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Indian Journal of Traditional Knowledge
Vol. 8 (3), July 2009, pp. 425-430
Effect of Psoralia corylifolia Linn. and Marham-e-Gulabi in
Da-al-sadaf (psoriasis)
M Shamim Khan, MMH Siddiqui* & Shagufta Aleem
Department of Moalejat, Ajmal Khan Tibbiya College, Aligarh Muslim University, Aligarh 202 001, Uttar Pradesh
Received 12 June 2007 revised 27 October 2008
The therapeutic evaluation of Psoralia corylifolia Linn. and Marham-e-Gulabi (non-pharmacopoeial), a Unani
formulation in 40 patients of Da-al-sadaf (psoriasis) revealed an over all clinical improvement in about 77.5% at the end of
45 days treatment. The test drug did not show any side effect on the kidney and liver.
Keywords: Da-al-sadaf, Unani Medicine, Psoriasis, Skin disease, Psoralia corylifolia, Marham-e-Gulabi, Antiinflammatory
activity, Antipsoriatic activity
IPC Int. Cl.8: A61K36/00, A61P1/02, A61P17/00, A61P17/02, A61P17/04
Da-al-sadaf (psoriasis) has not been mentioned in any
classic medical literature. However, it was mentioned
in Unani medicine and in Ayurveda as Kust Kutam1-5
.
In recent times, psoriasis has been identified as an
independent disease or skin disorder and described in
its present form6-7
. Da-al-sadaf is derived from two
Arabic words Daun (= disease) and Al-Sadaf’
(= oyster shell), while psoriasis is derived from a
Greek words so-ri-a-sis, which means itching7-8
.
Technically, it may be defined as a common
genetically determined, inflammatory and
proliferative disease of the skin. The most
characteristic lesions consisting of chronic, sharply
demarcated, dull red scaly plaques, particularly on
extensor aspect, bony prominences and scalp9-10
.
Psoriasis is a worldwide disease. The estimated
prevalence is 0.5-1.5% of population in India and
1- 2% of population globally11.
It occurs with equal
frequency in both sexes, but female tends to develop
psoriasis earlier than male10,12
. It has a bimodal peak
of incidence at 16-22 yrs and 57-60 yrs10
. Typically,
psoriasis begins in teenage and early adult life; the
attack is more common in winter than summer13
.
There is an increase prevalence of psoriasis in
individuals with human leukocyte antigens (HLAs),
HLA, BW17, B13 and BW3712
. Thirty percent of
patients have a family history of disease13
. The exact
etiology of the disease is still unknown, but it is
considered to be an autoimmune disease and has a
strong genetic prediction in the form of polygenic
dominant inheritance14
. According to Unani concept,
there are some precipitating and triggering factors such
as abnormal humours (Sauda-e-Mohtaraq, Merah-e-
Sauda and Balgham-e-Shor); diet (cold & dry and salty
diet), red meat, low calcium and high iodine diet; mental
stress, trauma, infections, sunlight, puberty, pregnancy,
drugs (antimalarial, β–blockers, antimalignant, immuno-
suppressive and NSAID)10,11,15-18
. Low humidity and
cold weather also aggravates it10
.
Regarding pathogenesis, scholars described that
when the khilt-e-sauda moves towards the skin, then
the tabiyat (homeostasis) of the body differs from the
skin, therefore the skin neither gets nourishment from
that khilt (humour) nor excretes it, which makes the
skin scaly19
. According to modern pathologists, the
basic defect is rapid epidermal proliferation in
psoriatic lesion and cellular turnover is increased up
to 7 folds and the transit time from the basal layer to
the top of the stratum corneum is 3-4 days rather than
usual 28 days. Thus, rapid turnover of keratinocytes
alters keratinization, resulting in thickened epidermis
(seen as papules and plaques) and para-keratotic
stratum corneum (silver scales). T lymphocytes for
epidermal proliferation play an important role, but the
exact mechanism underlying this benign proliferation
reaction is unknown12
. Clinically, psoriasis presents as
chronic, well defined erythematous plaques with
silvery or micaceous scales and symmetrical in
distribution, itching or burning, candle grease like
scale can be repeatedly scraped on scratching the ________________
*Corresponding author
INDIAN J TRADITONAL KNOWLEDGE,VOL 8, No.3 JULY 2009
426
psoriatic lesion (Candle grease sign), other important
clinical features are pin point bleeding on removal of
scales (Auspitz sign), appearance of typical lesion at
the sites of even trivial injuries (koebner
phenomenon), affected nails become like dents made
with a ball point pen; tanoval spots of 2-4 mm in
diameter (oil spots)11,13,14,20
. The healing lesions of
psoriasis become non scaly and dusky in color
encircled by a clear peripheral zone (Hallo or
woronoff ring)14
. Two of the chief features of the
psoriasis are its tendency to recur and to persist11
. On
the basis of epidemiology, the psoriasis is divided into
2 major groups: Type-1 psoriatic showing an onset in
the teenage and early adult life, such individuals
frequently have a family history and there is an
increased prevalence of HLA CW6antigen; Type-2
psoriatic onset is in individuals of fifties or sixties,
family history is less common and the HLA CW6
antigen is not so prominent20
.
