Abstract
Ayurveda, an ancient system, offers in-depth insights into various skin disorders. It provides detailed understanding of causative factors and pathomechanisms, along with time-tested traditional treatments based on its principles. We report a 16-year chronic case of psoriasis (36-year-old male patient) with plaques and peeling erythrodermic skin rashes over the back and front of the trunk area and both legs. The scalp area and nail beds were also affected. The early involvement of joints was also noted. A two-year multimodal Ayurveda treatment has shown notable efficacy in managing chronic plaque and erythrodermic psoriasis, with no reported adverse events or side effects. The progressive events were documented in the form of photographs with the proper consent of the patient. The Ayurveda medicines, strict dietary regimen, and regular follow-ups together resulted in promising outcomes, revalidating the potential of Ayurveda in controlling psoriasis and its complications.
Keywords: Psoriasis, Erythrodermic, Ayurveda, Kustha, Herbs, Case report
1. Introduction
Psoriasis, a chronic autoimmune skin condition impacting 2%–3% of the world's population, is acknowledged as a major global health issue by the World Health Organization. Beyond its physical effects, the visible symptoms can significantly impact mental well-being and overall quality of life [1,2]. However, its pervasiveness differs across countries, with preponderance figures varying from 0.51% to 11.43% [3,4]. The immune-mediated chronic inflammatory condition extends beyond the skin and nails and causes Non-Communicable Diseases and co-morbidities in psoriatic patients [5,6]. Stress, trauma, infections, and some medications can act as triggering factors in psoriatic patients. Psoriasis, often appearing in early adulthood, exhibits diverse clinical forms like plaque, guttate, flexural, pustular, and erythrodermic. The condition involves hyperproliferation and inflammation of the epidermis. Psoriasis pathogenesis involves immune cell infiltration driven by a cytokine network. Interactions among dendritic cells (DCs), T cells, neutrophils, and macrophages influence pro-inflammatory and anti-inflammatory pathways, shaping the development of the condition [7,8]. Correlating psoriasis with a specific type of Kushtha Vikaras (skin disorders) in Ayurveda may oversimplify the intricate pathogenesis of psoriasis, which involves a complex interplay of genetic, immune, and environmental factors. The holistic management of psoriasis necessitates a nuanced approach that extends beyond the treatment principles associated with any singular type of Kushtha Vikara.
2. Patient information
A 36-year-old male was diagnosed with severe psoriasis exhibiting characteristics of both plaque and erythrodermic types. Over the past 16 years, he has sought treatment from various dermatologists in both government and private healthcare settings. During this period, he has consistently received allopathic treatment with regular follow-ups. The patient experienced symptomatic relief through a combination of topical and systemic immunosuppressive therapy in his most recent treatment course. The patient's personal history reveals a generally good state of health, as all routine tests consistently showed results within the normal range. No concomitant illnesses were found to be associated with the condition. However, due to the adverse effects resulting from prolonged allopathic treatment and the recurrence of symptoms possibly due to unidentified aggravating factors, the patient has chosen to explore Ayurvedic treatment as an alternative approach.
3. Clinical findings
The patient's presentation is characterized by plaques and erythrodermic skin rashes affecting the back, front of the trunk area, both legs, and the scalp. The affected skin displays a variable shade of red to pink, and notably, it showed few elevated silvery scales, which is often seen in conditions like plaque and erythrodermic psoriasis types (Fig. 1A). The patient presented with pronounced pruritus (intense itching) and sporadic episodes of a burning sensation over the affected areas. Clinical examination revealed positive Koebner phenomenon, signifying the development of new psoriatic plaques at sites of skin trauma. Additionally, early manifestations of mild psoriatic arthritis and nail bed psoriasis were observed. The clinical presentation strongly suggests a mixed form of plaque and erythrodermic psoriasis, accompanied by early-stage psoriatic arthritis and nail involvement.
Fig. 1.
Periodic clinical outcomes in response to Ayurveda treatment.
