DESCRIPTION

• It is a skin disease that causes hard, itchy lumps on the skin.
• The itching can be intense that cause people to scratch themselves to the point of bleeding or pain. 
• Scratching can cause more skin lesions to appear.
• Itching is worsened by sweating, heat, or cloth irritation. 
• People with prurigo nodularis have a history of other diseases such as eczema, lymphoma, HIV infection, severe anemia, or kidney disease. 
  

Causes

The exact cause of prurigo nodularis is not known, but the lesions are due to the result of itchy skin which have many reasons. Prurigo nodularis has been associated with several conditions, including:

• Atopic dermatitis
• Diabetes
• Chronic kidney failure
• Chronic hepatitis C
• Neurological disorders
• Psychiatric disorders
• Post-herpetic neuralgia
• Lymphoma
• Lichen planus
• Congestive heart failure
• Chronic obstructive pulmonary disease 
• HIV
• Some therapeutic drugs for cancer 
  

SYMPOTOMS

• The main symptom of prurigo nodularis is the formation of hard, very itchy lumps on the skin. 
• The nodules size from very small to about half an inch in diameter. 
• The nodules are rough, dry from the top and vary in number from a few to hundreds. 
• Most commonly the nodules form on the outer arms, shoulders, legs and also form on the neck, and trunk, they rarely form on the face and palms. 
• Nodules may be lighter or darker in color than the surrounding skin. 
• Scarring may occur after nodules begin to heal.
• The symptoms of prurigo nodularis can begin at any age but are most common in adults between 20-60 years. 
• People who have may become very concerned about the appearance of the nodules, and the intensely itchy skin may interfere with sleep or with everyday activities.
  

DAILY ROUTINE THAT CURE PRURIGO NODULARIS

• Use an ice pack to cool itchy areas.
• Take a lukewarm, short bath with colloidal oatmeal.
• Moisturize frequently with Vaseline or a hypoallergenic cream.
• Use fragrance free soaps
  

Treatment

Topical drugs

• Topical steroid creams such as clobetasol, pimecrolimus.
• Topical coal tar
• Topical vitamin D-3 ointment
• Capsaicin cream
• Menthol

Injections

• Corticosteroid injections for some nodules.
  

Systemic medications

• Antihistamines help to sleep at night.
• Antidepressants help to stop scratching.
• Paroxetine and amitriptyline.

Other therapies

Therapies that help to shrink the nodules and relieve itching include:

• Cryotherapy
• Phototherapy
• Psoralen used in combination with UV
• Pulsed dye laser
• Excimer laser treatment

CAC TREATMENT FOR PRURIGO NODULARIS

• CAC DETOX PREMIUM POWDER – these are herbo-mineral sachets which are purely Ayurvedic formulation. These sachets mainly detox the body and eliminate toxic substances and helps in proper metabolism of all the functions. This formulation act at the level of the nervous system and facilitate proper conduction of signal impulse from the nerves to the muscles. These sachets have anti-inflammatory, antioxidant, and anti-bacterial, anti-fungal, and immune-modulator. The ingredients present in it are moti pishti, parwal pishti, shukta pishti, Giloy satv, kamdudha ras, Jahar Mohra, akik pishti, gandhak rasayan, sutshekhar ras, etc. These ingredients balances all the three doshas (Vata, Pitta & Kapha) and helps in blood purification, reduces burning sensation, weakness, and hot flashes in ulcerative colitis patients. It reduces the level of high uric acid in the body. The powder is very beneficial in relieving discomfort, numbness, muscle ache, and reduces swelling of the pelvic region.
  DOSAGE – Take 1 sachet twice daily with normal water.

• CAC SKIN CARE TABLET – this is herbo mineral and purely ayurvedic formulation. It help to maintain the texture of your skin depending on the type of skin you have. It contains various herbs like Haridra khand, Panchnimb churna, Khadir chahal, Chirayta, Mulethi, Chopchini, Gandhak, Ajmoda that work very effectively on all skin types. Skin care is a blood purifying tablet. It cools and detoxifies the blood, removes stagnant blood and dissolves obstructions in the blood flow that further increase blood circulation of the skin. It minimizes the blemishes, lighten sun tan, delay ageing of skin and heal skin problems.
  DOSAGE – Take 1-2 tablets twice daily.

