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Indian Traditional Treatments for Psoriasis: A Critical Appraisal of Available Evidence Supporting Efficacy

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Abstract

Objective

To examine data from studies supporting the clinical efficacy of medical approaches from India traditional systems of medicines like Ayurveda, Unani, Siddha, and Homeopathy for psoriasis using outcome indicators employed in clinical practice and research.

Methods

Searches were conducted between December 2019 and September 2020 in databases PubMed, Scopus, Web of Science and Ovid Medline using search terms including traditional, complementary, psoriasis, Kushtha, Ayurveda, Siddha, Unani, Homeopathy and clinical. Controlled trials, case series and case reports published from India were included.

Results

Data of 17 selected studies were extracted. Treatment efficacy in terms of improvement in Psoriasis Area and Severity Index (PASI) score or/and percentage reduction in score (PASI 50, PASI 75 and PASI 90) or/and patient-reported outcomes using instruments like Dermatology Life Quality Index and Psoriasis Disability Index were noted. All studies reported good improvement as per the study specific outcome. However, study characteristics, including study design, sample size, follow-up period, inclusion and exclusion criteria were heterogeneous, and the choice of outcome measures was not adequate to conclude the effectiveness of intervention. The use of some herbs as common ingredients in several formulations across different systems of medicines were noted in analyzing individual formulation.

Conclusions

Future studies must incorporate a comprehensive study design with specific outcome measures like PASI, PASI 75, PASI 90, quality of life parameters, compliance to medications, adverse reactions, remission period, relapse rate and cost-effectiveness with long term follow-up. The currently available evidence on the roles of these herbs at molecular level in psoriasis is preliminary.

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Authors and Affiliations

  1. Department of Pharmacology, Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, 576104, India

    Nayak Deeksha Dayanand, Arul Amuthan &  Vasudha Devi

  2. Department of Dermatology, Venerology and Leprosy, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, India

    Sathish Pai Ballambat

  3. Department of Cell and Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, India

    Shama Prasada Kabbekodu

  4. Centre for Cardiovascular Pharmacology, Manipal Academy of Higher Education, Manipal, 576104, India

    Vasudha Devi

Authors
  1. Nayak Deeksha Dayanand
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  2. Arul Amuthan
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  3. Sathish Pai Ballambat
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  4. Shama Prasada Kabbekodu
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Contributions

Devi V and Amuthan A conceived and planned the design. Nayak DD screened the literature, extracted data and wrote the manuscript in consultation with Devi V. Devi V contributed to interpretation of results, reviewed and edited the manuscript. Amuthan A, Sathish PB and Shama PK contributed by reviewing the manuscript. All authors read and approved the final version of the manuscript.

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Correspondence to Vasudha Devi.

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All authors declare that they have no conflict of interest.

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Dayanand, N.D., Amuthan, A., Ballambat, S.P. et al. Indian Traditional Treatments for Psoriasis: A Critical Appraisal of Available Evidence Supporting Efficacy. Chin. J. Integr. Med. 29, 69–73 (2023). https://doi.org/10.1007/s11655-022-3519-y

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  • DOI: https://doi.org/10.1007/s11655-022-3519-y

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