3.1. General examination
The vital signs were all within normal limits: body temperature at 98.0 °F, pulse rate at 82 beats per minute, and blood pressure measuring 120/82 mmHg.
3.2. Systemic examination
In the course of the systemic examination, the respiratory and cardiovascular systems displayed no abnormalities. Nonetheless, the patient's overall stability was compromised due to distressing sensations of itching and burning specifically localized to the psoriatic lesions.
3.3. Nidanapanchaka
The involvement of Nidanapanchaka (five diagnostic principles) has been detailed in Table 1.
Table 1.
List of factors involved in Ayurevedic pathophysiology and disease progress.
| Nidanapanchaka (five diagnostic principles) | |||
|---|---|---|---|
| 1. Nidana (causative factors) | 5. Samprapti (pathogenesis) | ||
| Apathyakar (unwholesome) & Viruddhahara sevana (antagonistic food) | Dosha (regulatory functional factors of the body) | Tridoshaja (three regulatory functional factors of the body) (dominating pitta - doṣa responsible for regulating body temperature and metabolic activities) | |
| 2. Poorva roopa (prodromes) | Dushya (which gets vitiated) | Rasa (primary product of digested food), Rakta (blood tissue), Mamsa (muscle tissue) and Asthi dhatu (bone tissue) | |
| Kanduta, Daha (burning sensation), Mandagni (weak state of agni) | Agni (digestive/metabolic factors) | Manda (weak state of agni) | |
| 3. Roopa (sign & symptoms) | Aam (a toxic by-product generated due to improper or incomplete digestion) | Jatharagni and Dhatvagnimandya nirmita (diminution of agni) | |
| Jwara (fever), Daha (burning sensation), Kandu (itching), Tvakavaivarnyata (skin discoloration), Balahani (loss of physical strength/weakness), Sandhishoola (pain in joints) | Srotasa (structural or functional channels) | Rasa (channels carrying nutrient fluids), Rakta (channels carrying blood tissue), Mamsa (channels carrying muscle tissue) and Asthivaha strotasa (channels carrying bone tissue) | |
| 4. Upashaya & Anupashaya | Adhisthana (place of manifestation of diseases) | Tvaka (skin) & Nakh (nail) | |
| Upashaya (favorable treatment and intervention) | Shita Sparsha (cold on touch/feel) | Rogamarga (presentation of pathological changes) | Bahyamarga (external body parts) |
| Anupashaya (unfavourable treatment and intervention) | Ushna Sparsha (hot on touch/feel) | Vyadhi Swabhava (stage of disease) | Chirakalin (chronic) |
3.4. Diagnostic assessment
Routine blood investigations showed normal results. The patient had previously been assessed by a dermatologist who identified a classical presentation of plaque and erythrodermic psoriasis. The diagnosis was further substantiated by careful consideration of the distinct characteristics of the skin lesions and the presence of a positive Koebner phenomenon.
4. Therapeutic interventions
The patient has discontinued both oral and topical modern medications. In this case, Tridosha involvement was determined through clinical presentation such as Daha (burning sensation), Kandu (itching), Raktavarnata (redness), Sandhishoola (joint pain), nail bed deformities, and the characteristics of skin lesions.
The specific internal and external medications prescribed are outlined in Table 2.
Table 2.
List of internal and external medications with dose, adjuvant, and duration.
