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A Critical Review of Daus-Sadaf(Psoriasis): Unani

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A Critical Review of Daus-Sadaf(Psoriasis): Unani www.ijcrt.org © 2020 IJCRT | Volume 8, Issue 7 July 2020 | ISSN: 2320-2882 A Critical Review of Daus-Sadaf (Psoriasis): Unani & Modern Perspectives Dr. Ashfaque Ahmad1, Dr. Farzana Khatoon2, Prof. Badrudduja Khan3, Dr. Mohammad Mohsin4 Assistant Professor1, Assistant Professor, EUMCH Lucknow2, Professor AMU Aligarh3, Associate Professor AMU Aligarh4 Department of Moalejat, Hayat Unani Medical College, Lucknow, U.P1 ABSTRACT Background: Psoriasis is chronic inflammatory skin disorders clinically characterized by erythematous, sharply demarcated papules and plaques covered by silvery micaceous scales. Daus-Sadaf is the Arabic term of psoriasis composed of two words. Da-disease, & Sadaf - molluscum shells, since in this disease shell like silvery white scales or flakes keep on shedding from horny layer of skin. Unani scholars described psoriasis with discussing other skin disease having similar clinical and morphological features. They have, described Taqasshur-wa-Qasaf-e-Jild (Icthyosis) in their writings which is resembled with sign & symptoms of psoriasis Aims and Objectives- To put forth a concrete and clear concept of Daus sadaf (Psoriasis) in light of Unani concept as well as modern perspectives. To make people aware about Unani humoral aetiology regarding pathogenesis of psoriasis. Material Methods- Humoral theory proposed by Buqrat (Hippocrates), serves the key role in the aetio-pathogenesis of all the idiopathic diseases in general and psoriasis in particular. Almost all Unani physicians believed that it is a Saudavi (Melancholic) disease. It occurs due to the Sauda-e-Mohtaraq, Merah-e-Safra / Balgham-e-Merari, indigestion, uncleanness, cold, and uses of dry-salty diets Conclusion & Future Perspective- After Scientific validation and knowing of Unani as well as modern perspectives of psoriasis, there will be many doors are open regarding prevention, diagnosis and treatment of diseases. Keywords: Unani system of medicine, Taqasshur Jild, Da-us-sadaf (Psoriasis), Saudavi (Melancholic) IJCRT2007491 International Journal of Creative Research Thoughts (IJCRT) www.ijcrt.org 4570 www.ijcrt.org © 2020 IJCRT | Volume 8, Issue 7 July 2020 | ISSN: 2320-2882 INTRODUCTION: In Unani classical literature Daus Sadaf is not vividly described as such same nomenclature. Though several and allied conditions are mentioned in Unani texts with different names. The terminology Daus Sadaf, was given much lately but there are some references of the descriptions of disease in the ancient texts of almost every renowned Unani physicians. They have described psoriasis with discussing other skin diseases having similar clinical and morphological features based on their own observations and experiences. Definitions: There are many definition of psoriasis described as different physicians like, Psoriasis is a chronic dermatosis characterized by an unpredictable course of remissions relapses and presence at typical sites of well defined, erythematous papules and plaques, which are surmounted with large loose silvery scales. There is frequent nail and joint involvement.1 Psoriasis is chronic inflammatory skin disorders clinically characterized by erythematous, sharply demarcated papules and plaques covered by silvery micaceous scales. 2 Psoriasis is a common, chronically recurring papulo-squamous disease, characterized by varying size whitish scaly patches seen most commonly on the elbow, knees and scalp. 3 Psoriasis is a non-infectious, chronic inflammatory disease of skin, characterized by well-defined erythematous plaques with silvery scales, with a predilection for the extensor surfaces and scalp, and chronic fluctuating course.4 The psoriasis can be defined as non-infectious and therefore non-contagious dermatosis in which the pathological changes in the dermis and in the upper dermis produced distinctive clinical pictures such as well-circumscribed erythematous, dry plaques of various sizes.5 The psoriasis can be defined as non-infectious and therefore non-contagious dermatosis in which the pathological changes in the dermis and in the upper dermis produced distinctive clinical pictures such as well-circumscribed erythematous, dry plaques of various sizes.6 Incidence and Prevalence: Psoriasis is a serious global problem with at least 100 million individuals affected worldwide. It occurs in all countries and individuals of all ages, prevalence of psoriasis defined ranges between 0.09% and 11.43%. According to a 2001 study in the United States, individuals with Caucasian or Black ancestry and others had a prevalence of 2.5%, 1.3% and 1.0%, respectively. In another United States study from 2009-2010, these differences were higher, with the prevalence for Caucasians, Blacks, Hispanics and others at 3.6%, 1.9%, 1.6% and 1.4%, respectively. According to another study, overall sex-age-adjusted incidence rate of psoriasis in Minnesota in the United States, between 1980 and 1983, was estimated at 0.60 per 1000 person-years. 7 A systematic review of international population-based studies showed that there are wide variation found in the global prevalence of psoriasis. 