Clinical Evaluation of Herbomineral Therapy Followed by Shodhana Therapy in Ekkustha with special reference to Erythrodermic Psoriasis

Abstract

Ayurveda is a holistic system of medicine that emphasizes maintaining harmony between the body, mind, and nature. The skin, described as Twacha in Ayurveda, reflects the internal health status of an individual. Any alteration in skin appearance may significantly affect both physical and psychological well-being. Acharya Charaka described six layers of Twacha, whereas Acharya Sushruta explained seven layers. In Ayurveda, all skin disorders are broadly classified under Kushtha. Ekakushtha, one among the varieties of Kshudra Kushtha, shows close resemblance to plaque psoriasis in terms of clinical manifestations. Although Vata and Kapha Dosha are predominantly involved in Ekakushtha, the vitiation of all three Doshas is considered responsible for the disease pathology. Psoriasis is a chronic, non-infectious, inflammatory dermatological disorder characterized by well-defined erythematous plaques covered with silvery white scales, commonly involving the extensor surfaces and scalp. It has a relapsing and remitting course and affects males and females equally. The clinical presentation of plaque psoriasis closely correlates with Ekakushtha described in Ayurvedic literature. The present case report highlights the effectiveness of Ayurvedic management in a patient diagnosed with plaque psoriasis. The treatment protocol included Deepana-Pachana, Virechana Karma, followed by Shamana Chikitsa with appropriate internal medications and external applications. Significant improvement was observed in scaling, erythema, itching, and extent of lesions after the treatment period. Reduction in PASI score and symptomatic relief indicated the beneficial role of Ayurvedic management in plaque psoriasis.