Ayurvedic Insights in the Management of Ek-Kustha (Psoriasis): A Case Report

About Author

Correspondence Address

Pandit Khushilal Sharma Govt Ayurveda College and Institute, Bhopal Madhya Pradesh
Contact No. : 9340525166, Email : Drratneshs@gmail.com

Date of Acceptance : 19 Sep 2025

Date of Publication : 29 Sep 2025

Article ID : SD-IJAY_147

How to cite this article : http://doi.org/10.55552/SDNJAY.2025.3307

Abstract

Psoriasis is a long-term inflammatory skin condition that can greatly affect a person’s daily life and well-being. It is marked by accelerated epidermal proliferation and regular acanthosis, resulting in the excessive build-up of the stratum corneum, leading to scaling. This disrupted skin turnover is a defining characteristic of the disease. While modern medicine has advanced in symptom management, some patients do not respond effectively to treatment, or its efficacy diminishes over time. Additionally, long-term use of modern medications may lead to adverse effects¹. In Ayurveda, psoriasis is classified as Ek Kushta, a condition dominated by Vata and Kapha doshas. According to Acharya Charaka, Kushtha is a tridoshaja (vata, pitta, kapha) vyadhi. This study presents the case of a 42-year-old male with moderate to severe erythrodermic psoriasis, who had previously undergone systemic treatment in modern medicine without adequate improvement. A traditional Ayurvedic approach was implemented, beginning with Samshodhana (purification therapy) through Virechanaa (therapeutic purgation), followed by 30 days of Samshamana (palliative treatment). At the end of the treatment period, a skin lesion assessment was conducted to evaluate the outcomes.

Introduction

Psoriasis is a common, chronic, inflammatory disease that can result in decreased quality of life. Psoriasis is characterised by increased epidermal proliferation and regular acanthosis, resulting in an accumulation of stratum corneum (scale). About 2-3% of the population have psoriasis.¹ In modern medicine, psoriasis is typically managed with topical treatments (like corticosteroids, vitamin-D analogues and moisturisers), phototherapy (UVB or PUVA), and systemic treatments (such as immunosuppressants and biologics). However, these treatments generally control the symptoms rather than cure the condition. When these treatments are stopped, remission and exacerbation are common due to the chronic, immune-mediated nature of psoriasis.^2,3 In Ayurveda, all skin diseases are grouped under the category of Kushtha, with Ekakushtha classified as a type of Kshudrakushtha. As described by Charaka, Ekakushtha is characterised by Aswedana (absence of sweating or reduced moisture in lesions), Mahavastu (extensive skin involvement), and Matsyashakalavat (scaly skin appearance). Due to its resemblance in symptoms, Ekakushtha is often associated with psoriasis. In ayurveda the treatment of Kushta Roga (skin disorders) is fundamentally based on Samshodhana (purification therapy) followed by Samshamana (palliative therapy)⁴.

Discussion

According to the Ayurveda perspective, most skin diseases are viewed as a raktaja condition with dosha vitiation, and the root cause of all disease in Ayurveda is diminished jathragni (mandagni). In which Chitrakadi vati is a deepana pachana dravya. It is very beneficial to improve the digestion power (agni) of the body and also remove toxins and impurities by aam pachan that exacerbate psoriasis.

After deepana pachan, snehan is done with Panchtikt Ghrita⁷. Snehpan is thought to loosen the bond between toxins and dhatu. Panchtikt ghrit is a combination of 5 tikta dravyas (kantkari, nimb, guduchi, vasa, and patol) that has sothahar (anti-inflammatory) property, which helps in reducing inflammation, detoxifying the body, and promoting tissue repair, and the ghrita in it serves as a vehicle for the herbal ingredients. The use of Tikta Rasa Dravya improves skin complexion, reduces scaling and itching, and helps eliminate deep-seated toxins from the tissues. Due to pitta balancing and snigdha properties, it helps in controlling scaling and dryness associated with psoriasis by providing nourishment to the tissue of the skin. It also enhances the absorption and efficacy of herbal ingredients in it and acts primarily to remove the doshas from the entire body and bring them into kostha.

After snehpan, the blockage in srotas is removed by sarvanga abhyang and swedana with marichyadi tail, which further brings vitiated doshas from Sakha to kostha, and it is followed by virechana karma, which is indicated in kustha. As we know, the term "kustha" was given to all types of skin disorders, so Eka-Kustha (psoriasis) is also included in it. Virechana karma with trivirat avleha (30 gm) and aragwadhadi Kashaya (20 ml) pacifies vitiated pitta dosha and also helps in eliminating vitiated kapha dosha and also corrects dushit rakta dhatu, causing vata anuloman and shrotoshodan. Due to the ushna, tikshna, vyvayi, and vikasi properties of virechnopag drugs, it helps in the removal of all toxins from the body; thus, burning sensation, inflammation, itching, and pain were reduced.

Afterward, 5 days of sansarjan karma, which is the peyadi diet, was given to the patients with day-wise planning of qualitative and quantitative diet on the basis of suddhi for 5 days during the schedule. A light diet was started first, and the heaviness of the diet kept increasing up to a normal diet to overcome agnimandya. Sansarjan karma helps to improve appetite and digestive power, just like the small fire is burned into a large one with the help of dry grass and cow dung cake.

When virechana is completed, then shaman ausadhi (Arogyavardhini vati, mahamanjisthaadi kwath, and a combination of gandhak rasayan, kamdugdharasa, and amritasatva)^{[8, 9, 10]} is given, which helps in detoxification and purification of the blood through its rakta prasadan property, and 777 oil, when applied locally, inhibits the multiplication of keratinocytes. Thus, Sodhan therapy along with shaman ausadhi completely expels the doshas out of the body and prevents the relapse of diseases like psoriasis.

Conclusion

Psoriasis is a chronic autoimmune skin disorder characterized by recurring flare-ups of red, inflamed, and raised patches of skin covered with silvery-white scales. The disease appears to be largely a disorder of keratinization. The basic defect is rapid displacement of the epidermis in psoriatic lesions (3-4 days instead of 28 days in normal life). Ayurveda believes in treating psoriasis that is correlated with Eka-Kustha through shodhana and shaman treatment. In all skin conditions, generally katu, tikta, and kashaya ausadh should be given as shaman due to the rakta dhatu shodhana property. Virechana karma is commonly used in the management of kushtha, as it helps in correcting the basic pathogenic factors and rakta and pitta also. After virechanaa karma, there was a reduction in redness, itching, and scaling of the plaque, and more improvement was observed after giving oral medicines in this case. Thus, Virechanaa karma followed by internal medicine is considered the best line of treatment for psoriasis that is Eka-Kustha.

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