Featured Case

TITLE OF CASE

Standalone successful ayurvedic management of plaque psoriasis- A case report

Dr Gaurang Joshi

ABSTRACT

A 30-year-old male patient was suffering from itching and dry scaly rashes all over the body for 7 years. He had consulted allopathic doctors and tried immunosuppressants, steroids, and topical ointments. He did not get relief and the clinical condition was progressive in nature. So, he now decided to try ayurveda and approached Dr Gaurang Joshi. Based on the clinical presentation and examination, a provisional biomedical diagnosis was made as Plaque psoriasis. The ayurvedic diagnosis was Ekakushta. The line of treatment followed was punah punah shodhana and tvak prasadana. The pre and post-treatment assessment was based on subjective parameters. After 1 month of Ayurvedic treatment, the symptoms reduced and after 1 year of treatment, the patient got complete relief from all the symptoms. The patient is in remission.

KEYWORDS

Plaque psoriasis, psoriasis, eka kushta, standalone, case report

INTRODUCTION

Plaque psoriasis is an autoimmune condition. It causes thick patches (plaques) on your skin, including your scalp. There isn’t a cure, but treatments can alleviate related symptoms.

Plaque psoriasis also called psoriasis vulgaris is a long-lasting autoimmune disease that causes your cells to reproduce very quickly. It’s a type of psoriasis that causes thick, scaly patches called plaques on your skin. It most commonly affects elbows, back, knees, and scalp. In severe cases of plaque psoriasis, the face, feet, genitals (penis, vagina, vulva), hands and legs also may be affected.

Symptoms: Raised, discoloured (red, brown, grey or purple) plaques with a white or silvery surface, Cracks (fissures), Bleeding, Itchiness, Irritation or pain.

Diagnostic criteria: Medical history and clinical evaluation are the basic diagnostic criteria used. Apart from this allergy tests, biopsy and blood tests to rule out infections are also done.

Treatment: The treatments given in Plaque psoriasis are Injections, oral medicines, and phototherapy.

Prognosis: There is no cure for Plaque psoriasis. There are flare-ups and remissions, and only temporary relief is predicted.

PATIENT INFORMATION

A 30-year-old male patient was suffering from itching and dry scaly rashes all over the body for 7 years.

Medical History: He had consulted allopathic doctors and tried immunosuppressants, steroids, and topical ointments. He did not get relief and the clinical condition was progressive in nature. So, he now decided to try ayurveda and approached Dr Gaurang Joshi.

Psychosocial History: The patient is stressed due to the disease.  

CLINICAL FINDINGS

On routine skin examination, silvery red patches on skin all over the body

TIMELINE

Image 1. The timeline of events is attached below

DIAGNOSTIC ASSESSMENT

Modern Diagnostic parameter: The biomedical diagnosis was made by the Ayurvedic physician, based on the clinical presentation and evaluation.

Image 2. The image of the patient before treatment dated 15.8.2020 added below

Ayurvedic Assessment was done based on the clinical evaluation by the ayurvedic physician.

Differential Diagnosis- The diagnosis was confirmed with clinical presentation and evaluation.  

Prognosis- Plaque psoriasis is an unpredictable disorder. Not only is there no cure, but it is difficult to know which patient it will relapse, how long the active disease will last or how frequently the patient will have remissions. In addition, all treatments have major adverse effects including skin cancers, liver damage and susceptibility to infections. In this case, the patient is having persistent symptoms for 7 years in spite of undergoing the standard of care. After 1 month of Ayurvedic treatment, the symptoms reduced and after 1 year of treatment, the patient got complete relief from all the symptoms.

THERAPEUTIC INTERVENTION

See the tab ‘Treatment details’.

FOLLOW-UP AND OUTCOMES

Clinician-based assessment; With 1 month of Ayurvedic treatment, the symptoms started reducing. With 1 year of ayurvedic treatment, the patient got complete relief from symptoms.

Image 3. The image of the patient after treatment dated 1.3.2021 is added below

Patient-assessed; Not relevant.                

Intervention adherence and tolerability – The patient adhered to the prescribed treatments and tolerated the treatments well.

Method of assessment- By monitoring the patient.

Adverse and unanticipated events; None reported.

DISCUSSION ;

Psorotel powder and Cap. Asoro - induces shodhana and skin rejuvenation as the principle of the treatment is punah punah shodhana. Soro cream - helps to moisturise the skin and helps to improve natural healing. Virgin coconut oil  - the best natural moisturiser and anti-inflammatory agent which contains medium-chain fatty acids which help to reduce inflammation and soothe the skin

PATIENT’S PERSPECTIVE

Not available.

LEARNING POINTS/TAKE-HOME MESSAGES

The 30-year-old male patient has been suffering from itching and dry scaly rashes all over the body for 7 years. Though he tried conventional medicines, not only did he not get relief, but the condition was progressing. With 1 year of Ayurvedic treatment, he got complete relief from his symptoms. He is in remission. This case report demonstrates the successful ayurvedic standalone management of a chronic condition like plaque psoriasis that was otherwise non-responsive to the standard of care.

INFORMED CONSENT

Written consent was obtained from the patient to publish the case report.

CONFLICT OF INTEREST

None declared.

FUNDING

None

REFERENCE

1. Taken from - https://my.clevelandclinic.org/health/diseases/22842-plaque-psoriasis
2. Caraka Samhita. Cikitsa Sthana. Chapter 7. Kushtha Cikitsadhyayam

Image 1. Timeline of events

Image 2. The image of the patient before treatment dated 15.8.2020

Image 3. The image of the patient after treatment dated 1.3.2021