Psoriasis research studies for holistic treatments

Eka Kushta is one among the Kshudra Kushta presenting with Aswedanam (absence of sweating), Mahavastu (extensive localization), Matsyashakalopama (resembles the scales of fish) lakshana thereby affecting the somatic make-up, psychological and social aspects of an individual. In modern parlance, it simulates Psoriasis, a chronic, non-infectious skin disease characterized by well defined, slightly raised, dry, silvery erythematous macules of typical extensor distribution with its prevalence ranging from 0.1% to 3% of world population. Virechana Karma (purgation) occupies the prime seat in the management of Eka Kushta as it is dominated mainly by Pitta as well as Rakta. Snehapana (oleation), the purvakarma (pre- procedure) of Virechana plays a pivotal role by its action of dosha utkleshana (excitement of doshas) thereby mobilizing the utklishta doshas (excited doshas) from Shakha (extremities) to Koshta (abdomen) and can be achieved by adopting either Arohanakrama (increasing order of snehapana) or Sadyo-Snehana (1 day of snehapana). Amruta Ghrita is used for Snehapana as it is indicated in Kushta. Hence, a study was planned to evaluate the efficacy of ArohanaKrama Snehapana and Sadyo-Snehana for Virechana Karma in Eka Kushta with special reference to Psoriasis. The present study is a open clinical study with pre – test and post – test design where in 40 patients of either sex diagnosed as Eka Kushta w.s.r. to Psoriasis were randomly assigned into two groups comprising of 20 patients in each. In Group A and B patient were subjected to Pachana–Deepana with Panchakola Churna. In Group A, patients were subjected to ArohanaKrama Snehapana with Amruta Ghrita followed by Virechana with Trivruth Avalehya whereas in Group B, patients were subjected to Sadyo-Snehana for 1 day with Amruta Ghrita followed by Virechana with Trivruth Avalehya. Based on shuddhi (amount of purification), Samsarjana Krama (dietary regimens) was advised in both the Groups. The overall observation in the study revealed that the maximum number of patients were males in the age group of 31 – 40 years belonging to middle class, Hindu Religion, married, graduated, having mixed diet and presenting with all the lakshanas of Eka Kushta for the duration of 1-5 years. The overall result in the study revealed that both the groups showed statistically significant result and there is no statistically significant difference between the two groups since both the groups showed similar improvement in almost all the parameters with p value < 0.001. All the patients in both the groups presented with Samyak Snigdha (proper oleation) and Samyak Virechana (proper purgation) Lakshanas. Hence, the present study reveals that there is no significant difference between Arohana Krama Snehapana and Sadyo-Snehana for VirechanaKarma in Eka Kushta.

AIM: The aim of the study was the evaluation of supplementation with Pycnogenol®, French maritime pine bark extract (registered trademark of Horphag Research Ltd.) to improve the effects of the management of psoriasis and reduce the need for treatments.
METHODS:
Patients (age range 30-45) with moderate/severe plaque psoriasis were included in a 12-week registry study that did not interfere with ‘standard management’. The minimum Psoriasis Area Severity Index (PASI) score at inclusion was 10. Subjects with 10-29% (grade 2) and 30-49% (grade 3) of involved area were included. Oxidative stress (plasma free radicals) was measured. Patient-reported measures included the Dermatology Life Quality Index (DLQI). The supplement was used at a dosage of 150 mg/day (50 mg three times daily).
Results:
The two registry groups (standard management and standard management+supplementation) were comparable. Dropouts were due to logistical problems. Single PASI items were evaluated: a decrease in the affected body area in boths groups was observed. The decrease in affected areas was more pronounced in the Pycnogenol group in all body regions. The severity score (erythema, induration, desquamation) improved more significantly with Pycnogenol. Considering the water content of skin in all areas, the increase was higher with Pycnogenol. The quantity of exfoliating cells (score from -5 to +5) was significantly reduced in both groups, with a better action using Pycnogenol. Skin moisture improved with treatment in all subjects, with better effects using Pycnogenol. Using a modified (12 items) DLQI indicating how much psoriasis had affected the patient’s life in the previous week, Pycnogenol-supplemented subjects performed better for each single parameter in comparison with standard management. Improvement in the treatment time (-32% in comparison with standard management) and costs (decreased on average 36.4% in comparison with standard management) were observed in the supplement group. A decrease in consumption of other drugs was observed with the supplement. Oxidative stress was significantly lower in the supplement group at 12 weeks.
Conclusion:
These results indicate the efficacy of Pycnogenol supplementation in improving control of the most common clinical aspects of psoriasis and in reducing oxidative stress. Further studies may indicate the possible systemic or local use of Pycnogenol and its role in controlling side effects and costs of standard management.

A total of 80 patients with chronic, stable psoriasis, 34 of whom also had psoriatic arthritis, were treated with 1122 mg/day eicosapentaenoic acid ethyl ester and 756 mg/day docosahexaenoic acid ethyl ester. Before the study and after 4 and 8 weeks of treatment a Psoriatic Association scoring index (PASI) score was assessed. Before treatment the mean PASI score was 3.56, after 4 weeks 1.98 and after 8 weeks 1.24; the decrease in the score was highly significant (P less than 0.001). The degree of pruritus decreased most rapidly, followed by scaling and induration of the plaques, and erythema was most persistent. At the end of the trial, seven patients were completely healed and in 13 other patients more than 75% healing was observed but in 14 patients the result was poor. The majority of patients with psoriatic arthritis reported a subjective improvement in joint pain during the study. It is concluded that polyunsaturated ethyl ester lipids may be useful for the treatment of psoriasis and psoriatic arthritis and may provide an important adjuvant to standard therapy of both conditions.