DOI QR코드

DOI QR Code

Management of Psoriasis through Unani Medicine: a Case Study

  • Khatoon, Faiza (Department of Moalajat (Medicine), National Research Institute of Unani Medicine for Skin Disorders (NRIUMSD)) ;
  • Uddin, Qamar (Department of Moalajat (Medicine), National Research Institute of Unani Medicine for Skin Disorders (NRIUMSD)) ;
  • Jabeen, Arzeena (Department of Moalajat (Medicine), National Research Institute of Unani Medicine for Skin Disorders (NRIUMSD)) ;
  • Azahar, Mohd (Department of Moalajat (Medicine), National Research Institute of Unani Medicine for Skin Disorders (NRIUMSD)) ;
  • Alam, Md Aftab (Department of Ilmul Advia (Pharmacology), National Research Institute of Unani Medicine for Skin Disorders (NRIUMSD)) ;
  • Munim, Abdul (Department of Moalajat (Medicine), National Research Institute of Unani Medicine for Skin Disorders (NRIUMSD))
  • Received : 2021.05.16
  • Accepted : 2021.05.24
  • Published : 2021.05.31

Abstract

Psoriasis is a chronic inflammatory skin disease clinically characterized by erythematous, sharply demarcated papules and rounded plaques covered by silvery white micaceous scales. It affects about 1-3% of the world's population. Although considerable advances have been made in the management of psoriasis in recent years, the disease remains incurable. Current treatment does not affect disease activity, and relapse occurs quickly after cessation of treatment. Moreover, topical and systemic conventional therapies used in the management of psoriasis are associated with adverse effects. In Unani system of medicine, psoriasis is known as Taqashshur al-Jild, which is caused by predominance of black bile and characterised by scaling of skin. Various topical as well as systemic Unani formulations are effectively used in the management of psoriasis. This case study was aimed to evaluate the efficacy of Unani formulations, Itrīfal Shāhtra and Marham Ḥinā in the management of psoriasis. A 49-year-old male patient presenting with psoriasis came to the OPD of National Research Institute of Unani Medicine for Skin Disorders, Hyderabad. Treatment was given to the patient for a period of 12 weeks. PASI score was significantly reduced from 40.5 at baseline to 2.2 after treatment. Unani formulations were found safe and effective in the management of Psoriasis as assessed by validated scales.

Keywords

Acknowledgement

Authors express their sincere thanks to Prof. Munawwar Husain Kazmi, Director, National Research Institute of Unani Medicine for Skin Disorders, Hyderabad for his kind cooperation.