• CAC PANCHTIKTA GHRIT GUGGULU – It is a herbo-mineral ayurvedic formulation of CAC consist of herbs specifically designed to treat drying, inflammation, and deadening of tissue and skin, particularly of the rectum area. The main ingredient is Neem which is best for treatment of ailments of the blood and plasma, most effective against many skin diseases which is caused due to harmful toxins and vitiation of the blood. It has antiseptic and anti-inflammatory effects which makes it useful in treating piles, and fissures. In addition, this blend contains many ingredients which shows cleansing action on the liver and kidneys, which further helps to detox the skin and post-digestive functioning. The herbs added shows rejuvenating and soothing action on the circulatory and digestive systems. It is used to treat a variety of skin conditions including, but not limited to, rectal bleeding and inflammation.
  DOSAGE – 1 tablet twice a day.

• CAC TWAK TAILAM – this is the herbal oil and is purely Ayurvedic preparation. CAC Twak Tailam provides relief from various skin problems such as pimples, blemishes, scars, ulcers, wounds, skin rashes, dry patches, itching, skin irritation, reduces redness, etc. It is composed of natural herbs that pacifies all three doshas and provides healthy skin. This oil is made up of pure herbs such as yashtimadhu (Glycyrrhiza glabra), manjistha (Rubia cordifolia). Twak tailam supports skin health, helps in reducing uneven pigments, delays the process of ageing, improves complexion, and helps in deep detoxification, blood purification without any side effects. This oil moisturizes your skin, and makes your skin spotless and glowing naturally.
  METHOD OF APPLICATION – Apply over the affected area of the skin.

• Psoriasis is an autoimmune skin condition in which inflammatory changes occur.  According to the National Psoriasis Foundation, Psoriasis affects about 2 to 3 percent of people worldwide. 
• Symptoms may vary from person to person. Usually symptoms may include raised and scaly skin patches, or plaques, that can vary in color depending on a person’s skin tone.
• Psoriasis is a chronic skin condition that may worsen at times and then improve. It’s an autoimmune condition caused by an overactive immune system that leads to rapid growth of skin cells.

There are different types of psoriasis. Psoriatic changes are mostly noticed on

• elbows
• knees
• back
• scalp

Psoriasis may affect the whole body or specific body parts  like the legs and trunk, or areas where skin touches skin, like under the  breasts or in the groin or armpits (called inverse psoriasis). Psoriasis can also affect the hands, feet, fingernails and joints.

What is scalp psoriasis?

When psoriasis affected the scalp region, it’s called scalp psoriasis. Scalp psoriasis is commonly seen among individuals with chronic plaque psoriasis. 

Causative factors include

• Exact reason of scalp psoriasis is not known yet but   specific genetic features might increase a risk of developing the condition. 
• Hereditary factors also play role in causing and so this condition runs in families.

Risk factors

• Use of or withdrawal from certain internal medications like corticosteroids
• Topical use of some creams
• Overexposure to UV light, for example, sunlight
• Some infections
• Stress

Clinical presentation of scalp psoriasis

• Scalp psoriasis causes rapid buildup of the skin cells, which results in scaly, thick itchy patches on the scalp and other areas of the body.
• In persons with lighter skin tones, pink or red colored patches appear with silvery white scales.
• Dark brown or purple patches appear on people with dark colored skin.
• It is difficult to treat plaque psoriasis on scalp because the usual topical steroid creams and ointments cannot penetrate the hair.
• Symptoms can also resemble like dandruff in some cases.

Symptoms and types of scalp psoriasis

Symptoms may vary from person to person and may be mild to severe and may include:

• Dryness of skin 
• Flaking or scaling of skin that resembles dandruff
• Itching, burning, or discomfort
• Raised reddish patches
• Silver-like scales
• Temporary hair loss or bleeding points may be noticed after scratching or removing the plaques on the scalp

These symptoms are noticed on both sides of the scalp, or they may affect most of the head. They may extend to the:

• Neck
• Ears
• Forehead
• Other parts of the face

Diagnosis & Treatment of scalp psoriasis

Diagnosis can be made by taking the complete history and by Physical examination. Certain investigations will help to confirm the diagnosis like blood investigations, skin biopsy. 

For treatment of scalp psoriasis topical corticosteroids or medicines are used in combinations.

Topical treatments

Topical medications for scalp psoriasis include:

• Corticosteroids (either topical or locally injected)
• Vitamin D derivatives such as calcipotriene
• Retinoids
• Coal tar shampoo
• Anthralin
• Salicylates

Due to present of hairs on the scalp topical medications for psoriasis are difficult to use. So, doctors usually recommend lotions, liquids, gels, foams, or sprays instead of thicker creams or ointments used on other parts of the body.