| Sr. No. | Formulation | Dose, Adjuvant, frequency, and timea | Duration |
|---|---|---|---|
| 1. | Mahatiktaka ghrita (medicated ghee capsules) | 3 capsules, totaling 1.5 g (with warm water), once daily in the early morning on an empty stomach. | 1 Year |
| 2. | Kaishor guggulu (Tablet) | 2 tablets, each containing 1 g of the medication (with lukewarm water), twice daily after meals. | 1 Year |
| 3. | Gandhaka rasayana (Tablet) | 1 tablet, containing 250 mg (with water), twice daily after having breakfast. | 1 Year |
| 4. | Patolakaturohinyadi kashaya (herbal decoction) | 20 mL, twice daily (mixed with 50 mL of lukewarm water), preferably on an empty stomach | 1 Year |
| 5. | Punarnavadi kashaya (herbal decoction) | 20 mL, twice daily (mixed with 50 mL of lukewarm water), preferably on an empty stomach (1 hour before Patolkaturohinyadi kashay) | 1 Year |
| 6. | Khadirarishta (herbal fermented liquid) | 20 mL, twice daily (mixed with 40 mL of normal water) following a meal | 1 Year |
| 7. | Winsoria oil (herbal coconut base oil) | Topical application (Twice a day) | 1 Year |
| 8. | Strict dietary plan | Restricted use of salt, sour foods, curd, aged butter, milk, sweet products, intake of meat and fish, and avoid overeating. | 3 Years |
Dose of the medicines has been reduced to half and continued the treatment for next 6 months (Table 2). The details of all the prescribed medicines including their classical reference, ingredients, and indications are given in Supplementary Table 1.
4.1. Follow-ups and periodic clinical observations
The follow-ups details with timeline, treatment protocol, and periodic clinical observations are mentioned in Table 3.
Table 3.
The follow-up and clinical outcomes.
| Timeline | Dates | Periodic clinical observations |
|---|---|---|
| Onset of treatment | October 27, 2020 | Ayurveda treatment started. (Fig. 1A) |
| Follow-up 1 | November 17, 2020 | Mild improvement observed in signs and symptoms, characterized by a reduction in itching and redness. |
| Follow-up 2 | December 22, 2020 | Significant improvements noted in signs and symptoms, with a notable reduction in joint pain. |
| Follow-up 3 | January 19, 2021 | Remarkable improvement observed in all signs and symptoms, with the absence of itching, burning sensation, and joint pain. |
| Follow-up 4 | February 23, 2021 | Recovered lesions (Fig. 1B). No itching and burning sensation. No erythematic plaques. No joint pain. Recovery in nail bed deformity noted. |
| Follow-up 5 | July 05, 2021 | Small lesions in scalp area noted. No recurrence in rest of the body area. Normal biochemical profile. No joint pain. |
| Follow-up 6 | July 27, 2021 | Scalp lesions get recovered. Nail bed deformity found recovered. No joint pain. |
| Follow-up 7a | December 07, 2021 | No recurrence observed in any sign or symptom. |
| Periodic follow-ups up to next 2 years | September 19, 2023 | Occasional very fine plaques were noted but resolved quickly. |
| Last follow-up | October 31, 2023 | No active recurrence (Fig. 1C). |
Dose of medicines reduced to half from 7th follow-up and stopped after next 6 months. On and off pattern of treatment was followed after the active treatment of one and a half years according to clinical symptoms.
5. Outcomes
The psoriatic lesions exhibited complete resolution of signs and symptoms without any reported adverse events during the course of treatment. Furthermore, the previously experienced arthritic pain has been effectively alleviated, with a marked improvement in nail deformity noted. A comparative analysis of psoriatic lesions before and after treatment is depicted in Fig. 1A-1C. The patient diligently adhered to a strict dietary regimen over the following 3 years, with no active recurrence observed.
6. Discussion
The current case involves a diagnosis of psoriasis with a combination of plaque and erythrodermic types. Additionally, the patient has developed psoriatic arthritis and nail deformities. This necessitated the creation of a treatment plan with a multifaceted approach, addressing the pathology on various levels. psoriasis, being a complex condition with multifaceted underlying factors, presents a treatment challenge when exclusively considering the principles of Kushtha Chikitsa (treatment of skin disoredrs) within Ayurveda. Correlating psoriasis with a specific type of Kushtha Vikaras (skin disorders) in Ayurveda may oversimplify the intricate pathogenesis of psoriasis, which involves a complex interplay of genetic, immune, and environmental factors. The holistic management of psoriasis necessitates a nuanced approach that extends beyond the treatment principles associated with any singular type of Kushtha Vikaras.
