Introduction

Skin is the largest sense organ of human body,which covers the other organs .It is the protective part of human body.it is also a target organ for many diseases.All the skin diseases in ayurveda have been classified under the broad heading of kushtha,which catogarised into mahakushtha(major)& kshudra kushtha (minor). Kitibh kushtha (psoriasis)is a common non communicable chronic skin disease which having no clear cause of cure. Skin is the mirror which reflects the harmony of internal functions of the body.Any  change in the skin colour disturbs the patient both mentally & physically.This condition causes negative impact on people's life.psorisis affects people of all ages in years..The word Psoriasis is derived from Greek word 'Psora' means 'itch' and 'sis' meaning 'acting condition'. In psoriasis the main abnormality is of increased epidermal proliferation due to excessive multiplication of cells in the basal layers. The etiology is unknown;the factors  which involved are genetic; biochemical and immunopathological.In kitibh kushtha Precipitating factors like trauma, infections, sunlight, some drugs and emotions may flare up. Kitibha Kushtha manifests due aggravation of tridosha especially dominance of Vata and Kaphaa. Mithya Ahara and vihar vitiate tridosh.Which further lead to affection of rasa,rakta,mansa&lasika.Predominance of Vata can be elicited with symptoms like blackish discoloration hardness, dryness and roughness to  touch. Kaphaa predominance can be appreciated with the presence of severe itching as a cardinal symptom. Visitation of tridosh affects twacha;rakta;mansa;&lasika which causes kushtha.These all are commonly called as seven morbid factors of kushtha which are called as Saptakodravya sangraha.Modern medical science treat psoriasis with retinoids;Methotrexate and Cyclosporine and Corticosteroids.But this gives serious side effects to the patients like liver& kidney Therefore ayurveda plays important role in the management of kushtha.Present case study gives effective ayurvedic treatment for kitibh kushtha.

METHOD – CASE STUDY: - A 12 years male came to O.P.D. of Kaychikitsa department of L.K. Ayurved Hospital, Yawatmal with chief complaints of

1.  Twak vaivarnya padatal bhagi-5-6yrs.

2.  Kandu (itching sensation) +

3.  Daah (burning sensation).   

4.  shav-kinkhar sparsh  

5.  Mndalotpti on hastatal.

PAST HISTORY OF ILLNESS: -

Patient having No/H/O_past illness.   

No/H/O – DM/ T.B./ Thyroid

No/H/O – No any major illness.

HISTORY OF PRESENT ILLNESS: - The patient was apparently normal 5 to 7 years before.But after that he is  having complaints of twakvaivarnya and kandu for which he started allopathic medicine like antifungal, antiallergic; steroids etc. But latter on these drugs produces adverse effect on him like indigestion, bloating etc. and with these drugs he gets symptomatic relief for some days. His symptoms worsened as he stopped talking medicine. So, she come to Kaychikitsa O.P.D. L.K. Ayurvedic Hospital, Yawatmal.

RUGNAPARIKSHAN: -

1.   Nadi: - 68/min

2.   Mal: - Samyak

3.   Mutra: - Samyak

4.   Jivha: - Alpasam

5.   Shabda: - Prakrut(spasta)

6.   Sparsha: - Samshitoshna

7.   Prakruti: - Vat-pittaj

8.   Nidra: - Anidra

9.   B.P.: - 100/60 mm of Hg

10. Temp.: - Afebrile.  

11. Druk-prakrut 

12. Akruti-krush

LABORATORY AND X-RAY EXAMINATION: -

1)   Blood Routine: - Normal

2)   ESR: -32mm/1hr. 

3)   Blood sugar: -84mg/dl.  

4)   c.r.p.-positive.

SAMPRAPTI GHATAKS OF KITIBH KUSHTHA: - 

Dosha: - Tridosh. 

Dushya-Twak;Rakt;Mans;Ambu.

Dhatu :-  Rasa,Rakta        

Updhatu-Twak;Mans

Udbhavsthan :- Pakwashay

Vyaktisthan :- Twacha

Strotas :- Rasavah, Raktavaha; Manswaha.

Rogmarga :- Bahya-abhyantar Maraga.                   

Aapathya_Viruddhaahar,abhishyandi padarth. 

Material and Methods: -

Methods: -

1) A case study

2)Centre: - P.G. Department of Kaychikitsa L.K. Ayurvedic Hospital, Yawatmal affiliated to

D.M.M. Ayurved College, Yawatmal.

Material: - (Shaman Chikitsa)

PANCHAKARMA CHIKITSA: -

1. Pada-avagah with Guduchi and nimba quath.and after that local application of padachira malam was given to patient.

Discussion

• Response to the treatment was recorded and therapeutic effect were evaluated by symptomatic relief of the patient. It was observed that the patient clinical symptoms were reduced gradually during the treatment period.

• Internal ayurvedic medicines like aarogya vardhini vati.; Kaishor guggul vitiate tridosh and then twacha; rakta;mansa; & lasika(saptakodravyasangraha). 
• Drugs like sariva; manjistha; haridra; & khadir gives relif to the patient on symptoms like daaha& twakvaivarnya and kandu which are main symptoms of kushtha vyadhi. 
• Charak has explained sariva & manjistha in varnya mahakashay. 
• Sariva is also described in dahaprashaman mahakashay by Acharya charak.

• Charak has described manjistha in varnya & vishaghna mahakashay &pittashaman mahakashay by Acharya sushrut. As it has tikta;kashay & madhur rasa it works as kaphapittashamak,which get vetation in kitibh kushtha&it acts as krimighna also.

PROBABLE MODE OF ACTION: - All medicine which are given in these patient are pitta kapha Shamak;kushthaghna&krimighna.which helps to reduce twakvaivarnya and kandu(itching) related with  kitibh kushtha.(Palmoplantar psoriasis.) These medicines also give relif to patient from Daah.

Conclusion

It is concluded that this treatment relieves symptoms in kitibh kushtha. (Palmoplantar psoriasis.) This medicine can be utilised in treating patients who are suffering from skin diseases like kitibh kushtha.