References

  1. Ali H, Aslam M, Sofi G. Unani Management of Taqashshure Jild (Psoriasis): A case report. Sch J Appl Med Sci. 2015;3(2B):677-681.
  2. Amli, Muhammad ibn Mahmud. Mujaz. (Lucknow, India: Matba'Munshi Naval Kishore), p. 219, 1304 Hijri.
  3. Anonymous. National Formulary of Unani Medicine, Part-VI. (New Delhi, India: CCRUM, Dept. of AYUSH, Ministry of Health & Family Welfare, Govt. of India), p. 78, 2011.
  4. Arzani, Hakim Muhammad Akbar. Mizan al-Tibb. Urdu translation by Hakim Muhammad Kabir al-Din. (New Delhi: Idara Kitab al-Shifa), p. 257, 2001.
  5. Arzani, Hakim Muhammad Akbar. Tibb-i-Akbar. Translated by Hussain HM. (Deoband, India: Faisal Publications), pp. 739-742, 1993.
  6. Baghdadi, 'Ali ibn Hubal. Kitab al-Mukhtarat fi'l Tibb. Urdu translation. Volume 2. (New Delhi, India: CCRUM, Ministry of Health & Family Welfare, Govt. of India), pp. 83,189-190, 2005.
  7. Burge S, Matin R, Wallis D. Oxford Handbook of Medical Dermatology. 2nd Edn. (UK: Oxford University Press), pp. 189-209, 2016.
  8. Buslau M & Benotmane K. Cardiovascular complications of psoriasis: Does obstructive sleep apnoea play a role? Acta Derm Venereol. 1999; 79(3):234. https://doi.org/10.1080/000155599750011075
  9. Carvalho AVE, Romiti R, Souza CS, Paschoal RS, Milman LM, Meneghello LP. Psoriasis comorbidities: complications and benefits of immunobiological treatment. An Bras Dermatol. 2016; 91(6):781-789. https://doi.org/10.1590/abd1806-4841.20165080
  10. Danielsen K, Olsen AO, Wilsgaard T, Furberg AS. Is the prevalence of psoriasis increasing? A 30-year follow-up of a population-based cohort. Br J Dermatol. 2013; 168:1303-1310. https://doi.org/10.1111/bjd.12230
  11. DiPiro JT, Yee GC, Posey LM, Haines ST, Nolin TD, Ellingrod VL. Pharmacotherapy:APathophysiologic Approach. 11th Edn. (New York, USA: McGraw-Hill Education), pp. 4772-4841, 2020.
  12. Dreiher J, Weitzman D, Shapiro J, Davidovici B, Cohen AD. Psoriasis and chronic obstructive pulmonary disease: A case-control study. Br J Dermatol. 2008; 159(4):956-960. https://doi.org/10.1111/j.1365-2133.2008.08749.x
  13. Gelfand JM, Shin DB, Neimann AL, Wang X, Margolis DJ, Troxel AB. The risk of lymphoma in patients with psoriasis. J Invest Dermatol. 2006; 126(10):2194-2201. https://doi.org/10.1038/sj.jid.5700410
  14. Gibbs S. Skin disease and socioeconomic conditions in rural Africa: Tanzania. Int J Dermatol. 1996; 35(9):633-639. https://doi.org/10.1111/j.1365-4362.1996.tb03687.x
  15. Gisondi P, Targher G, Zoppini G, Girolomoni G. Nonalcoholic fatty liver disease in patients with chronic plaque psoriasis. J Hepatol. 2009; 51(4):758-764. https://doi.org/10.1016/j.jhep.2009.04.020
  16. Ibn Zuhr. Kitab al-Taysir. Urdu translation. (New Delhi, India: CCRUM, Ministry of Health & Family Welfare, Govt. of India), pp. 204-205, 1986.
  17. Jilani, Hakim Ghulam. Makhzan al-Hikmat. (New Delhi, India: Ejaz Publishing House), pp. 698-699, 1996.
  18. Khan, Hakim Muhammad A'zam. Iksir-i-A'zam (Farsi). (Kanpur, India: Matba' Nizami), p. 511, 1289 Hijri.
  19. Khan, Hakim Muhammad Akmal. Qarabadin-i 'Azam wa Akmal. Urdu Translation. (New Delhi, India: CCRUM, Dept. of AYUSH, Ministry of Health & Family Welfare, Govt. of India), p. 7, 2005.
  20. Majusi, 'Ali ibn 'Abbas. Kamil al-Sana'a al-Tibbiyya. Urdu translation by Hakim Ghulam Hasnayn Kinturi. Volume I-II. (New Delhi, India: Idara Kitab al-Shifa), pp. 431-433, 2010.
  21. Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies. J Am Acad Dermatol. 2009; 60(4):643-659. https://doi.org/10.1016/j.jaad.2008.12.032
  22. Millard TP, Antoniades L, Evans AV, Smith HR, Spector TD, Barker JN. Bone mineral density of patients with chronic plaque psoriasis. Clin Exp Dermatol. 2001; 26(5):446-448. https://doi.org/10.1046/j.1365-2230.2001.00855.x
  23. Nestle FO, Kaplan DH, Barker J. Psoriasis. N Engl J Med. 2009; 361(5):496-509. https://doi.org/10.1056/NEJMra0804595
  24. Nickoloff BJ, Wrone-Smith T, Bonish B, Porcelli SA. Response of murine and normal human skin to injection of allogeneic blood-derived psoriatic immunocytes: detection of T cells expressing receptors typically present on natural killer cells, including CD94, CD158, and CD161. Arch Dermatol. 1999; 135(5):546-52.
  25. Papadakis MA, McPhee SJ, Rabow MW. Current Medical Diagnosis & Treatment. 58 th Edn. (US: McGraw-Hill Education), pp. 115-117, 2019.
  26. Peternel S, Prpic-Massari L, Guina T, Novak S, Brajac I, Kastelan M. Treatment of Severe Psoriasis with Infliximab: Report of Two Cases. Acta Dermatovenerol Croat. 2009; 17(3):204-206.
  27. Qarshi, Hakim Muhammad Hasan. Jame-ul-Hikmat. Vol. 2. (Delhi, India: Idara Kitab al-Shifa), p. 1005, 2011.
  28. Rahman M, Alam K, Ahmad MZ, Gupta G, Afzal M, et al. Classical to current approach for treatment of psoriasis: a review. Endocr Metab Immune Disord Drug Targets. 2012;12(3):287-302. https://doi.org/10.2174/187153012802002901
  29. Razi, Abu Bakr Muhammad ibn Zakariyya. Kitab al-Fakhir fi'l Tibb (Arabic). Part-1. (New Delhi, India: CCRUM, Ministry of Health & Family Welfare, Govt. of India), pp. 28, 46, 2005.
  30. Razi, Abu Bakr Muhammad ibn Zakariyya. Kitab al-Hawi fi'l Tibb (Urdu translation by Hakim MY Siddiqui). Vol-23. (Aligarh, India: Saba Publishers), pp. 61-62, 1994.
  31. Razi, Abu Bakr Muhammad ibn Zakariyya. Kitab al-Mansuri. Urdu translation. (New Delhi, India: CCRUM, Ministry of Health & Family Welfare, Govt. of India), p. 200, 1991.
  32. Sehgal, VN. Textbook of Clinical Dermatology. 5 th Edn. (New Delhi, India: Jitendar P Vij, Jaypee Brothers Medical Publishers), pp. 135-148, 2011.
  33. Sheu JJ, Wang KH, Lin HC, Huang CC. Psoriasisis associated with an increased risk of parkinsonism: a population-based 5-year follow-up study. J Am Acad Dermatol. 2013; 68(6):992-999. https://doi.org/10.1016/j.jaad.2012.12.961
  34. Tabari, Abu'l Hasan Ahmad ibn Muhammad. Mu'alajat alBuqratiyya (Urdu translation). Vol-2. (New Delhi, India: CCRUM, Ministry of Health & Family Welfare, Govt. of India), pp. 153-155, 1997.
  35. Valia RG & Valia AR. IADVL Textbook of Dermatology. 3 rd Edn. Vol. 1. (Mumbai, India: Bhalani Publishing House), pp. 1025-1055, 2010.