An ayurvedic approach to diagnosis and management of psoriatic arthritis on principles of Vatarakta: A review

Psoriatic arthritis (PsA) is inflammatory arthritis usually occurring in patients with psoriasis. Even though skin disease and joint involvement are linked in PsA, they can occur irrespective of each other. An equivalent entity in Ayurvedic literature, Vatarakta is a disabling illness occurring due to the concurrent aggravation of Vata and Rakta. Its Moolasthana (~primary site) of manifestation is joints of hands and feet. With this article, we aim to develop a clinical approach to PsA on the principles of Vatarakta. Relevant information from authentic texts of Ayurveda and contemporary medical literature is gathered, and facts are analyzed to find similarities and dissimilarities between PsA and Vatarakta's etiology, pathogenesis, clinical features, prognosis, and management principles. It was seen that PsA bears similarity to Vatarakta on grounds of etiology, pathogenesis, and clinical features. The few differences seen are not found to be conceptually contradictory. Concepts of Vatarakta can explain the vascular, dermal, musculoskeletal, and systemic changes seen in PsA. The differential of Asthimajjagata Kushtha, Kushtha Updrava, and Aamvata is mandatory to rule out any diagnostic dilemma. Often the patients with psoriasis and/or PsA have hyperuricemia, which has been long viewed and treated on principles of Vatarakta. Hence, Vatarakta may be seen as an umbrella term for immune-mediated or inflammatory musculoskeletal disorders with dermal and systemic manifestations. Clinically, PsA can be understood and managed on principles of Vatarakta.