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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