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 Table of Contents  
CASE REPORT
Year : 2019  |  Volume : 8  |  Issue : 3  |  Page : 202-205

Efficacy of short-term naturopathy and yoga interventions on palmoplantar psoriasis


Department of Naturopathy, Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India

Date of Submission18-Jul-2018
Date of Acceptance07-Jun-2019
Date of Web Publication05-Aug-2019

Correspondence Address:
Dr. Y Rosy Ayda
Department of Naturopathy, Government Yoga and Naturopathy Medical College, Arumbakkam, Chennai - 600 106, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_59_18

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  Abstract 


Psoriasis is a chronic inflammatory disease, associated with a higher risk of cardiovascular, metabolic, and renal disease, and patients may experience significant impairment of health-related quality of life even with localized disease. According to a study conducted on 3065 patients, plantar lesions were seen in 91.9% of patients and palmar lesions in 55.6% of patients. Our patient is a 47-year-old married man, with a history of erythema, scaling, itching pain often associated with bleeding on the affected area of both palms and soles since 6 months. After obtaining informed consent, he was admitted to our inpatient Department of Government Yoga and Naturopathy Hospital. Since naturopathic interventions aimed to put right the lifestyle improvement, he underwent treatments such as neutral enema, mud therapy, diet therapy, acupuncture, and yoga therapy at our inpatient department (IPD). Considering the basic principle of naturopathy, i.e., accumulation of morbid matter, one of the main causes of disease has been taken into an account for planning the line of treatment. Pre-blood investigations include resting blood pressure, pulse rate, respiratory rate, fasting blood glucose level, and serum cholesterol level. The patient was asked to fill the Psoriatic Area and Severity Index (PASI) was used as a tool to measure the severity of the lesions and the area affected. Pre- and post-assessments were done using PASI. Immediately after 2 days of intervention, the pain and the itching in the affected area was subsided, and after 15 days of intervention, our patient was provided with exclusive juice diet with 6 servings per day. After 20 days of intervention, the PASI Scoring was reduced from 8.8 to 2. A 20-day naturopathic intervention has shown clinically significant change in the severity of psoriatic lesions in our case.

Keywords: Alternate medicine, naturopathy and yoga, palmoplantar psoriasis


How to cite this article:
Ayda Y R, Manavalan N. Efficacy of short-term naturopathy and yoga interventions on palmoplantar psoriasis. Int J Health Allied Sci 2019;8:202-5

How to cite this URL:
Ayda Y R, Manavalan N. Efficacy of short-term naturopathy and yoga interventions on palmoplantar psoriasis. Int J Health Allied Sci [serial online] 2019 [cited 2019 Oct 14];8:202-5. Available from: http://www.ijhas.in/text.asp?2019/8/3/202/263950




  Introduction Top


Psoriasis is a noncontagious, autoimmune condition that affects the skin and the joints. It can appear almost anywhere on the body, but it most frequently affects the arms, legs, fingers, scalp, lower back, and upper torso.[1] A chronic skin disease characterized by dry red patches covered with scales. Frequent mud baths are evident and learned to improve the complexion, clear spots and patches on the skin. It is very beneficial in the treatment of skin diseases.[1]

Other than skin, it also affects nails, joints, and the psoriasis may also lead to metabolic disorder if not treated at the earliest.[2] The prevalence rate in different populations may vary and observed to the maximum of 11.8%.[2],[3] However, the study by Okhandiar and Banerjee,[4] reported the incidence of psoriasis in India was found to be only 1.02% during 1963, although the Indians were unprivileged for health care. Bedi[5] studied psoriasis and focused on northern India found the geographical variation in the incidence and was found to be 2.8%. A study from tertiary health-care center in north India[6] showed that psoriasis accounted for 2.3% of all dermatology outpatients. It is very clearly indicates that the ignorance and unawareness of psoriasis in human population are the major cause in health care.

Although many therapies are being in practice, the periodical notes and observation on any therapy is still in question. This paper is intended to report on naturopathic and yogic approach on a psoriasis patient, and the patient was taken for continuous observation.


  Case Report Top


The patient we observed is a 47-year-old man living with family at his village. His medical history learned from him by us is that he was with a history of erythema, scaling, and itching, and in consequent, he suffered himself with pain and often associated with bleeding on the affected area of both palms and soles since 6 months. It is very important to note that the said patient could not be feel free to tell his difficulties. His medical history revealed that he was suffering with hypertension for the past 3 months from the date on our observation.

On examination, we observed multiple hyperkeratotic plagues present bilaterally on both palms and soles. Our further observation on the skin of both heels, along with nail dystrophy in both hands confirmed hyperkeratotic plague.

It resulted us to console him, and we spend lot of time with him and observed that he was a neglected person by socioeconomic society. In conjunction of this situation, the less expensive naturopathic and yogic interventions are advised and aimed to improve his quality of life (QOL) through little modification of his lifestyle changes. After obtaining informed consent from him and family, he was admitted to our Department of Government Yoga and Naturopathy Hospital as inpatient on March 10, 2018.

Although advised to continue hypertensive drugs, the patient was disinterested to continue the conventional medication as he was suffering for long time and was interested to undergo naturopathic and yogic intervention for a month.

He underwent treatments such as neutral enema, mud therapy, diet therapy, acupuncture, and yoga therapy at our IPD [Table 1].
Table 1: Details of intervention provided

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Treatments

Considering the basic principle of naturopathy, i.e., accumulation of morbid matter, one of the main causes of disease has been taken in to account for planning the line of treatment.[1]

Naturopathy treatments are most welcome at present days, and it is proved that it enhance QOL.[7] As part of naturopathy, the acupuncture application is also provided to the patient for symptomatic relief from pain. Yoga therapy, which includes Sheetali and Sheetkari Pranayam along with relaxation techniques as Yoga Nidra and Mantra Chanting, which intended to keep our patient's mind relaxed.

