INTRODUCTION:

Psoriasis is a known chronic inflammatory condition of the skin as well as joints and is accompanied by emotional and social complications that lead to significant disabilities with profound impaired quality of life.

It is a common skin conditions that causes skin redness, irritation, dryness. Psoriasis having thick, red skin with flaky and silver-white patches on the skin Psoriasis is a disease known in medical text from Greek times, and these patients were cast out from societies. The main reason for this was a misconception, as people feared that psoriasis was an infectious disease. In addition to this misconception, medical practitioners of previous eras failed to recognize psoriasis as a non-infectious chronic dermatological disease. ¹

Psoriatic patients on biologics show greater improvement than do patients on topical, phototherapy, or conventional systemic agents, and both patients and their dermatologists express greater satisfaction with these biological therapies.²

Causesof Psoriasis:-

a) The psoriasis is cause due to little sunlight on infected skin.

b) It also cause due to too much sunlight.

c) Drinking alcohol.

d) psoriasis is caused due to bacteria or viral infections, including strep throat and upper respiratory infections.

e) psoriasis is cause due to very dry skin.

f) It cause due to injury to the skin.

g) It is also cause due to lesser immune system.

SYMPTOMS:-

a) Irritated skin.

b) Readiness on the skin.

c) Red colour patches on specific site of the body.

d) Most common it is occurs in elbows, knees and middle on the body parts.

e) Scales like skin.

f) Dryness of the scalp.

g) Red scaly, white patches.

h) Small scaling spots mostly in children.

i) Dry, cracked skin.

j) Burning, itching or soreness.

k) Pitted or cracked nails.

l) Joint pain.

m) Stiff joints.

n) Itching sensation.

The risk factors for psoriasis disease are:

· Family history:

Psoriasis disease can pass on from one generation to another. If your parents have this disease then the chances of you getting it increases

· Stress:

As stress greatly impacts your immunity, high-stress levels may increase your risk of psoriasis.

· Smoking:

Tobacco smoking increases the risk of psoriasis but it also escalates the intensity of the disease. Smoking can also play a trigger factor in the initial development of the disease.

Psoriasis skin disease can induce other complications, such as

· Psoriatic arthritis

· Problems like conjunctivitis, uveitis and blepharitis.

· Obesity.

· High blood pressure.

· Type 2 diabetes disease.

· Certain autoimmune illnesses, such as sclerosis, celiac disease, and the inflammatory bowel disease called Crohn’s disease.

· Health problems, such as depression and low self-esteem.

Types of Psoriasis:

The disease may manifest in different forms with respect to clinical features and severity. Clinical type of psoriasis is an important element in determining the therapeutic regimen.

Figure no1.Types of Psoriasis:

1. Psoriasis vulgaris:-

It is the most common clinical form of psoriasis, which has erythematosus plaques with sharp boundaries, localized in knees, elbows, scalp, and sacral region. It is a kind of parakeratotic hyperkeratosis. The pathology is related to decreased prostaglandin levels.

2. Plaque Psoriasis:-

It is well circumscribed, erythematosus, scaly plaques >0.5 cm in diameter, either as single lesions or as generalized disease.

3. Flexural Psoriasis:-

It is also known as intertriginous or inverse psoriasis. It is well circumscribed, minimally scaly, thin plaques localized to the skin folds (inflammatory, axillary, groin, genital, natal cleft regions)

4. Nail Psoriasis:-

It can be present without concomitant skin plaques. It can be pitting, distal oncholysis, sublingual hyperkeratosis, oil drop sign, splinter hemorrhages, leukonychia, and crumbling, red lunula.

5. Scalp Psoriasis:-

It is one of the most common sites of psoriasis and is difficult to treat.

6. Palmoplantar Psoriasis:

It is localized to the hands and soles of the feet. It has redness and scaling without obvious plaques to poorly defined scaly or fissured areas to large plaques covering the palm or sole. Erythema is not always found, but when it exists it appears as a pinkish-yellow lesion.

7. Pustular Psoriasis:

It has sheets of monomorphic pustules on painful, inflamed skin and is most commonly localized to palms and soles.

8. Guttae Psoriasis:

It appears as acute eruption of “dew drop”, salmon-pink, fine-scaled, small plaques on the trunk or limbs. It can follow history of group A streptococcal pharyngitis or perennial group. A streptococcal dermatitis. It is frequently seen in children and youngsters. The antistreptolysin titers are usually raised. They appear in trunk, face, scalp, and limbs.

9. Erythrodermic Psoriasis:

It is acute or sub acute onset of generalized edema covering 90% or more of the patient’s entire body with little scaling. It might be associated with hypothermia, hypoalbunimia, electrolyte imbalances, and high-output cardiac failure and could be a life-threatening emergency. Desquamation can lead to edema and organ failure such as cardiac, renal, or hepatic.

10. Annular Psoriasis:

It is well demarcated erythematosus scaly plaques with central clearing.³

FOOD TO AVOID:

1)Gluten-free Diet:

People with psoriasis tend to have a higher sensitivity to gluten. Avoid gluten-rich foods including-but not limited to-wheat, barley, pasta, baked goods, and beer or malt beverage.