In Unani System of Medicine, the recommended
lines of management to control psoriasis are Nuzuj wa
Tanqiyah-e-Akhlat-e-Ghair Tabayiah (concoction and
expulsion of abnormal humour) specially, Sauda
(melancholic humor) by Aftimoon wilaiti
(Cuscuta reflexa Roxb. ), Tukhm-e-Babchi (Psoralia
corylifolia Linn), Bisfaij Fistaqi (Polypodium vulgaris
Linn), Ghariqoon (Polyporus officinalis Fries)
Turanjbeen (Fraxinus ornus Linn.); along with
Tahleel-e-auram
(resolution of inflammation) by
Mako (Solanum nigrum Linn.), Kasni (Cichorium
intybus Linn.), Brinjasif (Artimisia vulgaris Linn.);
Tasfeeh-e-dam (blood purification) by Shahatra
(Fumaric parviflora Lam.), Unnab (Zizyphus vulgaris
Lam.), Chiraita (Swertia chirata Buch.-Ham.),
Sarphoka (Tephrosia purpurea (Linn.) Pers.), Ushba
maghrabi (Smilex aspera Linn.), Karela (Momordica
charantia Linn.); Indimal-e-zakhm (Cicatrization) by
Sendoor (plumbum), Sang-e-Jarahat (Silicate of
magnesia), Mazu (Quercus infectoria Oliv.), Hina
(Lawsonia inermis Linn); Taskeen-e-Jild
(demulcefication) by Behdana (Cydonia vulgaris
Pers.), Unnab (Zizyphus vulgaris Lamk.), Tukhm-e-
kahu (Lactuca scariola Linn), Samagh-e-arabi
(Acacia arabica Willd); Tarteeb-e-umoomi wa
muqami (general and local moisturization) by
Arq-e-gulab (rose water), Roghan-e-badam (almond
oil), Roghan Zaitoon (oliv oil), Roghan-e-narjeel
(coconut oil) and use of Jali (detergents) like neem
(Azadiracta indica Linn.), haldi (curcuma longa
Linn.), kamela (Mallotus philippinensis
Muel.Arg.)3,4,21
. In Allopathy, the goal of therapy is to
decrease epidermal proliferation and underlying
inflammation, for this purpose antimitotic or cytotoxic
agents like methotrexate, azathioprine, cyclosporine-
A and photochemotherapy are adopted12,13
.
Tukhm-e-Babchi (Psoralia corylifolia Linn. seeds)
are odourless but on chewing they emit a pungent
odour and have a bitter unpleasant acrid taste derived
from babchi (Psoralia corylifolia Linn.) plant22
. They
are hot and dry in nature23
. Psoralen and Isopsoralen
are considered therapeutically active constituents of
these seeds22
. They are specially recommended in the
treatment of leucoderma, leprosy, psoriasis and other
inflammatory diseases of the skin22,23
. Marham-e-
Gulabi is a non-pharmacopoeial formulation of Ajmal
Khan Tibbiya College Hospital, Aligarh Muslim
University, Aligarh. It is claimed to be beneficial in
psoriasis as a Nafe-e-busoor wa Qurooh24
. Keeping this
fact an attempt has been made to study the clinical
significance of these drugs in psoriatic patients.