8 Prevalence of disease rises to increase with increasing distance from the equator. A systematic worldwide review found the prevalence of psoriasis ranged from 0.5 to 11.4 percent in adults and 0 to 1.4 percent in children. 9 A bibliometric study conducted on Indian psoriasis research in 2013 shows contribution of Indian researchers in the area of psoriasis. According to published reports, prevalence in different populations varies from 0% to 11.8%. 65. IJCRT2007491 International Journal of Creative Research Thoughts (IJCRT) www.ijcrt.org 4571 www.ijcrt.org © 2020 IJCRT | Volume 8, Issue 7 July 2020 | ISSN: 2320-2882 10-14 In the USA, the prevalence of psoriasis was estimated to be around 4.6% while in Canada it was 4.7%. Data from Europe show little variation in countries with a range from 1.4% (Norway), 1.55% (Croatia) and 1.6% (UK). In East Africa, the figure was 0.7%, in the Henan district of China only 0.7% was found affected.15 In 2001 and 2005, a study in Italy reported an incidence of psoriasis (in adults) of 2.30–3.21 cases per 1000 person-years. In India prevalence of psoriasis varies from 0.44 to 2.8%, it is twofold more common in males in comparison of females, and most of the patients are in their 3rd or 4th decade at the time of presentation. Prevalence studies from India are mostly hospital based. A study was done in medical colleges of Dibrugarh, Calcutta, Patna, Lucknow, New Delhi and Amritsar. It was found that the incidence of psoriasis among total skin patients ranged between 0.44 and 2.2%, with overall incidence of 1.02%. It was noted that the incidence in Amritsar (2.2%) was higher as compared to other centres in Eastern India and indicated that it may be related to different environmental conditions, like extremes of temperature), dietary habits, and genetic factors. The ratio of male to female (2.46:1) was very high. Highest incidence was noted in the age group of 20-39 years and the mean age of onset in males and females was comparable. 15 Psoriasis affects both sexes equally but females tends to develop Psoriasis slightly earlier than males.16 However, in India psoriasis in more prevalent in male than female. 17 Aetio-Pathogenesis: Etiology of Daus Sadaf is multifactorial and not completely understood.18 Scientists believes that, psoriasis occurs due to result of several factors, including genetics, environmental, and immune system. It is a disease of T cells, with interplay of genetic factors (PSORS 1-8 genes), and environmental influences (physical, trauma, infections and drugs etc.). 1 Family history is also common, and certain genes and HLA antigens (Cw6, B13, and B17) are associated with psoriasis. An environmental trigger is also thought to evoke an inflammatory response and subsequent hyper-proliferation of keratinocytes. The etiology of psoriasis is unclear but the Humoral theory proposed by Buqrat (Hippocrates), serves the key role in the aetio-pathogenesis of all the idiopathic diseases in general and psoriasis in particular. Humoral theory states that, certain errors in the body functions even in the mood, emotions and behaviors were caused by an excess or lack of humours (body fluids) and an alteration in their qualities.19 Almost all Unani physicians believed that it is a Saudavi (Melancholic) disease. It occurs due to the Sauda-e-Mohtaraq, Merah-e-Safra / Balgham-e-Merari, indigestion, uncleanness, cold, and uses of dry-salty diets.20 Psoriasis has its genetic preponderance as well as of environment sensitivity, thus has variations in its clinical presentation, individual susceptibility response to a particular treatment etc. There are following causative factors of psoriasis: I.Humoral Factors: According to Unani Medicine, there are many types of abnormal Khilt which responsible for the diseases like, altered Khilt-e-Sauda (black bile), Safra-e-Ghair Tabayee (morbid black bile), Safra mutahrrika Mirrah sauda Muhtaraq Khilt-e-Sauda (charred black bile), Khilt-e-Hareef wa Laza, Khushk boraqi madda, Zojaji Balgham, Ratubat Raddia Hadda Akalah18 Balgham-e-shor,18 Balgham Malih & Mutaffin raqeeq bokharat ratubiya mutakharijah.19Body excretes abnormal humours in form of viscid fluids which moves towards the skin and forms crests that cause malnourishment of the skin. Toxins accumulate in the skin and decaying of skin appears in the form of scales. Sauda-e-Muharraq (charred black bile), Ghaleez Mutaffin Balgham (viscid putrid phlegm) causes extreme dryness in the body.21 IJCRT2007491 International Journal of Creative Research Thoughts (IJCRT) www.ijcrt.org 4572 www.ijcrt.org © 2020 IJCRT | Volume 8, Issue 7 July 2020 | ISSN: 2320-2882 II.Hereditary Factors: Genetic factors are probably involved as demonstrated by the family character of the disease. Therefore, heterogeneity of disease susceptibility has been suggested since different susceptibility loci for psoriasis have been identified in different groups of populations. HLA is the main genetic factor responsible for the inheritance which is located on chromosomes 6 i.e., HLA CW6 as the studies of familial component 1 & twins to psoriasis suggests a hereditability of around 80%.
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