2)Dairy:

Dairy (especially eggs) contains high levels of saturated fat. egg or egg dishes whenever possible. It promotes the growth of tissues and increases skin cell proliferation that worsen the psoriasis.

3) Processed Foods:

In general, processed Foods are not good for you overall health because they are likely to contain sodium’s, sugars, and trans-fat. When doing your grocery shopping, do your best to avoid packaged deli meats, microwaveable dinners, canned fruits and vegetables, and any other heavily processed foods.

4) Alcohol:

Alcohol disrupts the various pathways of the immune system making it a trigger for any autoimmune flare-ups, including psoriasis. To avoid, drink sparingly. Elimination diets have helped many sufferers of chronic skin conditions heal their skin naturally.^[8]

Food To Eat

1)Low caloric diet

A well balanced diet is desirable. Proper nutrition may diminish the severity of the disease, may help to build stress resistance, increase physical endurance, increase the resistance to the disease, and promote in creased emotional stability.

2)Fresh fruits and vegetables

Burdock, milk thistle, yellow dock, mountain grape, sarsaparilla, red clover, Goa powder, aloe vera, masterwort, etc. have been taken into consideration.

3)Folate

Some studies have suggested that folate may be deficient in some people with psoriasis. Food sources of folic acid are: asparagus, beets, broccoli, Brussels sprouts, spinach, avocados, soy beans, chick-peas, beans, cabbage, savoy, turkey, peas, oranges, etc. lentils

4)n-3 PUFA and flax seed oil

Fish oils and flax seed oils are important sources of n-3 PUFA.

5)(Zn)

Skin contains one fifth of total body's zinc supply. Zn sources such as shellfish and who legrain foods, also provide copper. Zn is very important for immune response, and its loss is common in psoriasis. ^4,5

TREATMENT

Psoriasis is a genetic disorder; although the exact cause of this disease is unknown but various factors are being considered having the role in pathogenesis. All types of adult psoriasis have been found in children with more or less frequency. Therefore, the similar treatment regimens have been tried in childhood psoriasis.

The use of topical therapy in childhood is the first line of treatment for skin limited disease, but with the chronicity of illness and in more severe cases, systemic therapy and phototherapy are added to help the remission.

Well-designed studies on systemic therapeutic modalities for psoriasis in paediatric age group are meagre and children are treated with the support of data extrapolated from that in adults.” Significant psychological disturbances are seen in children with psoriasis, irrespective of the involved surface area.

The opinion is that the chronic disease should be treated more aggressively to improve the quality of life because this may cause severe psychological disturbance. The drug are used to control the symptoms and prolonged treatment is required may be used topically or systemically.^6,7

Ayurvedic treatment

Olive oil:-Olive oil is an effective treatment for mild cases of plaque psoriasis. It can be massaged directly onto affected areas of the skin to reduce dryness and irritation as well as to facilitate healing.

Coleus:- Although there is less scientific evidence, the Ayurvedic herb coleus has been used historically as one of many herbal psoriasis remedies. Coleus is valuable in treating skin disorders such as psoriasis due to its ability to promote normal cell division.⁷

Allopathy treatment

Leflunomide:-It is an immunosuppressant which inhibits T cell activation and proliferation by inhibiting pyrimidine synthesis. It is Food and Drug Administration (FDA)-approved to treat rheumatoid arthritis. A placebo-controlled trial for the treatment of psoriatic arthritis found that it is effective in the management of skin disease.

Methotrexate:-Methotrexate inhibits T cell expansion and suppresses immunocompetent cells in the skin and is effective in moderate to severe chronic plaque psoriasis. It may be used along with other drugs like biological agents and phototherapy in psoriasis.

Cyclosporine:- Cyclosporine inhibits interleukin-2 production and is used in severe refractory psoriasis. ⁸

Marketed preparation for Psoriasis treatment:-

Table no.1 Marketed preparation for psoriasis treatment

Sr.no	Ayurvedic drug	Allopathy drug
	Botanical name of Ayurvedic drugs	Brand name of Allopathic drugs
1	Alov-vera	Tazorac
2	Alpinia galango	Humira
3	Angelica sinensis	Enbrel
4	Azadirachta indica A.Juss	Otezla
5	Curcuma longa L	Dovonex

CONCLUSION:

Psoriasis is a common, chronic, inflammatory, multifactorial disease with predominantly skin and joint manifestations affecting 2.5 % of world population. Initially it is considered as a disorder of keratinization but recent studies the role of immunological, genetic and environmental factors. Several studies suggest a strong relation between skin and mind (psyche). As a result, more than a cosmetic nuisance, psoriasis is associated with psychosocial effects that seriously affect quality of life and social relations.

ACKNOWLEDGEMENTS:

Special thanks to Mr Rahul Khaire from PRES College of pharmacy (For women) Chincholi Nashik, and also my parents for their support me all time.

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Received on 24.11.2022 Accepted on 03.03.2023

Int. J. Tech. 2022; 12(2):47-52.

DOI: 10.52711/2231-3915.2022.00009