Hence, the treatment protocol was developed by considering the involvement of dosha and dushya and treatment principles and formulations of Kushtha Chikitsa, Jeerna Jwara Chikitsa (treatment of chronic fever), Vatarakta Chikitsa (treatment of rheumatism), Shoth Chikitsa (treatment of inflammation/swelling), and Rasayan Chikitsa (rejuvenation). In chronic diseases, Ayurveda emphasizes holistic, prolonged treatment. Pathyapathya (wholesome/unwholesome), dietary and lifestyle guidelines, are crucial for maximum recovery and reducing recurrence.
Mahatiktaka Ghrita is a medicated ghee used for its therapeutic effects on balancing doshas, primarily in cases of Kushtha, which refers to skin diseases. To make it more palatable, this ghee is administered internally in the form of capsules, with each capsule containing 3 ml of the ghee. Mahatiktaka Ghrita has a subtle action (sukshmastrotogamitva), allowing it to reach and nourish the Shukradhatu (reproductive fluids; semen).
In cases of Kushtha, it is recommended to use Mahatiktaka Ghrita both internally and externally. This medicated ghee is enriched with the Tikta (bitter) and Kashaya (astringent) tastes. It contains various active phytoconstituents that work in synergy, possibly through a liposomal drug delivery system, to effectively address psoriasis [9].
Guggulu (Commiphora mukul Hook. ex Stocks) has demonstrated promising effects against a spectrum of chronic inflammatory diseases. These benefits stem from its potent anti-inflammatory and antioxidant properties, which target multiple signaling pathways [10].
The therapeutic effects of Guggulu can be attributed to its rich composition of terpenes, guggulsterols, essential oils, guggulsterone and dehydroguggulsterone-M, ferrulates, lignans, and flavanones [11]. Significantly, it exhibits a Yogavahi property (synergism) in Ayurveda, functioning as a drug carrier with the ability to entrap active pharmaceutical ingredients and facilitate sustained release actions [12].
A notable finding suggests that gugulipid from Guggulu competes with tetracycline in treating nodulocystic acne, highlighting the potent anti-infective and antimicrobial properties [13]. This underlines its potential as an alternative treatment for skin infections.
Furthermore, Kaishor Guggulu, a polyherbal preparation recommended for Vatarakta (rheumatism/gout), is renowned for its Kantikara property (restores skin's natural radiance and suppleness) in Ayurveda. It contributes to restoring the healthy, glowing appearance and flexibility of the skin while alleviating the inflammatory pain associated with Vatarakta through the purification of the blood. This preparation also demonstrates antiallergic and antibacterial properties, making it an effective solution for addressing redness, inflammation, and deep-seated doshas in psoriasis [14]. In summary, Guggulu and its derivatives offer a multifaceted approach to managing chronic diseases, presenting a valuable resource in both traditional and potentially modern medicine. The diverse range of bioactive compounds within Guggulu contributes to its extensive therapeutic potential.
In Ayurveda, Gandhak, or sulfur, is esteemed for its diverse therapeutic properties. It is known for its effectiveness in alleviating various skin conditions, Gandhak is valued for its ability to address dermatological issues (Kushthaghna). It is recognized for its anti-poisonous attributes, indicating its potential to counteract the effects of certain toxins in the body (Garavishahara). Gandhak is associated with rejuvenation, believed to enhance vitality and promote longevity (Rasayana). It regulates excessive moisture or fluids in the body (Kledaghna). It is also acknowledged for its capacity to enhance digestion and address digestive disorders (Aampachana). Gandhak is believed to purify and improve the quality of blood (Raktaprasadana) [15].
Gandhak Rasayana involves the processing of purified sulfur with various medicinal herbs. This synergistic approach is employed to significantly enhance the pharmacological effectiveness of sulfur. It's a common practice in Ayurveda to combine substances with other herbs to amplify their therapeutic effects [16].