Methodology
The clinical study was conducted on 40 psoriatic
patients selected from OPD and IPD of Department of
Moalejat, Ajmal Khan Tibbiya College Hospital,
Aligarh Muslim University, Aligarh during
2004-2006. Children, mentally ill, prisoners, pregnant
and lactating women, the person who had positive
history of allergic manifestation, secondary infection
on their lesion and those suffering from any systemic
disease and metabolic disorders were excluded from
the study. The patients between 10-70 yrs of age of
both sexes with well established clinically diagnosed
psoriatic patients were included in the study14
. The
micro fine powder (Safoof) of babchi seeds, obtained
from Dawakhana Tibbiya College, Aligarh Muslim
University, Aligarh was prepared and Marham-e-
Gulabi (Table 1) obtained from Ajmal Khan Tibbiya
College Hospital dispensary was used as a topical
agent. The patients were advised to take 6 gm of
Safoof-e-Babchi twice a day in the form of a zulal
(decant water) on empty stomach and apply the
Marham-e-Gulabi on the lesions once a day24,25
.
Table 1—Ingredients of Marhame-e-Gulabi per 20 gm
Name of ingredients Quantity in gm
Sendoor (Plumbum) 0.09
Mom (Bee’s wax) 1.82
Boric Acid (Boracic acid) 9.00
Carbolic Acid (Phenol) 0.09
Roghan-e-Narjeel (Coconut Oil) 9.00
KHAN et al.: EFFECT OF UNANI MEDICINE IN PSORIASIS
427
The duration of study was 45 days and no
concomitant treatment was allowed during the study.
The patients were assessed on the basis of clinical
examination on every 15th day. The necessary
investigations were carried out at the beginning and at
the end of the study. All the observation were
tabulated and statistically analyzed by applying Z-test
to note significance of drugs efficacy.
Results and discussion
Itching was observed in all the 40 patients at the
beginning of the treatment, but at the end of the
study, only 8 cases (20%) had itching (Table 2 &
Fig. 1). The effect of drugs was found to be highly
significant on itching. This improvement may be
due to antipruritic effect of Babchi, Mom, carbolic
acid, Roghan-e-narjeel and blood purifying
property of Babchi 23,25-27
. During the study, it was
found that 9 cases (22.5%) had burning sensation at
the beginning of the study. But at the end of the
study, burning disappeared in all the cases (100%)
(Table 2 & Fig. 1). This may be due to the soothing
effect of Sendoor, emollient and analgesic effects of
Mom25,28
. All 40 cases had scaling and after 45 days
of treatment, 37 cases (92.5%) improved
(Table 2 & Fig. 1). It was deduced that the effect of
the drugs on scaling was highly significant. This
improvement may be because of antimelancholic
property (Mana-e-sauda) of babchi, detergent
properties of babchi and sendoor, and moisturizing
property of roghan-e-narjeel23,25,27,31
. It was
observed that out of 40 cases, 6 cases (15%) had the
complaints of discharge from the lesion at the
beginning of the study. The discharge ceased in all
cases after 45 days of treatment (Table 2 & Fig. 2).
This result may be due to the vasoconstructive
effect of sendoor, siccative effect of sendoor and
mom28,29
.
It was observed that 20 cases (50%) had new
eruption before the treatment and after 45 days of
treatment, 14 cases (70%) have shown
improvement (Table 2 & Fig. 2). The effect of the
drugs on new eruption was significant. The most
probable reason can be the antiinflammatory action
of babchi, sendoor, mom and antipsoriatic effect of
babchi roghan-e-narjeel 22,23,25,28
. Woronoff ring
sign was negative in all patients before the
treatment, 26 cases (65%) improved after the
treatment of 45 days (Table 2 & Fig. 2). The effect
of the drugs was significant. This improvement may
be due to the cicatrizing property of sendoor, mom,
carbolic acid, roghan-e-narjeel and antipsoriatic
effect of babchi, and roghan-e-narjeel23,25,27-29.
Twenty eight cases had papules at the beginning of
the study. Only 2 cases (7.1%) had papules at the
end of the study (Table 2 & Fig. 3). The effect of
the drugs was significant. The reason behind this
effect may be the antiinflammatory property of
babchi, sendoor,
mom, and roghan-e-narjeel
2225,28 30.
