available From
https://jaims.in/jaims/article/view/2831

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-08-14 2023-08-19 2023-08-24 2023-08-29 2023-09-26
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 22.55%

© 2023by Tilavat Y, Unadkat Nand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2023;8(10)231
Yogita Tilavat et al. A single case study on Ekakustha with Ayurvedic Management

Introduction

In Ayurveda classics, all skin diseases described under heading of Kushtha. Among them Ekakushtha is type of Kshudrakushtha.[1] According to Charaka, Ekakushtha characterized by Aswedana (anhydrotic / hypohydratic lesions), Mahavastu (covering of large surface area), Matsyashakalavat (scaly lesions) Twacha.[2] Ekakustha can be correlated with psoriasis due to resemblance of signs and symptoms. The most characteristic lesions consist of red, scaly, sharply demarcated, and present particularly over extensor surfaces and scalp. Psoriasis is a chronic and inflammatory skin disease with reactive abnormal epidermal differentiation and hyper proliferation that affects 4-5% of the global population.[3] It is often appears between the ages of 15 and 25, but can develop at any age.[4] Chronic plaque type psoriasis was the most common (90%) clinical phenotype.[5] Western literature reports psoriasis prevalence to be around 0.71% in children.[6] Acharyas have described that all Kushthas have Tridosha involvement. Ekakustha is disease of predominantly occurs with Kapha Vata Dusti. Ayurveda treatment like Takra Dhara is followed by internal medications (Shamana therapy) are considered as the best line of management for skin disorders.[7] In all types Kushtha, the basic body components vitiated are called as Saptakodravyasangraha i.e. Tridosha (Vata, Pitta, Kapha), Twaka, Rakta, Maans, Lasika.[5-6] In Ekakushtha dominant Dosha are Vatakapha and Twacha is the main Doshadhishthan.[8] Clinical features of Ekakushtha mentioned by Acharya Charaka are very much similar to psoriasis, Aswedanam (Absence of sweating), Keshapatan (Hair falling), Matsyashakalopamam (scaling), Shiro Kandu (itching on scalp), Darunaka (Dandruff).[9] In modern medical system topical medication, phototherapy etc. are general treatment used to treat psoriasis, but provide only temporary relief.[10] When their use is discontinued, remission and exacerbation occur.

Case History

Here a 32 years old male patient came with complain of Shiro Kandu (itching on scalp), Kesha Patan (Hair falling), Darunaka (Dandruff) for about 2 years. Simultaneously he was suffering from constipation, loss of appetite, hypersensitivity

to cold and mental stress. Patient had taken allopathic treatment for 2 years from the locality doctor, but didn’t get any significant relief. Routine blood investigation was done to rule out any possible associated disorder. There was no past history of any type of addiction. He was diagnosed with Ekakustha (psoriasis).

Medical history

No /K/C/O - Hypertension and Diabetes Mellitus or any metabolic disorder.

History of present illness

The patient was normal 6 months before, with gradual onset of above complaints, he felt itching with ‘dandruff like' white powder exfoliating from scalp, then slowly it turned into whitish scaly patches all over the scalp for which he started taking allopathic medicine from different doctors but he got symptomatic relief for some days. His symptoms worsened as he stopped taking medication.

On Examination:

Nadi : 88/ min.
Mala : 1 time a day incomplete evacuation Malabadhata
Mootra : Prakruta
Jivha : Saam
Agni : Manda

Treatment Plan

  • Shamana Chikitsa
  • Very strict Diet regime
  • Lifestyle changes
  • Stress management

Patient was advised not to take sour, bitter, spicy food as well as junk food, fried items and curd. He was also advised to have Pranayama regularly.

Treatment advised

Takradhara (Takra + Triphala Churna) was done daily early morning for 45 minutes. Oil 777 was applied on scalp after this procedure.

Table 1: Internal medicine

DrugDoseDurationAnupana
Psora tablet2 tablet BD2 monthsLuke warm water
Psorakot tablet2 tablet BD2 monthsLuke warm water
Mentoclam tablet1 tablet BD2 monthsLuke warm water
S.I.V.A drops10 drops BD2 monthsHoney
Arogyavardhini Vati2 tablet BD2 monthsLuke warm water
Gandhak Rasayan1 tablet BD2 monthsLuke warm water

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Yogita Tilavat et al. A single case study on Ekakustha with Ayurvedic Management

Result and Discussion

Scalp psoriasis is chronic inflammatory, non-infectious disease. The symptoms of scalp psoriasis like white silver scaling, cover wide part of body, the lesion are dry and rough are closely similar to the symptoms of Ekakushtha as Aswedanam (less or no sweating all over the body), Mahavastu (lesion are found all over the body), Matsya Shakalopamam (Fish scale like white silver scale). Ekakushtha is included under Kshudrakushtha, so the treatment is adapted from Kushtha Chikitsa.