Patolkaturohinyadi Kashaya is a time-honored herbal formulation deeply embedded in Ayurvedic tradition. It is esteemed for its effectiveness in alleviating a range of skin conditions. It is also known for its potential in correcting liver metabolism. Additionally, it is reputed for its ability to enhance appetite and facilitate digestion. Analysis via GC-MS has revealed the presence of various phytochemical components, suggesting a multifaceted approach that may address the underlying pathophysiology of psoriasis [17].
Punarnavadi Kashay is prepared by using eight herbs wherein, Punarnava (Boerhavia diffusa Linn.) is Shothahara (anti-inflammatory) and has properties that can help balance the Vata and Kapha doshas in Ayurveda [18]. Studies suggest that Punarnava may possess the ability to modulate or regulate the immune system, potentially enhancing its function [19]. It demonstrates antioxidant properties, safeguarding cells from damage caused by free radicals and contributing to overall cellular health. It provides a protective shield for the liver, guarding it against damage induced by toxins or other harmful agents [20]. Punarnava's anti-inflammatory properties suggest it may help reduce inflammation [21]. It possesses the ability to inhibit the rapid multiplication of cells by its anti-proliferative activity [22]. The aqueous extract of Giloy (Tinospora cordifolia Willd Miers.), administered at a dose of 300mg/kg body weight, demonstrated notable efficacy in preventing inflammation in mice with imiquimod-induced psoriasis-like dermatitis [23].
Th17 cells and their associated cytokines, particularly interleukin-17 (IL-17), interleukin-21 (IL-21), and interleukin-22 (IL-22), play pivotal roles in the pathogenesis of autoimmune and inflammatory disorders, notably psoriasis and psoriatic arthritis. The anti-inflammatory properties of T. cordifolia primarily target T cells, demonstrating notable effectiveness in Th17-associated autoimmune and inflammatory diseases [24]. Berberine present in Darvi (Berbesis aristata Linn), one of the ingredients of Punarnavadi Kashay also exhibited a direct suppression of the Th17 cells and dendritic cell responses [25].
In a study involving 50 psoriasis patients, Neem (Azadirachta indica A. Juss.) demonstrated potential benefits. The treatment involved oral neem capsules, specifically an aqueous neem leaf extract, in combination with a topical application of crude tar (5%) and salicylic acid (3%) in petrolatum. This combination led to a noteworthy reduction in the Psoriasis Area Severity Index (PASI) when compared to a control group receiving a placebo alongside the same tar and salicylic acid ointment [26].
Shunthi (Zingiber officinale Roxb.) is indeed considered a potential herbal remedy for the treatment of psoriasis due to its anti-inflammatory properties, primarily attributed to its active compound, gingerol. The anti-inflammatory effects of ginger have been demonstrated in various studies, making it a natural candidate for managing the inflammatory aspects of psoriasis [27].
In this way, Punarnavadi Kashaya exhibits a synergistic mechanism in managing psoriasis, addressing various levels of its pathogenesis. The formulation's constituents work in concert to target the complex underlying factors, including immune system dysregulation, inflammation, and aberrant skin cell proliferation.
Arista Kalpana is an innovative continuous hydro-alcoholic extraction technique designed to extract phytoconstituents from raw herbs. What sets Arista Kalpana apart is its potential for enhanced therapeutic efficacy, attributed to biological transformations occurring within the medium, facilitated by microbial activity. The involvement of microbes in the process suggests the possibility of creating novel phytochemical compounds or improving the bioavailability of existing ones, ultimately contributing to the heightened therapeutic effectiveness of the resulting extract [28].
Khadirarista, a traditional remedy, is widely recommended for various types of Kushtha, or skin disorders, in Ayurvedic practice. This formulation is noteworthy for its antipsoriatic properties, with many of its ingredients known to possess such beneficial effects. Central to Khadirarista is the heartwood decoction of Khadir (Acacia catechu Willd.), a component that has been utilized in traditional medicine for an extended period, particularly in the treatment of skin conditions like psoriasis. Its blood-purifying properties are well-regarded. Additionally, it is believed to exhibit immunomodulatory actions, potentially influencing both cell-mediated and humoral immunity. In Acacia catechu, catechins, among other phytoconstituents, are believed to play a significant role in conferring anti-inflammatory and antioxidant properties [29].