Only two cases had pustules before the
commencement of the study. After 45 days of
treatment, only 1 case (50%) got improvement
(Table 2 & Fig. 3). Since, the efficacy of drugs in
case of pustules is 50% therefore it is very difficult
Table 2— Efficacy of drugs on clinical features of psoriasis
After treatment
Response
Before treatment
15 day 30 day 45 day
No
response
p-Value
Clinical feature
No % No % No % No % No %
Itching 40. 100 03 07.5 09 23.0 32 80.0 08 20.0 p < 0.001
Burning 09 100 04 44.4 06 67.0 09 100.0 00 00.0 -
Scaling 40 100 10 25.0 26 65.0 37 92.5 03 07.5 p < 0.001
Oozing 06 100 03 50.0 04 67.0 06 100.0 00 00.0 -
New eruptions 20 100 06 30.0 09 45.0 14 70.0 06 30.0 p < 0.05
Woronoff ring 40 100 02 05.0 07 18.0 26 65.0 14 35.0 p < 0.05
Papules 28 100 02 07.1 06 21.0 26 92.9 02 07.1 p < 0.001
Pustules 02 100 00 00.0 00 00.0 01 50.0 01 50.0 -
Plaques 40 100 02 05.0 07 18.0 26 65.0 14 35.0 p < 0.05
Auspitz sign 40 100 09 22.5 25 63. 38 95.0 02 05.0 p <0.001
Erythema 40 100 02 05.0 11 280 30 75.0 10 25.0 p <0.001
Psoriatic nails 03 100 00 00.0 00 00.0 01 33.3 02 67.0 -
Psoriatic arthropathy 03 100 00 00.0 01 33.0 02 66.7 01 33.0 -
Loss of hair 02 100 00 00.0 01 50.0 02 100.0 00 00.0 -
INDIAN J TRADITONAL KNOWLEDGE,VOL 8, No.3 JULY 2009
428
to deduce any result. Hence further studies requires
on large sample size. All 40 cases had plaques at
the beginning of the study, but 26 cases (65%) have
shown improvement after 45 days of treatment
(Table 2 & Fig. 3). The effect of the drugs was
significant. This result may be due to
antiinflammatory effect of babchi, sendoor,
momand roghan-e-narjeel22,25,28,30
.
In the study, Auspitz sign was present in all
cases. But after treatment of 45 days, in 38 cases
(95%) it disappeared (Table 2 & Fig. 4). The value
was found highly significant. The most probable
reason can be the ciccative effect of mom, sendoor
and haemostatic property of sendoor28,29
. During
study, the erythema was present in all cases before
the treatment. 30 cases (75%) showed improvement
KHAN et al.: EFFECT OF UNANI MEDICINE IN PSORIASIS
429
INDIAN J TRADITONAL KNOWLEDGE,VOL 8, No.3 JULY 2009
430
at the end of the study and statistical analysis was
found significant (Table 2 & Fig. 4). The reason
behind this significant effect may be the anti
inflammatory effect of babchi, sendoo, mom and
roghan-e-narjeel22,25,28,30
. It was observed that the
psoriatic nails were found in 3 cases before the
treatment. Only 1 case (33.3%) improved after 45
days of treatment (Table 2 & Fig. 5). It was
observed that in 3 cases there were psoriatic
arthropathy before the treatment, and after 45 days
of treatment, psoriatic arthropathy remained
positive in 1 case (33.3%) only (Table 2 & Fig. 5).
The loss of hair was present in
2 cases and after the treatment, all patients
improved in this regard (Table 2 & Fig.5). Because
of small sample size it is very difficult to evaluate
the efficacy of drugs on psoriatic nails, psoriatic
arthropathy and loss of hair.
Conclusion
On the basis of above observations it may be
concluded that the effects of Safoof-e-Babchi and
Marham-e-Gulabi on the clinical evidences of
psoriasis were found satisfactory (Figs 6-17). The
drugs used were well tolerated and without
unwanted effects. However, further study of large
sample size of the ailment as well as long term
effects of the drugs should be carried out to
established possible cure of psoriasis.
Acknowledgement Authors are grateful to Mrs Rana Sherwani,
Department of Pathology, JN Medical College,
Aligarh Muslim University, Aligarh and M Javed,
Director, Life Line Diagnostic Centre, Medical Road,
Dodhpur, Aligarh for providing valuable help to pin
point the diagnosis of psoriasis by skin scraping and
skin biopsy.
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