2BAMS (BRABU); MHA, State Health Services, Government of Bihar, Director (Hon) Aarogyam Punarjeen, Are Garden Road Jagdeo path, Patna 14, India
3BAMS (BRABU), Director, Centre for Indigenous Medicine & Research, Warisaliganj (Nevada) Bihar, 805130, India
Synthetic retinoids, Immuno suppressor, Recombiant monoclonal antibody, Cholecalciferol orally
Topical use- = Allantoin, anthralin and Desonide
Evaluation of immune boosting therapeutics i.e. Self-blood and betamethasone intramuscular to counter the antigen generated in the body and calm the antigen-antibody activity in patients of psoriasis and its sequel psoriatic arthritis
Patients of psoriasis attending at the OPD of RA. Hospital & Research Centre, Warisaliganj (Nawada) Bihar and Aarogyam Punarjeevan, Ram Bhawan, Ara Garden Road, Jagdeopath, Baily Road Patna 14 with following presentation were selected. Bleeding on pulling of dry white flake of skin, a confirmatory sign of Psoriasis termed as AUSPETZ sign 
- Plaques of red skin often covered with loose silvery scales
- Occasionally with cracks and bleed
- Plaques of scales or crust on the scalp
- May be associated with psoriatic arthritis (stiff, swollen and painful joint)
- Thickened, ridged and pitted nail
- Stiff and swollen joint
Pustular psoriasis : Red and scaly skin on the palms of the hands and/or feet
With tiny pustules
Guttate psoriasis: Often starts in childhood or young adulthood, small, red Spots, mainly on the torso and limbs. Triggers may be
Strep throat, tonsillitis, stress, injury to the skin, and
Use of anti-malarial and beta-blocker medications.
Inverse psoriasis: bright red, shiny lesions that appear in
Skin folds, such as the armpits, groin area, and under
Erythrodermic psoriasis: Periodic, fiery redness of the skin and shedding of
Scales in sheets;
Follow up Period: 2015-2018
Selected patients were interrogated for the history of diseases, drugs taken and their response, examined clinically and investigated for typing the lesion, base line biological status to adjudge the clinical effect or adversity
Erythema: Absent Mild Moderate Severe Very severe
The percentage area affected by psoriasis is evaluated in the four regions of the body. In each region, the area is expressed as –
|Area involved||Grade of severity|
- Head and neck
- Upper limbs
- Lower limbs
Each of the body area scores is multiplied by the area affected.
- B1 x (0 to 6) = C1
- B2 x (0 to 6) = C2
- B3 x (0 to 6) = C3
- B4 x (0 to 6) = C4
The Cardiff Dermatology Life Quality Index is a simple 10-question validated questionnaire to assess the impact of a skin disease on the patient's life. The same team have devised a specific assessment for the quality of life in psoriasis, the Psoriasis Disability Index.
Mild: Involved body surface area (BSA) < 10
Psoriasis Area severity index (PASI) < 10
Dermatology life quality index (DLQI) < 10
Severe: Involved body surface area (BSA) > 10
Psoriasis area severity index (PASI) > 10
Dermatology life quality index (DLQI) > 10
Grades of severity Characteristics
Mild: Few scaly patch with itch
Moderate: Wide spread scaly lesion and associated
Bleeding on pulling scales.
Severe Wide spread silvery patch or scales with
generalised itch, swelling and agonising
Pain in joints.
Every 4th day, week, 10th day, 15th day, monthly, 2 month, 3 months and 6 months for 10 injections each on competition of therapy therapeutic outcome is assessed as per following index of assessment.
Grade I complete alleviation of clinical presentation without any residue, withdrawal or adjuvant or adversity
Grade II Marked relief in clinical presentation but recurrence on treatment withdrawal
Grade III No response of therapy except transient relief.
Selected patients were of age group 20-60 years and majority 186 were of age group 50-60 yrs. (T-1), Out of all 264 were male and 155 were female (Pie diagram)
|Age group||Number of patients|
|Area of distribution||Number of patients|
Duration of illness
|Number of Patients|
|Medication consumed||Number of patients|
|Particulars||Number of patients|
|Qualified and middle-upper class||237||146||383|
|Illiterate & down trodden||27||09||36|
|Basic Profile||Number of patients|
|< 100 mg%||258||148||406|
|Characteristics Number of patients
Grade of therapeutic response:
Any untoward effects Non
Drug related adversity Non
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