The aqueous extract of Acacia catechu displayed the ability to inhibit TNF-α (a pro-inflammatory cytokine) while concurrently exhibiting a significant elevation in the cytokine IL-10. IL-10 plays a role in modulating the secretion of pro-inflammatory cytokines by promoting the proliferation of thymocytes, B cells, and mast cells [30].
Darvi (Berberis aristata DC.) is recognized for its anti-inflammatory properties. The aqueous extract of Berberis aristata has shown effectiveness in treating skin diseases through both internal and external applications [31,32].
Bakuchi (Psoralia corylifolia Linn.) comprises a spectrum of phytoconstituents including flavonoids, alkaloids, meroterpens, coumarins, and some essential oils. These constituents collectively contribute to its multifaceted pharmacological actions in managing psoriasis by its anti-inflammatory, antioxidant, antibacterial, and immunomodulatory activities [33,34].
Dhataki Pushpa (Woodfordia fruticosa Kurz.), scientifically known as Woodfordia fruticosa, is a plant renowned for its therapeutic properties. Flowers are known for their potent anti-inflammatory attributes, making them beneficial in alleviating various inflammatory conditions. Furthermore, Dhataki Pushpa is utilized in the treatment of skin disorders [35].
Winsoria oil is a blend of coconut oil with Vidphala (Wrightia tinctoria R. Br.), Manjishta (Rubia cordifolia), and Sariva (Hemidesmus indicus R. Br.). This formulation is suggested to facilitate improved permeation through the skin, potentially contributing to the treatment of psoriasis.
This formulation is purported to effectively retard hyperkeratinization, alleviate silvery scales, and reduce inflammatory responses. Moreover, it demonstrates potential in minimizing skin exfoliation and discoloration. Additionally, Winsoria oil proves beneficial in preventing itching, as well as the formation of scales and sores. Vidphala, known to control inflammation of the scalp and dandruff formation, is a widely sought-after ingredient in various hair oil formulations. The leaf of Wrightia tinctoria is a key ingredient in the preparation of 777 Oil, a coconut oil-based herbal remedy specifically indicated for psoriasis [36].
The ethyl acetate fraction derived from the ethanolic extract of Manjishtha (Rubia cordifolia) root, when formulated into a topical gel, demonstrated antiproliferative action on keratinocytes in a mouse tail model. This finding suggests potential antipsoriatic activity, as psoriasis is characterized by excessive keratinocyte proliferation [37].
Sariva (Hemidesmus indicus R.Br.) is recognized for its noteworthy properties such as anti-inflammatory, immunomodulatory, antioxidant, Raktaprasadana (enhancing the quality of blood), Dahaprashamana (alleviates burning sensations), and Shothahara (reduces swelling and edema). Collectively, these properties highlight Sariva's potential to address a wide array of health concerns, particularly those associated with inflammation, immune system regulation, and oxidative stress [38].
Certainly, coconut oil offers notable benefits in addressing skin disorders. Its moisturizing, soothing, and emollient properties play a pivotal role in improving symptoms. Moreover, its anti-inflammatory activity further contributes to its efficacy in skincare. Coconut oil effectively quells inflammation by suppressing pivotal inflammatory markers. Psoriasis is a skin condition where epidermal keratinocytes respond to pro-inflammatory cytokines such as tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ). Interleukin 6 (IL-6) contributes to the development of epidermal hyperplasia in psoriatic skin. Coconut oil has shown potential in mitigating inflammation by reducing IL-6 secretion. Psoriasis involves overproduction of inflammatory cytokines, disrupting the skin barrier. Additionally, topical application of coconut oil has demonstrated inhibitory effects on various cytokines, including TNF-α, interferon-γ, and various interleukins [39]. Coconut oil has been shown to enhance the skin's barrier function and can serve as a safe permeation enhancer for facilitating drug absorption through the skin [40].
