A REVIEW ON ANALYSIS OF THERAPEUTIC PROCEDURE OF SHIRODHARA AND ITS PROBABLE MODE OF ACTION

Shirodhara is one of the four types of Murdha Taila, which involves a continuous impact of medicated oil due to gravity flow from a dhara pot at the height of 4 angulas through a wick on the forehead of the subject at a controlled temperature for a prolonged duration (approx. 30-45 min.). In today’s era, unhealthy lifestyle, stress, and anxiety lead to many problems like insomnia, headache, facial paralysis, scalp psoriasis, hair fall etc. There is a need for time to find out the safe and effective treatment modalities to combat these challenges from the treasures of Ayurveda. In Ayurveda, many Samhitas have mentioned procedural outcomes, but their mode of action is not mentioned anywhere. So a review study was conducted, and various Samhitas, Nighantus, research papers, scientific journals, and modern books were considered.

AYURVEDIC MANAGEMENT OF KITIBH KUSHTHA (SCALP PSORIASIS) – A CASE REPORT

People suffering from Autoimmune diseases is increasing day by day. The exact cause of the autoimmune disease is still unknown. Psoriasis is one such disease. Dry thick raised itchy patches on the skin are the sign of psoriasis. They are covered with silvery-white scales. It is triggered by infection stress and cold. There is no known cure but with proper management, serious flares can be avoided. It generally affects the scalp, sole, palm, elbows and knees. Such diseases can be effectively managed by Ayurveda. Ayurveda defines the major- ity of skin diseases under the category of Kushtha. Clinically we can compare scalp psoriasis to Kitibha Kush- tha mentioned in the granthas. In the present study, a 53-year-old male patient was treated for scalp psoriasis. He presented himself with itching, dry scales, flake formation and whitish-pink patches on the scalp. He was treated with Arogyavardhini, Sukshma Triphala, Panchatikta Ghrut, Jatamansi choorna internally and Karan- ja Tel for local application. The treatment was given for seven months. The case report is presented here to share effective management of scalp psoriasis by Ayurveda. Keywords: Psoriasis, Kitibha Kushtha, autoimmune diseases, Arogyavardhini, Ayurveda.

Efficacy and Safety of Different Formulations of Calcipotriol/Betamethasone Dipropionate in Psoriasis: Gel, Foam, and Ointment

Preparations containing calcipotriol combined with betamethasone dipropionate (in the forms of ointment, gel, and foam) are available for the topical treatment of psoriasis. This review summarizes the differences in the efficacy and safety of these formulations, as well as the preferences of patients with various forms of psoriasis (plaque, scalp, and nail psoriasis). It has been documented that foams provide higher bioavailability, resulting in increased efficacy in plaque psoriasis compared to ointments and gels. Gels or foams are preferred by patients for their different practical qualities (e.g., gels for “easy application”, and foams for “immediate relief”). The available data indicate that ointments may be the most effective formulation in nail psoriasis, and gels are preferred by patients with scalp psoriasis because of their cosmetic features. Treatment with a foam formulation is associated with a lower number of medical appointments compared to treatment with an ointment and with a lower probability of developing indications for systemic treatment. The safety profiles of foams, ointments, and gels are comparable, with the most common adverse effect being pruritus at the application site (in 5.8% of the patients). A long-term proactive maintenance therapy markedly reduces the number of relapses and is likely to close the gap between topical and systemic treatment in psoriasis.

AYURVEDIC MANAGEMENT OF SCALP PSORIASIS WSR TO KITIBHA KUSHTHA – A CASE STUDY

Background- Psoriasis is a chronic inflammatory condition. The age of onset, chronicity, a physical and psycho- logical consequence of the disease cause psoriasis to have a significant impact on patient quality of life. Scalp Psoriasis is no different and effective treatment results in an improvement in quality of life. Aim- To study the efficacy of ayurvedic management of Scalp Psoriasis w.s.r to Kitibha Kushtha. Methodology- This study deals with a 45-year-old female patient having complaints of itching over the scalp region, powdery discharge from that region, burning present over that region for 2 years. The patient was diagnosed with Scalp Psoriasis as per modern and Kitibha Kushtha as per Ayurveda. Result- The patient got symptomatic relief in Scalp Psoriasis at the end of treatment. Conclusion- Ayurvedic management was found to be effective in Scalp Psoriasis. Keywords: Kitibha, Kushtha, Scalp Psoriasis.

Relationships between psoriasis severity indices and dermatological life quality index in children with psoriasis

Objective — to аssess the impact of dermatosis on the quality of life of children with psoriasis. Materials and methods. Psoriasis severity indices (BSA, PASI, PGA) and dermatological life quality indices (DLQI, CDLQI) in children with psoriasis aged 4 to 17 years depending on the clinical and epidemiological features of dermatosis were determined. A correlation analysis of the presence of a relationship between the obtained indicators was carried out. Results and discussion. In 73.81 % of children, the BSA index was higher than 10, which provided an average BSA of 25.85 (8.78—38.38). The calculated PASI index at the beginning of treatment averaged 9.3 (3.6—18.9). 53.06 % of children had PASI < 10. The PASI index at the first diagnosis was almost 1.5 times lower than in relapses (p = 0.043). The average PGA index was 3 (2—3), namely, 32.99 % of children had PGA 1—2, 43.20 % had PGA 3 and 23.81 % of children had PGA 4. In the group of children aged 4—7 years, there was the smallest number of participants with the PGA index 4 (7.69 %), while in the group aged 16/17—17 years, this number was the largest (41.49 %) (p = 0.039). The calculated DLQI in children with psoriasis was 5 [3—9]. The average DLQI indicator in the group of girls was statistically higher than in the group of boys (p = 0.016). Statistically significant differences were identified between DLQI in the age groups, where the highest impact on quality of life was found for the children aged 16—17 years (p < 0.001) and depended on the clinical form of psoriasis: in scalp psoriasis, the impact on quality of life was moderate, and in inverse psoriasis, it was insignificant (p = 0.021). It was found that in moderate­severe/severe psoriasis, the impact on the quality of life in children increased and was assessed as moderate, while in mild psoriasis, the impact was assessed as minor (p < 0.05). Conclusions. The course of psoriasis in children can be assessed as moderate and severe, but in the first episodes of psoriasis in droplet and inverse forms, the course is mostly mild. The intensity of skin manifestations increases with age, especially in case of the disease recurrences in the plaque form. On the whole in children, psoriasis has an ambiguous impact on the quality of life: in boys, the impact of the disease is minor; in girls, it is moderate. Damage to the visible skin areas caused by psoriasis, an increase in the area affected by the pathological process and an increase in the intensity of skin manifestations with age leads to a more negative impact on the quality of life of a child.

Treatment of Genital, Scalp and Face Psoriasis with Risankizumab

Psoriasis affecting the face, scalp, hands, feet, nail and genitals may cause disproportional impact on quality of life despite the small surface area compromised. Genital psoriasis can affect 33 to 63% of psoriasis patients at any time during their lives. Even though GenPs is relatively common, these lesions may be under-reported and under diagnosed because of embarrassment of patients, unfamiliarity with the disease or concerns about having a sexually transmitted disease. Several effective treatments have been reported for plaque psoriasis, however there are few studies and reports regarding GenPs treatment. We report here a case of successful treatment of a patient with genital, face and scalp psoriasis with risankizumab, an anti-IL23 drug