Sarciodosis

CUTANEOUS  SARCIODOSIS 
Scrcoidosis is a multisystem granulomatous disease that may involve almost any organ of the body. This means that there are scattered collections of mixed inflammatory cell (granulomas ) affecting many parts of the body. This results in various clinical manifestations. 
Cutaneous sarcoidosis occurs in upto one third of the the patients with systemic sarcoidosis. Recognition of the cutaneous lesions are important because they provide a visible clue to the diagnosis and are easily accessible source of tissue for histological examination. The lesions of cutaneous sarcoidosis can exhibt many different morphologies that is why it is also known as “ great imtators” in dermatology. Specific manifestations of saqrcoidosis includes papules , plaques , lupus pemio , scar sarcoidosis and rare symptoms like alopecia , hyperpigmented patches , ulcers and ichthyosis. 
It ususlly starts in the lungs or lymph nodes in the chest. It is thought that the inflamation of the aloveoli is the start of the disease process in the lungs. 
Other than lungs the commonly affected organs are Skin – 20-35 % , Eyes 20-30% , Liver 30-40% , Heart   5-20% , Nervous system 1-5% , Muscloskeleton 2-35%

CUTANEOUS SARCOIDOSIS DIAGNOSIS
Skin biopsy from the affected skin and microscopic examination is helpful to made diagnosis.
The blood test for the levels of calcium and ACE ( Angiotensin converting enzyme ) , if the level of both are raised it strongly suggests the sarcoidosis. 
As sarcoidosis commonly affects the lungs or the lymph nodes in the chest , so X-Ray of the chest should be performed. 
Other investigations will be needed for the symptoms and the clinical findings.

 PRESENTATION OF THE CUTANEOUS SARCOIDOSIS
 
Papules and plaques are the most common way for the sarcoid to affect the skin. The papules are very small and raised bumps that are often purplish red or brown in colour. They can occure anywhere on the body but are commonly seen on the face. Plaques are the similar in colour but they are larger and tend to occur anywhere on the body.

Erythema  Nodosum  is the another presentation of the skin sarcoidosis . These are fleshy tender bumps that occur on the front of the shins. There are many other diseases that can cause erythema nodosum and sarcoid is just one of them. When the painful red bump fade a bruise like area is left behind. Some people may experience fever , joint pains and swelling and feel discomfort when the lesions first appear.  One third of the patients out of 10 may experience it.

Lupus Pemio  -  in this the dusky purpllish swollen areas that appears on the nose , cheeks , ears or fingers. This is the more aggressive presentation of the disease that appears on the skin and may may affect other parts of the body. This may be harder to treat and can cause scarring.

Scar Sarcoidosis - There are rarer types of Sarcoid in the skin that includes Scar Sarcoidosis , in which an exsiting scar ot tattoo becomes red , lumpy and firmer to touch. Sarcoid can also affect  the scalp , nail or mouth and occasionally causes area of ulceration or breakdown in the skin.

AYURVEDIC VIEW ON CUTANEOUS (SKIN ) SARCOIDOSIS
According to the Ayurveda  Sarcoidosis is caused by the generation of the endotoxins “AMA” . This AMA – the endotoxin while moving through the circulatory and lymphatic systems interferes with the chemical functions of the immunity and disturbes the normal circle that results in accumulating the antibodies in the form of inflammatory lumps in the different part of the body.
The pathology starts due to the formation of “ama” the endotoxin produced by the faulty digestion.  Poor digestion forms immature “rasa”  or chyle . This is the main culprit to develop  any disease. In Sarcoidosis the dosha becomes disturbed due to the faulty rasa dhatu. All the three doshas gets vitiated  and produce their symptoms. Deranged vata produces pain . Deranged pitta produces inflammation and heat. Deranged Kapha produced lymph node swelling.  
The imbalances of the dosha causes the “ Rasa vaha Strotas Dushti” .The proper nutrition doesn’t reach to them due to nutrition deficiency the muscles  &  skin  and the other organs of the body.

AYURVEDIC TREATMENT FOR CUTANEOUS – SKIN – SARCOIDOSIS 
Ayurvedic and  Panchakarma treatments  can successfully manage and treat Sarcoidosis.

• First of all Improves and corrects the faulty digestive system to check the “ama” or toxin formation. So that the health “Rasa Dhatu “ gets formed.
• Removal of the already formed toxins from the body muscles , skin and from circulatory system through oral Ayurvedic Medicines.
• Panchakarma Detoxification is very important for opening the “Strotas” , so that proper nutrition may reach to them.
• Panchakarma Therapies for Rejuvenation are very helpful.
• Oral Ayurvedic Herbal , Herbo-Mineral mixtures and Gold Preparations to enhance the Immunity.
• Ayurvedic medicines which acts on muscular tissue and helps in providing proper nourishment to the “Mamsa Dhatu”. This gradually improves the strength of muscular tissue and muscle fibers.
• Ayurvedic Mixtures are also used to treat the skin , subcutaneous tissue , blood and blood vessels to reduce inflammation and it nourishes the skin. Slowly the skin rashes become healed.
• There are many  Ayurvedic medicines which are very helpful for the patients , but we have to decide the medicines and Panchakarma therapies according to Dosha , Dushya , Vay , Samarth , Aayu , so the choice of medicines are different for different patients.
• We have seen clinically that the treatment is required for long time to get good results. Patients go to the stage of remission of disease after proper treatment. 

The herbs which are very helpful in Sarcoidosis are ::
 Haridra -Curcuma longa- is very helpful in treating the sarcoidosis. It has been using for many skin diseases and systemic diseases including malignancies for many years in AYURVEDA. It is very good home remedy for all types of skin problems. 
Daruharidra – Berberis aristata – it is one of the best Ayurvedic Herb which corrects the metabolism , improves the liver functions ,detoxifies the Skin and the whole body  and nourishes the skin on the deeper levels. 
Aloe vera , kanchannar Guggulu , Khadira , Arogya vardhini vati , Swarna Yogas , Panchatikt ghrit , Ashwhandharishta , Dashmoolarishta , Mahamanjishtaide Qwath , Swarn Makshik bhasma , Vaikrant Bhasma , 100 putti Loha Bhasma , Bala < Guduchi  are the other Ayurvedic Herbs and Minerals which are very helpful in treating the Sarcoidosis.

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