The favorable outcomes observed in this case can be attributed to the synergistic effects of Ayurvedic medicines, strict adherence to the prescribed diet plan (pathya sevana), and consistent follow-ups by the patient. This integrated approach exemplifies the holistic nature of Ayurvedic treatment, wherein various components work in harmony to facilitate the body's innate healing mechanisms. The presented treatment protocol aligns with previous case reports, reinforcing the potential therapeutic benefits of Ayurveda in managing various types of Psoriasis effectively and safely [17]. The conceivable role of Ayurvedic treatment in mitigating the pathophysiological processes associated with psoriasis have been illustrated in Fig. 2 and Table 4.
Fig. 2.
The possible role of herbs in controlling the Psoriasis at different levels of pathology.
Table 4.
The components of Ayurveda treatment protocol to treat Psoriasis.
| Name of the medicine | Pharmacological action | Combined effect of treatment protocol |
|---|---|---|
| Khadirarishta & Mahatiktaka Ghrita | Kushthahara (alleviate pathophysiologyof skin diseases) |
1. Raktaprasadana (Qualitative improvement of blood tissue) 2. Rasaprasadana (Physiological improvement of chyme) 3. Angidipana (regulation of gut metabolism) 4. Aampachana (regulation of toxic/antigenic factors) 5. Twakaprasadana (improvement of the skin complexion) |
| Patolakaturohinyadi Kashaya | Jirnajwarahara (Mitigation of chronic inflammatory manifestations) | |
| Punarnavadi Kashaya | Shothahara (Anti-inflammatoryAction) | |
| Kaishor guggulu | Vataraktahara (Antirheumatic Action) | |
| Gandhaka Rasaayana | Rasaayana (Rejuvenation) | |
| Winsoria oil | Vranaropana, Shothahara, and Twakaprasadana (Wound healing, anti-inflammatory action, and improves the skin complexion) |
7. Conclusion
In the present case, the treatment protocol was designed in accordance with the principles of Ayurveda, specifically taking into consideration the concept of "samprapti," which pertains to understanding the pathogenesis and progression of a disease. The patient also responded more rapidly to Ayurvedic treatment in comparison to previous allopathic treatments. There have been no instances of active recurrence following the end of active treatment. This also underscores the continued importance of Pathyapathya as a promoter of good health in case of chronic autoimmune diseases. Ayurvedic treatments, both external and internal, effectively address the intricate pathophysiology of psoriasis and related chronic diseases. In sum, the comprehensive approach of multimodal Ayurvedic treatment brought about a rapid and substantial recovery in a chronic psoriasis case.
Patient's perspective
The patient initially endured substantial discomfort, including severe itching, burning sensations, joint pain, and significant stress upon presentation. However, by the conclusion of the treatment, the patient was entirely free from all signs and symptoms.
Informed consent
Written consent was obtained from the patient for the publication of this case study including images and clinical information. The patient understands that his name and initials will not be published and due efforts will be made to conceal the identity, but anonymity cannot be guaranteed.
Author contribution
GCN: Conceptualization; Visualization, Writing Original Draft, AKC: Visualization, Review and Editing, LNG: Visualization, Review and Editing, MB: Visualization, Review and Editing.
Declaration of generative AI in scientific writing
The authors declare that no generative AI and AI-assisted technologies have been used in the writing process.
Sources of funding
The research did not receive funding from public, commercial, or not-for-profit sectors.
Conflict of interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgement
We are thankful to the patient for giving consent to publish the case report. We also acknowledge Sir Sunder Lal Hospital, IMS, Banaras Hindu University for providing OPD facilities.
Footnotes
Peer review under responsibility of Transdisciplinary University, Bangalore.
Supplementary data to this article can be found online at https://doi.org/10.1016/j.jaim.2024.101091.
Appendix A. Supplementary data
The following is the Supplementary data to this article.
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