Ayurveda Interventions Achieving Complete Remission in Erythrodermic Psoriasis (Eka-Kustha)

Abstract

Erythrodermic psoriasis (EP) is a rare, severe, and potentially life-threatening form of psoriasis, characterized by generalized erythema and scaling involving more than 75% of the body surface area. The clinical presentation of EP closely resembles Eka-kushta as described in classical Ayurvedic texts, wherein a personalized and holistic therapeutic approach is advocated for long-term disease management. This case report documents the successful management of erythrodermic psoriasis through classical Ayurvedic interventions, resulting in complete clinical remission. A 52-year-old male with an eight-year history of Erythrodermic psoriasis, unresponsive to conventional therapies, sought Ayurvedic care at the outpatient department. Following a detailed evaluation of Dosha, Dushya, and Roga bala, an individualized treatment protocol was formulated. The management strategy comprised Shodhana (purificatory procedures) followed by Shamana (palliative measures), including Siddharthaka snanokta dravya kashaya administered for Pana and Pariseka, along with Panchatiktaka ghṛta. These interventions were complemented by disease-specific dietary guidelines and lifestyle modifications. Marked clinical improvement was observed within four weeks, with complete remission achieved by six weeks. The Psoriasis Area and Severity Index (PASI) score reduced from 60.6 to 0.6. Clinical remission persisted for two months after completion of therapy. Mild recurrence at the three-month follow-up was successfully managed with Ayurvedic treatment. This case highlights the effectiveness of Ayurvedic Shodhana-based therapy in achieving rapid remission and sustained disease control in Erythrodermic psoriasis.