Systemic and biologic treatments

• When topical treatment is not effective then oral systemic medications and biologic infusions or injections should be used.
• These treatments effectively slow down the growth of skin cells or reduce inflammation.
• Biologic medications are helpful to block proteins in the immune system that may lead  to psoriasis, such as:

• Tumor necrosis factor-alpha (TNF-alpha)
• Interleukin 17-A
• Interleukins 12 and 23

Phototherapy treatments

In Phototherapy, ultraviolet light (UV) is used which heals patches of psoriasis on your scalp, especially when other treatments haven’t worked.

Self-care measurements 

• Consult doctor for proper treatment and skin care management. 
• Avoid scratching or picking of skin. Scalp psoriasis is different condition than common dandruff. There may be large and silvery scales. The scales must be removed carefully. Avoid scratch or pick them.
• Combing and brushing. Extra care should be taken while combing or brushing your hair, it can irritate your scalp. You can use a comb to gently remove scales. Proper cleaning should be done before each use to prevent infection, and consult with your doctor about any kind of adverse effects.

Complications of scalp psoriasis

Bleeding. Scalp psoriasis can cause itching and discomfort. Scratching or removing scales leads to bleeding.

Hair loss. Scalp psoriasis affects hair follicles, heavy scaling and excessive scratching leads to noticeable hair loss.  Use of many kind of scalp psoriasis treatments and stress can cause hair loss.

AYURVEDIC TREATMENT OF SCALP PSORIASIS

Chandigarh Ayurved centre provides effective Ayurvedic treatment for Scalp psoriasis. CAC provides a kit named ‘Psoriasis care kit’. This kit contains medications that are very effective to treat this kind of skin condition.

Psoriasis care kit

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Description of medications

1.Detox Premium Powder

The powder is very beneficial to cure any kind of body pain as it removes excess toxins from the body and balances the aggravated pitta and vata dosha. The ingredients help in reducing swelling, redness, shrinkage of tear lining in the anus, burning sensation, etc.

2.Blood Purifier Syrup

It is ayurvedic syrup that consists of various natural ingredients as the syrup purifies the blood by removing excess toxins it is very beneficial in maintaining proper circulation and improves the skin naturally.

3.Twak Tailam

Twak tailam is very effective for the skin as it deeply nourishes the tissues and improves the skin luster. The tailam supports skin health, helps in reducing uneven pigments, improves complexion, and helps in deep detoxification and blood purification without any side effects.

4.Skin care tablet

It helps to maintain the texture of your skin depending on the type of skin you have. Skin care is a blood purifying tablet. It cools and detoxifies the blood, increase blood circulation of the skin

5.Panchatikta Ghrita Guggulu

This tablet promotes detoxification and rejuvenation. Panchatikta Ghrita Guggulu tablet is a natural source of anti – oxidant. 

6.Neem soap

Neem (Azadirachta indica) is such a wonderful herb that is easily available and shows Anti-bacterial, Anti-inflammatory, Antioxidant, Anti-microbial, Antifungal, Antiseptic properties.

7.Trikatu Tablet

Trikatu Tablet helps to eliminate excess Kapha or mucous from the body, supports respiratory system, manages weight, helps to take out impurities or ama from the body, supports healthy detoxification, reduces swelling. It shows anti-inflammatory, analgesic, expectorant, antioxidant properties.

DESCRIPTION

• Seborrheic dermatitis is a common skin disease 
• It causes itchy rash with flaky scales, show redness on light skin and light patches on darker skin. 
• It is also known as dandruff, cradle cap, seborrheic eczema, seborrhea, and seborrheic psoriasis.
• It looks similar to psoriasis, eczema, or an allergic reaction.
• It usually happens on scalp but people can get it anywhere on their body.

SEBORRHEIC DERMATITIS CAUSES

Exact causes of seborrheic dermatitis is not known. There are some few reason that cause seborrheic dermatitis include:

• Stress
• Genes
• A yeast that usually lives on people skin without causing problems
• Certain medical conditions and medicines
• Cold, dry weather
• An immune system response
• An increased level of androgens hormone.
• An increased level of skin lipids.
• An inflammatory reaction.
• Family history
  

SEBORRHEIC DERMATITIS RISK FACTORS

Newborns and adults ages 30 years to 60 years are more prone to get seborrheic dermatitis. Most commonly seen in men than women and people with oily skin. Some conditions can also raise adult’s seborrheic dermatitis risk including:

• Acne 
• AIDS
• Alcoholism 
• Depression 
• Eating disorders 
• Epilepsy 
• Heart attack or stroke recovery 
• Parkinson’s disease 
• Psoriasis
• Rosacea
  

SEBORRHEIC DERMATITIS SYMPTOMS

• Itchy white flakes on scalp. 
• When scratched the flakes mix with hair or fall onto neck and shoulders.
• Red scales on skin.
• Crusty yellow scales on infants heads. 
• Blepharitis
• Pinkish plaques of scales on both sides of face.
• Flaky patches on chest shaped like a ring or flower petal.
• Redness in the folds and creases of genitals, armpits and beneath breasts.
• Inflamed hair follicles on cheeks and the upper half of trunk.
  

