Clinical Efficacy of Shamana and Shodhana Chikitsa in Mandala Kushtha w.s.r. to Psoriasis

Abstract

Psoriasis is a chronic inflammatory skin disorder characterized by erythematous, scaly plaques and recurrent exacerbations. Plaque psoriasis accounts for nearly 90% of cases, and conventional therapies often provide temporary relief with frequent relapse. In Ayurveda, Mandala Kushtha described under Mahakushtha closely resembles plaque psoriasis. Case Presentation: A 27-year-old unmarried female presented with erythematous to hyperpigmented scaly lesions over the limbs, trunk, and scalp associated with itching, dryness, and occasional burning sensation. Chronic scalp scaling and nail discoloration had been present for nearly twelve years. Previous intermittent topical steroid therapy provided only temporary relief. Intervention: The patient was managed with classical Ayurvedic treatment, including Shamana Chikitsa followed by Shodhana Chikitsa in the form of Vamana and Virechana Karma after appropriate Purvakarma. Outcome: A significant reduction in lesions, itching, scaling, and PASI score was observed, with no relapse during follow-up. Conclusion: This case demonstrates that Ayurvedic management with combined Shamana and Shodhana Chikitsa may provide significant clinical improvement in Mandala Kushtha w.s.r. to psoriasis.