EKA KUSHTA (PSORIASIS)

DEFINITION
Kushta is the one which is having the capacity to deform the skin in the form of discoloration and is of spreading nature. So the term Kushta is used for all types of skin diseases.

ETILOGICAL FACTORS

Excessive intake of Nava Anna (new rice), Tila, Masha (gram), Dahi (curd), Sarpi (ghee), Ksheera (milk), Takra (buttermilk), Guda (jaggery), Madhu (honey), Mastya (fish), Lavana (salty), Ati Tilataila (a type of oil).

Environmental triggers – Although there is undoubtedly a genetic component to the development of Psoriasis, environmental factors are also important, and may trigger the disease.

Physical trauma – In approximately one-third of patients with Psoriasis, trauma to the skin will result in the development of Psoriatic lesions at the site of trauma.

Infections – The organism most commonly associated with Psoriasis is the β-hemolytic streptococcus.

Stress – There is no doubt that, in patients with the genetic predisposition for Psoriasis, stress may precipitate Psoriasis and aggravate existing disease. Stress has effects on hormones, and the autonomic nervous and immune systems.

Drugs – Certain drugs, notably lithium, β-blockers, Antimalarials (Chloroquin, Hydroxychloroquin and Quinacrine) and non–steroidal anti–inflammatory drugs (NSAIDs).

Hypocalcemia – It is an interesting observation that the very rare condition of hypocalcemia aggravates Psoriasis.

Alcohol – There has long been a reported association between Psoriasis and a high intake of alcohol. Originally this was attributed to patients taking alcohol in an attempt to alleviate their feelings of frustration and anxiety/depression because of their Psoriasis.

Climate – Psoriasis tends to improve in warm climates and to become worse in cold ones.

Sunlight – Although sunlight is generally beneficial, in a small minority of patients, Psoriasis may be provoked by strong sunlight and cause summer exacerbations in exposed skin.

Metabolic factors – The early onset of Psoriasis in women, with a peak around puberty, changes during pregnancy and provocation of Psoriasis by high dose oestrogen therapy potentially indicates a role for hormonal factors in the disease. Thus, if Psoriasis changes in pregnancy, it is more likely to improve than worsen, while in the postpartum period it is more likely to deteriorate.

Smoking – Individuals smoking more than 15 cigarettes per day had an odds ratio of 10.5 for association with Palmoplantar Pustulosis.
HIV and acquired immune deficiency syndrome – The association between severe Psoriasis, Psoriatic Arthropathy and Human Immune Deficiency Virus (HIV) infection is well recognized.

TYPES ACCORDING TO DIFFERENT PRESENTATION:
Plaque Psoriasis, Guttate Psoriasis, Chronic Plaque Combined with Guttate Psoriasis, Erythrodermic Psoriasis, Pustular Psoriasis – Generalized Pustular Psoriasis& Localized Pustular Psoriasis, Acral Psoriasis, Seborrheic Psoriasis, Childhood Psoriasis, Diaper Psoriasis and Linear Psoriasis

PSORIASIS AT SPECIFICSITES:
Scalp, Beard & Pubic area, Palms & soles, Flexures & intertriginous areas, Genitalia, Mucous membranes and Nails

Prognosis
Indulgence in caustive factors
Depletion of digestive fire (agni)
Formation of ama (toxins)
3 doshas getting vitated
Entering into dhatus
Causing kushta

Treatment
Chikitsa (Treatment) aims not only at the radical removal of the causative factors of the disease, but also at the restoration of doshic equilibrium. The importance of chikitsa lies in the disintegration of the process of samprapti (integral factors). The general line of treatment explained for Kushta is applicable to EkaKushta also. In Kushtachikitsa, Shodhana karma (Purification therapy) is given prior importance.

Charaka mentions, according to the doshic predominance Shodhana have to be adopted.

In VataPredominantKushta, Sarpipana (internal ghee consumption)

In KaphaPredominantKushta Vamana (induced vomiting)

In Pitta PradhanaKushta, Virechana (Purgation) and Raktamokshana (blood letting)

Patient who are contraindicated for Purification therapy Tikta and Kashaya Dravyasare given

CONCLUSION:
Prevention is the best Medicine so avoid the causative factor