LORD DHANVANTARI

SAINT DNYANESHWAR

VAIDYARAJ ATMARAM WAMAN DATARSHASTRI

PIONEER OF PANCHABHAUTIK CHIKITSA, AN INNOVATIVE AYURVEDIC APPROACH IN DIAGNOSING AND TREATING DISEASES.

LET’S DISCUSS A WELL KNOWN CHRONIC DERMATOLOGICAL DISORDER……

I AM

DR. ANIRUDDHA KULKARNI FORM

MIRAJ, MAHARASHTRA, INDIA

AND WILL SHARE MY THOUGHTS AND EXPERIENCES ABOUT –

MANAGEMENT OF PSORIASIS

WITH

PANCHABHAUTIK CHIKITSA

PSORIASIS - INTRODUCTION

• IT IS THE MOST COMMONLY RECOGNIZED PAPULOSQUAMOUS DISEASE.

• IT OCCURS IN 2 TO 3% OF THE GENERAL POPULATION.

• IT AFFECTS MALE AND FEMALE PATIENTS EQUALLY.

PSORIASIS - PATHOLOGY

• FORMERLY THOUGHT TO BE PURELY A DISEASE OF KERATINOCYTE HYPERPROLIFERATION.

• BUT NOW, IT IS CLEAR THAT IT IS AN IMMUNOLOGICALLY MEDIATED DISEASE.

• FACTORS PLAYING ROLE IN PATHOGENESIS –

T CELLS, CYTOKINES, CHEMOKINES, GROWTH FACTORS, DENDRITIC CELLS, EICOSANOIDS, NEUTROPHILS AND MAST CELLS.

PSORIASIS - DEVELOPMENT

DEVELOPMENT OF CUTANEOUS LESIONS

SUBSEQUENT RELEASE OF INFLAMMATORY MEDIATORS

FOLLOWED BY INFLUX OF NEUTROPHILS

GENERATION OF CYTOKINES

ACTIVATION OF T CELLS

EXPOSURE TO PRECIPITATING FACTORS

GENETICALLY SUSCEPTIBLE INDIVIDUALS

PSORIASIS – CLINICAL MANIFESTATIONS

• IT CAN INVOLVE THE SKIN, SCALP AND NAILS.

• SKIN LESIONS ARE CHARACTERIZED BY ERYTHEMATOUS MACULES, PAPULES OR PLAQUES THAT ARE USUALLY COVERED WITH SILVERY SCALES.

• ON REMOVAL OF THE SCALES, PINPOINT BLEEDING MAY BE OBSERVED. (AUSPITZ SIGN)

PSORIASIS – DISTINCT FORMS

• PSORIASIS VULGARIS

• THE MOST COMMON TYPE

• APPEARS AS A PERSISTENT ERYTHEMATOUS SCALY PAPULE AND PLAQUE ON ELBOWS, KNEES AND SCALP.

PSORIASIS – DISTINCT FORMS

• GUTTATE PSORIASIS• USUALLY OCCURS AFTER

VIRAL OR BACTERIAL(MOST COMMONLY STREPTOCOCCAL) INFECCTION.

• APPEARS AS SMALL, ERYTHEMATOUS, SCALY PAPULES SCATTERED OVER A LARGE AREA OF THE BODY IN A RAINDROP DISTRIBUTION.

PSORIASIS – DISTINCT FORMS

• INVERSE PSORIASIS

• IT OCCURS IN SKINFOLD AREAS SUCH AS THE GROIN, AXILLA AND INFRAMAMMARY FOLDS.

• SCALES ARE USUALLY ABSENT.

PSORIASIS – DISTINCT FORMS

• ERYTHRODERMIC PSORIASIS

• APPEARS AS WIDESPREAD ERYTHRODERMA WITH FINE SILVERY SCALES ASSOCIATED WITH FISSURES.

PSORIASIS – DISTINCT FORMS

• PUSTULAR PSORIASIS

• IT IS A RARE VARIANT OCCURING WITH GENERALIZED PUSTULES THAT ARE 2 TO 3 MM IN DIAMETER AND ASSOCIATED WITH FEVER.

DERMATOLOGICAL DISORDERS -KUSHTHA

• THE WORD KUSHTHA MEANS THE ONE WHICH DESTROYS WITH CERTAINITY.

• AS FAR AS THE CHRONICITY OF DISEASE IS CONCERNED, KUSHTHA IS THE MOST CHRONIC AMONG ALL THE DISEASES.

• KUSHTHA IS A DISEASE WHERE DISFIGURATION OF BODY ELEMENTS IS SEEN ALONGWITH THE DISCOLORATION.

KUSHTHA – CAUSATIVE FACTORS

• DIETARY • INTAKE OF CONTRADICTORY, INCOMPATIBLE AND

DISAGREEABLE FOOD ITEMS.

• EXCESSIVE INDULGENCE IN NEW RICE, CURDS, FISH, SALT, SOUR, FLOUR PRODUCTS, OILY AND LIQUID FOOD.

• BEHAVIORAL• BATHING IN COLD WATER IMMEDIATELY AFTER BEING

IN THE HOT SUN, EXERTION, SUPPRESSION OF NATURAL URGES, SLEEPING DURING DAYTIME.