Neutral enema was given on alternate days for 5 days. A volume of 500 mL of water to 1 L of water is administered which is helpful in relieving inflammatory conditions of colon, ulcerative colitis, and improving the digestive conditions.[8] Diet therapy exclusively includes the intake of raw vegetable salads, fruit salads, vegetable and fruit Juices, along with moong dal sprouts with six servings a day. Mud pack was given to both abdomen and eyes every day once for 20 min.

In this study, we report the changes on the severity of psoriasis were assessed using Psoriatic Area and Severity Index (PASI) Scoring.

A detailed history was taken at the time of admission before the intervention. Pre-blood investigations include resting blood pressure, pulse rate, respiratory rate, and fasting blood glucose level. The patient was asked to fill the PASI, a tool to measure the severity of the lesions and the area affected.

Outcome measures

  • Weight: Assessed in kilogram using standard weighing scale
  • BMI: Calculated using the formula (weight in kilogram/height in meter square)
  • BP: Systolic and diastolic blood pressure measured using sphygmomanometer
  • Blood Analysis: Done to assess fasting blood sugar and postprandial blood sugar level.


Literature review

During raw juice therapy, the eliminative and cleansing capacity of the organs of elimination, namely lungs, liver, kidneys, and the skin, is greatly increased and masses of accumulated metabolic waste and toxins are quickly eliminated.[8] Mudpack has shown improvement in the microcirculation and vasomotion score, as reported by Poensin et al.[9] The role of Triphala and its extract has been emphasized in stimulating neutrophil function. Under the condition of inflammatory stress, its immunosuppressive activity is attributed to its inhibitory action on complement system, humoral immunity, cell-mediated immunity, and mitogen-induced T-lymphocyte proliferation. The biologically active compounds such as chebulagic acid, gallic acid, and ellagic acid make Terminalia chebula highly potent antioxidant, which may be responsible for its immunomodulatory activity. The application of its extract neutralizes reactive oxygen species and scavenges free radicals.[10] Stange[11] stated that when applied to functional disorders, dietary treatment - the most important measure in natural medicine - has its greatest effect.


  Results and Discussion Top


The postinterventional report showed possible improvements in weight, pulse rate, blood pressure, body mass index, fasting blood sugar, and postprandial blood sugar levels when compared to baseline assessments. This shows the effectiveness of 20-day naturopathic and yogic interventions in reducing the severity of psoriasis and the associated pain.

Pre- and post-assessments were done using PASI. Immediately after 2 days of intervention, the pain and the itching in the affected area was subsided and after 15 days of intervention our patient was provided with exclusive juice diet with six servings per day. After 20 days of intervention, the PASI Scoring was reduced from 8.8 to 2 [Figure 1].
Figure 1: Pre and post Psoriatic Area and Severity Index score

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Pre- and post-assessment measures are summarized in [Table 2].
Table 2: Demographic characteristics of pre- and postassessment

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  Conclusion Top


This study found to be the first to report the efficacy of naturopathic and yogic intervention in treating palmoplantar psoriasis. Large-scale studies have been recommended for better results. The low-cost structures, simplicity, natural modalities, and a concentration of psyche apart from other causes of an ailment are possibly the best reasons for naturopathy and yoga systems to have global spurt.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published, and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Bakhru HK. The Complete Handbook of Nature Cure. Mumbai: JAICO; 2012.  Back to cited text no. 1
    
2.
Kaur I, Kumar B, Sharma KV, Kaur S. Epidemiology of psoriasis in a clinic from North India. Indian J Dermatol Venereol Leprol 1986;52:208-12.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Swanbeck G, Inerot A, Martinsson T, Wahlström J. A population genetic study of psoriasis. Br J Dermatol 1994;131:32-9.  Back to cited text no. 3
    
4.
Okhandiar RP, Banerjee BN. Psoriasis in the tropics: An epidemiological survey. J Indian Med Assoc 1963;41:550-6.  Back to cited text no. 4
    
5.
Bedi TR. Psoriasis in North India. Geographical variations. Dermatologica 1977;155:310-4.  Back to cited text no. 5
    
6.
Kaur I, Handa S, Kumar B. Natural history of psoriasis: A study from the Indian subcontinent. J Dermatol 1997;24:230-4.  Back to cited text no. 6
    
7.
Chung J, Callis Duffin K, Takeshita J, Shin DB, Krueger GG, Robertson AD, et al. Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared with moderate to severe plaque psoriasis. J Am Acad Dermatol 2014;71:623-32.  Back to cited text no. 7
    
8.
Garg BD. Nature Cure Treatment. 2nd ed. Bangalore, India: Institute of Naturopathy and Yogic Sciences; 1994.  Back to cited text no. 8
    
9.
Poensin D, Carpentier PH, Féchoz C, Gasparini S. Effects of mud pack treatment on skin microcirculation. Joint Bone Spine 2003;70:367-70.  Back to cited text no. 9
    
10.
Belapurkar P, Goyal P, Tiwari-Barua P. Immunomodulatory effects of triphala and its individual constituents: A review. Indian J Pharm Sci 2014;76:467-75.  Back to cited text no. 10
  [Full text]  
11.
Stange R. Naturopathic dietary treatment in functional disorders. MMW Fortschr Med 2006;148:34-6.  Back to cited text no. 11
    


    Figures

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    Tables

  [Table 1], [Table 2]



 

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