A protocol for the Ayurvedic management of Psoriasis: a clinical trial

Abstract

Psoriasis is a chronic inflammatory skin condition characterized by an overactive immune response, primarily involving T-helper 1 (Th1) and Th17 cells. While its exact etiopathogenesis remains elusive, research points to a complex interplay of genetic predispositions, lifestyle choices, environmental triggers, and psychological stress. Globally, the prevalence of psoriasis varies significantly, ranging from 0.09% to 11.4%. In India, as of 2023, the reported prevalence is between 0.44% and 2.8%. Conventional management often relies on immunosuppressant drugs, which carry a risk of broad immune suppression and associated complications. In contrast, Ayurveda offers an alternative approach through immunomodulatory drugs, which are believed to act more selectively on the immune system, potentially minimizing adverse effects. This study aimed to develop and evaluate a specific Ayurvedic protocol for the management of psoriasis. The research was designed as a pre-post interventional study involving 30 participants, aged 18-60 years, diagnosed with psoriasis based on characteristic signs of erythema, induration, and scaling. Participants were recruited from the Agadatantra Outpatient Department (OPD) of Government Ayurveda College, Tripunithura. The comprehensive treatment protocol encompassed various Ayurvedic procedures, including deep anapachana rookshana, vicharana snehapana, Abhyanga-ushnambu snana, virechana, Brihmana varnaprasadana chikitsa externally, samana rasayana drugs internally, apyayana chikitsa, and a second round of virechana. The total study duration was 47 days, followed by a 14-day follow-up period. Assessments were conducted on Day 1 (baseline), Day 25 (after the first virechana), Day 48 (after the second virechana), and after the 14-day follow-up, utilizing the Psoriasis Area and Severity Index (PASI) score. Statistical analysis of the results demonstrated a significant reduction in scaling, erythema, and induration scores for 90% of the participants across successive assessments. This suggests that the immunomodulatory drugs and therapeutic procedures integrated into the developed protocol are effective in the management of psoriasis.