Oil 777 was topically applied, Patient was given these medicines for 2 month. After the treatment of two months, he has got significant improvement. [Fig:1] and [Table: 1,2]

Table 2: Therapeutic effect on clinical signs and symptoms for treatment protocol

Sign & SymptomsBefore treatmentAfter TakradharaAfter treatment
Aswedanam210
Keshapatan310
Matsyashakalopamam320
Shirokandu310
Darunaka210

Takradhara is a very reactive treatment. Takradhara has an effect on the mana and Prana Vayu and it promotes healthy sleep by lowering stress, anxiety and autoimmune illness. This is extremely important in the treatment of skin disease. Arogyavardhini Vati improves health. It has natural antibiotic and anti-viral properties, supports skin, imbalance of Tridosh. It helps strengthening the immune system. Gandhak Rasayan tab. has fungicidal, bactericidal, anti-parasitic effect and mainly used in various skin disease. SIVA herbal drops are a polyhedral proprietary siddha drug which has been proven abundantly through several scientific studies for its immune modulation property and improving the phagocytic ability of macrophages, the primary immune surveillance cells in human circulation and fluid tissue.[10] Psora tab. contains Panchatikta Ghrut Guggul, Mahanimba (Melia azadirachta), Chalmogra Taila (Oil of Hydrocarpus laurifolia), Narayan Taila, Oil of Bakuchi (Psoralea corylifolia). These all are beneficial for skin. They all have anti-inflammatory and antioxidant properties that can help to purify the blood and manage skin rashes also promote skin elasticity and firmness.

Figure 1
Jaims_2831_01.jpg

Conclusion

In this case 70-80% relief in signs and symptoms after Shodhana therapy and 80% to 90% relief after oral medications, external applications and Nidan Parivarjana. So, it can be concluded that Ayurveda treatment protocol like Deepan, Pachan, Takradhara, internal medication and local application along with diet modification is found very effective in curing the Psoriasis (Ek Kushtha).

References

1. Vaidya Yadavaji Trikmji Acharya. Editor of Charaka Samhita, Ayurved dipika commentary of Chakrapanidatta. Chaukhambha Publications; New Delhi: 2016. Chikitsasthana 7/13, p. 451.

2. Vaidya Yadavaji Trikmji Acharya. Editor of Charaka Samhita, Ayurved dipika commentary of Chakrapanidatta. Chaukhambha Publications; New Delhi: 2016. Sutra Sthana Chikitsasthana 7/21, p. 451.

3. Gelfand JM, Feldman SR, Stern RS, Thomas J, Rolstad T, Margolis DJ. Determinants of quality of life in patients with psoriasis: a study from the U.S. population. J Am Acad Dermatol. 2004 Nov;51(5):704-8.

4. Bedi TR. Clinical profile of psoriasis in North India. Indian J Dermatol Venereol Leprol. 1995;61:202-5.

5. Augustin M, Glaeske G, Radtke MA, Christophers E, Reich K, Schδfer I. Epidemiology and comorbidity of psoriasis in children. Br J Dermatol. 2010;162:633-6.

6. Augustin M, Glaeske G, Radtke MA, Christophers E, Reich K, Schδfer I. Epidemiology and comorbidity of psoriasis in children. Br J Dermatol. 2010;162:633-6.


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7. Vaidya Jadavaji Trikmji Acharya. Editor of Charaka Samhita, Ayurved dipika commentary of Chakrapanidatta. Chaukhambha Publications; New Delhi: 2016. Sutra Sthana 16/20-21, p. 97.

8. Brahmanand Tripathi. "Charaka Chandrika" Hindi commentary on Charaksamhita. Chikitsasthana chapter 7/21. 2013 ed. Choukhamba Surbharati Prakashan; Varanasi (India): p. 305.

9. Stern RS. Psoralen and ultraviolet a light therapy for psoriasis. N Engl J Med. 2007;357(7):682-690.

10. Soundharya R, Aruna V, Amruthavalli GV, Gaythri R. Lithotriptic Potential of Certain Herbs and its implication in Human Health. Research & Review: Journal of Herbal Science. 2020;9(2):7-14.


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