KUSHTHA – INVOLVEMENT OF BODY CONSTITUENTS

• DOSHAS

• VATA

• PITTA

• KAPHA

• DUSHYAS

• BLOOD(RAKTA)

• SKIN(TWAKA OR RASA)

• LYMPH(LASIKA)

• PARASITES(KRUMI)

KUSHTHA - CLASSIFICATION

MAHAKUSHTHAS

• KAPALA

• AUDUMBARA

• MANDALA

• RUSHYAJIHVA

• PUNDARIKA

• SIDHMA

• KAKANAKA

KSHUDRA KUSHTHAS

• EKAKUSHTHA

• CHARMADALA

• KITIBHA

• VIPADIKA

• ALASAKA

• DADRU

• CHARMAKUSHTHA

• PAMA

• VISPHOTA

• SHATARU

• VICHARCHIKA

KUSHTHA – DISEASE PROCESS

THE TOXINS ARE TRIED TO EXPEL FROM THE BODY RESULTING IN SKIN LESIONS

THE PROCESS OF PUTREFACTION STARTS IN THE REGION OF MAHABHUTA SIMILAR TO ITS PROPERTY

ILL DIGESTED AAHARA RASA STARTS CIRCULATING IN THE BODY

OPPRESSED DIGESTIVE FIRE RESULTING IN INDIGESTION

INGESTION OF CONTRADICTORY DIET (MAIN CAUSATIVE BACKGROUND)

APPEARANCE OF LESIONS ACCORDING TO MAHABHUTAS

• FROM THIGHS TO TOEPRITHVI MAHABHUTA

• LOW BACK AND SACRAL AREA

AAPA MAHABHUTA

• ABDOMEN AND BACK REGION

TEJA MAHABHUTA

• CHEST, HEAD AND SCALP REGION

VAYU AND AAKASHA MAHABHUTA

KUSHTHA - PRODROMAL SYMPTOMS

• ROUGHNESS OF THE SKIN

• ITCHING

• EXCESSIVE OR TOTAL ABSENCE OF SWEATING

• NUMBNESS

COMPARISON WITH KUSHTHA LESIONS DESCRIPTION

• HAVE ERUPTIONS WHICH ARE ELEVATED, CIRCULAR, ARE MARKED BY ITCHING AND ARE SLOW IN DEVELOPING

PUNDARIK AND DADRU KUSHTHAS

• REDDISH BLACK DISCOLORATION OF THE SKIN IS SEENEKAKUSHTHA

SIGNS AND SYMPTOMS OF INVOLVED DHATUS

RASA DHATU

• NUMBNESS

• SWEATING

• ROUGHNESS

• SLIGHT ITCHING

RAKTA DHATU

• NUMBNESS

• ITCHING

• PRESENCE OF PUS

MANSA DHATU

• THICK CIRCULAR PATCHES

• ROUGHNESS

• PRICKING PAIN

• HARDNESS

SIGNS AND SYMPTOMS OF INVOLVED DHATUS

MEDA DHATU

• FOUL ODOR

• INCREASE IN WASTE PRODUCTS

• PUS

• PARASITES

ASTHI AND MAJJA DHATU

• SINKING OF NASAL BRIDGE

• EYE DISEASES

• PRESENCE OF WORMS IN ULCERS

SHUKRA DHATU

• DEFORMITY OF HANDS AND LIMBS

• LOSS OF POWER OF LOCOMOTION

PRINCIPLES OF TREATMENT

DETERMINATION OF CAUSATIVE

FACTOR

CORRECTION OF DIGESTION PROCESS

DIGESTION OF AAMA

IMPROVEMENT IN

NOURISHMENT OF DHATUS

DIGESTION OF METABOLIC

TOXINS

INSPECT AND TREAT KRUMI IF

ANY

SHODHANA(PURIFICATION) TREATMENTS

BLOODLETTING

PURGATION

EMESIS

TAKRADHARA

SHAMANA(PALLIATION) TREATMENTS

EXTERNAL MEDICATIONS

HARIDRA TAILA

CHATURTHAKA TAILA

SHAMANA(PALLIATION) TREATMENTS

INTERNAL MEDICATIONSAAROGYAVARDHINI

PHALATRIKADI GUGGUL

PATOLADI GUGGUL

CHATURTHAKA YOGA

SHWADANSHTRADI GUGGUL

TAMRA BHASMA

JWARAHARA YOGA

BENEFICIAL AND AVOIDABLE DIET AND REGIMEN(PATHYA-APATHYA)

APATHYA(AVOIDABLE)• GREEN CHILLIES

• RAW GARLIC AND ONION

• SPROUTS

• CURD

• MILK WITH FRUITS

• MILK WITH SOUR AND SALT FOOD ARTICLES

• INCOMPATIBLE DIET

• CONTRADICTORY DIET

PATHYA(BENEFICIAL)• SIMPLE DIET

• RICE

• MUNG DAL

• FRUIT VEGETABLES

• FRESH AND SWEET BUTTERMILK

• PROPER TIMINGS OF MEALS AND SLEEP

• PRACTICE STRESS REDUCTION TECHNIQUES LIKE MEDITATION

THANK YOU!!!