DOES THE WEATHER MAKE SEBORRHEIC DERMATITIS WORSE?

• Dry air during the winter months will make seborrheic dermatitis worse.
• The dermatitis cure during the summertime. 
• The Ultravoilet-A and Ultravoilet-B light have been shown to kill the yeast that overgrows on the skin of people who get seborrheic dermatitis.

WHAT’S THE DIFFERENCE BETWEEN SEBORRHEIC DERMATITIS AND PSORIASIS?

• Psoriasis and seborrheic dermatitis can mimic each other. 
• Both are patches of red skin with flakes. 
• Both can be found on scalp and back.
• Psoriasis is an inflammatory skin disease that affects 2% to 4% of the population. 
• Psoriasis scales are thicker than seborrheic dermatitis. 
• The edges of scales are very well-defined. 
• Scalp psoriasis scales are silver in color than white or yellow. This condition called sebopsoriasis where seborrheic dermatitis and psoriasis overlap and people have the symptoms of both white flakes and silver flakes.

SEBORRHEIC DERMATITIS DIFFERENTIAL DIAGNOSIS

• Psoriacic
• Eczema 
• Rosacea
•  Allergic reaction
• Systemic lupus erythematous
  

WHAT IS THE TREATMENT FOR SEBORRHOEIC DERMATITIS?

Treatment of seborrhoeic dermatitis involves following options.

• Keratolytics can be used to remove scale, e.g. salicylic acid, lactic acid, urea, propylene glycol
• Topical antifungal agents are applied to reduce malassezia.
• Mild topical corticosteroids are prescribed for 1–3 weeks to reduce acute flare inflammation. 
• Topical calcineurin inhibitors are indicated 
• Topical corticosteroids have fewer adverse effects on facial skin.
• In resistant cases, oral tetracycline antibiotics or phototherpy may be recommended. 
• Low dose oral isotretinoin has also been effective for severe or moderate seborrhoeic dermatitis.

Scalp treatment

• Medicated shampoos containing ketoconazole, ciclopirox, selenium sulfide, zinc pyrithione, coal tar, and salicylic acid, used twice weekly for at least a month. 
• Steroid scalp applications reduce itching, and should be applied daily for a few days.
• Calcineurin inhibitors such as tacrolimus can be used as steroid alternatives.
• Coal tar cream can be applied to scaling areas and removed several hours later by shampooing.
• Combination therapy is often advisable.

Face, ears, chest and back

• once or twice each day using a non-soap cleanser
• Apply ketoconazole or ciclopirox cream once daily for 2 to 4 weeks
• Hydrocortisone cream can also be used applied up to twice daily for 1 or 2 weeks. 
• Topical calcineurin inhibitors such as pimecrolimus cream or tacrolimus ointment may be used instead of topical steroids.
• A variety of herbal remedies are commonly used.

Management in infants

• Regular washing baby scalp with baby shampoo or aqueous cream.
• White petrolatum may be useful.  
• Topical antifungals are often used depending on the extent of the rash.

CAC TREATMENT FOR SEBORRHOEIC DERMATITIS

• Detox Premium Powder – This is a herbo-mineral preparation that contains ingredients like Parwal Pishti, Giloy satv, Shukta Pishti, Kamdudha Ras, Gandhak Rasayan, etc.

1. Parwal Pishti – This Pishti reduces inflammation, flaking, itching of the skin. The Pishti is composed of natural coral calcium processed with rose water.
2. Shukta Pishti – It helps to balance the Pitta dosha in the body. All signs and symptoms related to Psoriasis patients are managed with this article.
3. Giloy Satv – This satv is prepared from the herb Giloy (Tinospora cordifolia). The anti-inflammatory, antioxidant, and analgesic properties of this herb deal with psoriasis easily.
4. Kamdudha Ras – This herbal-mineral classical preparation balances Pitta dosha in the body.
5. Gandhak Rasayana – This herbal preparation is used since ancient times for all types of skin disorders.
6. Tal Sindoor – It contains ingredients like Shuddh parad, Aloe vera, Gandhak, etc that relieve redness in psoriasis patients.
7. Akik Pishti – This Pishti reduces all types of Pitta related disorder hence it gives good results in psoriasis.
   Recommended Dosage – Take 1 sachet twice daily with plain water.

• Blood Purifier Syrup – It is ayurvedic syrup that consists of various natural ingredients such as Khadir Chall (Acacia catechu), Manjistha (Rubia cordifolia), Neem (Azadirachta indica), Giloy (Tinospora cordifolia), Harad (Terminalia bellirica), Baheda (Terminalia chebula), Amla (Emblica officinalis), etc. As the syrup purifies the blood by removing excess toxins it is very beneficial in maintaining proper circulation and improves the skin naturally.
  Recommended Dosage – Take 2 teaspoonful twice daily.
  
• Twak Tailam – Twak tailam is very effective for the skin as it deeply nourishes the tissues and improves the skin luster. The tailam is composed of yashtimadhu (Glycyrrhiza glabra), manjistha (Rubia cordifolia), etc. The tailam supports skin health, helps in reducing uneven pigments, improves complexion, and helps in deep detoxification and blood purification without any side effects.
  Method of Application – Apply over the affected area of the skin.
• Skin care tablet – skin care tablet is a pure ayurvedic formulation. It help to maintain the texture of your skin depending on the type of skin you have. It contains various herbs like Haridra khand, Panchnimb churna, Khadir chahal, Chirayta, Mulethi, Chopchini, Gandhak, Ajmoda that work very effectively on all skin types. Skin care is a blood purifying tablet. It cools and detoxifies the blood, increase blood circulation of the skin. It minimizes the blemishes, lighten sun tan, delay ageing of skin and heal skin problems.
  Recommended Dosage – Take 1 tablet twice daily.
  
• Panchatikta Ghrita Guggulu – Panchatikta Ghrita Guggulu is an ayurvedic preparation mainly used for skin diseases. This tablet contains pure herbal ingredients such as Nimba(Azadirachta indica), Patola(Cucumis acutangulus), Guduchi(Tinospora cordifolia), Vasa(Adhatoda vasica), etc. This tablet promotes detoxification and rejuvenation. Panchatikta Ghrita Guggulu tablet is a natural source of anti – oxidant. It promotes engender vibrant and healthy skin.
  Recommended Dosage – Take 1 tablets twice a day with normal water.
  
• Panchsakar Churna – Panchsakar Churna is an ayurvedic formulation that consists of five ingredients named as – Saindhav Lavana (Rock Salt), Swarnapatri (Cassia angustifolia), Shatapushpa (Anethum sowa), Shunti – (Zingiber officinale), Balaharitaki  (Unripe fruits of Terminalia chebula). Panchsakar Churna is naturally detoxifying, thus it removes the toxins from the body. It relieves inflammation and useful in all types of skin problems.The powder has an anti – inflammatory properties due to which it can reduces the swelling.
  Recommended Dosage – Take 1 teaspoonful with lukewarm water at bedtime.
  
• Neem soap – Neem soap is natural and herbal handmade soap prepared from the standard extract of herb Neem (Azadirachta indica). Neem herb is widely used to cure acute to chronic Skin problems such as Pimples, Itching, Dryness, Blemishes, Dark spots, Pigmentation, Scars etc. It is such a wonderful herb that is easily available and shows Anti-bacterial, Anti-inflammatory, Antioxidant, Anti-microbial, Antifungal, Antiseptic properties. Neem cleanses the pores and protects the skin from various infections, Psoriasis, Eczema, Leprosy, Skin ulcers. It restores the health of damaged skin, tones skin complexion, prevents premature ageing, Wrinkles, Fine lines can protect against UV rays, and acts as a natural moisturizer for the skin.
  Method of Application – Neem Soap can be regularly used on face and body, as a bath soap.
  
• Trikatu Tablet – Trikatu Tablet helps to eliminate excess Kapha or mucous from the body, supports respiratory system, manages weight, helps to take out impurities or ama from the body, supports healthy detoxification, reduces swelling. It shows anti-inflammatory, analgesic, expectorant, antioxidant properties. This tablet is made up of equal parts of three herbs such as Pippali (Piper longum), Shunthi (Zingiber officinale), & Marich (Piper nigrum) that maintains the metabolism in the body.
  Recommended dosage – Take 1 tablet twice daily with normal water.