Case report · K U S H T H A
Role of Ayurvedic Polyherbal Formulations & Dietary Regimen in Psoriasis
Dr. Ankur Kumar Tanwar
M.D. (Ayu.), Ph.D. (Ayu.)
Senior Ayurveda Consultant · Contact: 9250868756
Explore this case study on the role of Ayurvedic polyherbal formulations and dietary management in psoriasis, highlighting the treatment approach and clinical observations.
Case Report · I N T E G R A T I V E A Y U R V E D A
Integrative Ayurvedic Approach to Refractory Cystic Acne: A Case Report
Dr. Mansi Mathur
Assistant Professor, Department of Roga Nidana evum Vikriti Vigyan Shree Ram Ayurvedic Medical College and Hospital, Meerut
Discover a case report exploring an integrative Ayurvedic approach using Ojurra Capsule as an adjunct in refractory cystic acne, with a focus on immunological and inflammatory marker correlations.
Role of Ayurvedic Polyherbal Formulations and Dietary Regimen in the Management of Psoriasis: A Case Study
Dr. Ankur Kumar Tanwar
M.D. (Ayu.), Ph.D. (Ayu.)
Senior Ayurveda Consultant · Contact: 9250868756
CONDITION
Psoriasis (Ekakushta)
PATIENT
42-year-old male, 20-year
history
APPROACH
Two-phase oral polyherbal
regimen, local oil, diet &
lifestyle
OUTCOME
~60% subsidence by day 20;
70–75% relief at one further
month
Psoriasis is a chronic dermatosis characterised by an unpredictable course of remission and relapse. It is a non-infectious skin disease characterised by scaly, silvery patches, mainly on the scalp and extensor surfaces of the body. The exact cause remains unknown. In Ayurveda, it closely resembles Ekakushtha, whose features described in the classics resemble the symptoms of psoriasis — a challenge for modern medicine. The drugs available for treating psoriasis are not very effective and have both local and systemic effects.
In Ayurveda, Vata, Pitta and Kapha Dosha are the main contributory factors; the disease manifests due to vitiation of the three Doshas, and the main line of treatment is Panchakarma and internal medicine. This article presents a case of a 42-year-old male with well-demarcated red, scaly, silvery patches mainly on both legs, hands, scalp, chest and back, with itching, and nail and joint involvement.
Background
ETIOLOGY
Unknown, but many factors have been associated:
Genetic: May be autosomal dominant.
Triggers: Physical trauma, infection and drugs.
Biochemical: Increased arachidonic acid and cyclic guanosine monophosphate (cGMP).
Immunological: Helper T cells.
EPIDEMIOLOGY
Approximately 1% of the population is affected; it can occur at any age and in both sexes. Most patients are worse in winter. Approximately 7 million people are affected in developed countries.
HISTOPATHOGENESIS
Increased epidermal cell proliferation.
Retention of nuclei in the stratum corneum.
Fibroblast proliferation.
Dilated and tortuous capillary loops.
Epidermal turnover shortened from the normal 60 days to 10 days.
CLINICAL FEATURES
Usually chronic indolent lesions that persist for months — mildly papular or plaque-like, erythematous plaques with characteristic silvery, large, loose scales. Patients may also experience depression and low self-esteem.
Sites: Scalp, pressure points and extensor surfaces; sometimes generalised. Nail and joint involvement should always be checked:
Nail (10–15% of patients): Pitting, nail plate thickening, subungual debris, discolouration and oil spots.
Joints (about 10% of patients).
Chronic recurrent psoriasis is difficult to treat; modern science uses PUVA and corticosteroids, which carry local and systemic side effects, including liver and kidney failure. It is therefore time to look for an effective and safe treatment. Medicines used in Ayurveda have been practised for many years, and a large number of drugs are prescribed for Kushtha.
Case Details
A 42-year-old male patient presented on 10 April 2016 with well-demarcated, raised, scaly, silvery patches on the chest, back, both legs and hands. He complained of itching all over the body; on scraping, white powder-like scales fell off, leaving a bleeding surface. Diagnosed with psoriasis by an allopathic physician, he had had the complaints for 20 years and taken allopathic and homeopathic medicines from various practitioners in U.P. and Delhi without relief.
He is a Brahmin who lives in a well-known temple in Delhi and visits homes for religious ceremonies. He feared that, as the disease continued to spread, he would be unable to work as a priest because people neglected him due to the disease. The disease was spreading over the body, involving nails and joints, with destruction of the nail plates of the hands and legs.
As the patient had lost trust after 20 years of unresolved illness, we first provided counselling, because reassurance and emotional support are invaluable; physical and mental rest enhance treatment effects. It is also important to inform patients that the disease is not contagious and is benign.
PRESENTING SYMPTOMS
Itching all over the body.
Silvery patches on the legs, chest and back, now spreading to the hands and scalp.
Destruction of the nail plates.
Swelling and pain in the left middle finger, with flexor deformity at the proximal interphalangeal joint.
Swelling and pain in the right middle metatarsophalangeal joint.
PRESENTING SYMPTOMS
CBC, LFT, KFT and serum uric acid were performed to rule out other pathologies; all were within normal limits. The patient was in good general health. Panchakarma along with oral medication was advised, but the patient refused, so internal medication was started.
Internal Medication
The medications were administered in two phases (table). In the first phase, a remarkable result was observed after five days: the rashes that had developed within the previous 4 to 5 months disappeared, and other rashes also subsided.
The patient returned on the 20th day with great results: rashes had almost subsided by 60%, and pain and swelling in the finger and ankle had reduced to a great extent. He was no longer taking any painkillers, and the nails of his legs had also improved. The same medicines were prescribed for one month along with physiotherapy for the finger deformity. After that, the patient reported 70–75% relief in symptoms and no additional rash during treatment. Dietary changes and living according to the rules of Ayurveda were also advised.
PHASE
FORMULATION
DOSE / ANUPANA
PURPOSE / NOTE
PHASE I — 5 DAYS
Oral
Panchsakar Churna
1 spoon, twice daily
Anulomana, Pachana
Panchnimba Churna
1 spoon, twice daily, with lukewarm water
Panchatikta Ghrita Guggulu
2 tablets, twice daily
Local
Oil containing Jyotishmati, Bakuchi, Chakramarda
Local application, legs only, for 5 days
PHASE II — AFTER DAY 5, FOR 15 DAYS
Continued
Same treatment as Phase I
Added
Haridra Khanda
1 spoon, twice daily
Guggulu Tikta Kashaya
3 spoons, twice daily, one hour before food
CLINICAL PHOTOGRAPHS
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Results
Psoriasis is a disease of unknown etiology triggered by many factors, and its treatment is challenging in modern science. Ayurvedic treatment provided satisfactory results and improved the patient’s quality of life. Ayurveda removes toxins from the body and corrects Aama formation, and offers both prevention and treatment. By following dietary and lifestyle changes, the recurrence of the disease can be prevented.
Discussion
This case demonstrates that Ayurvedic polyherbal formulations combined with dietary and lifestyle modifications can provide significant symptomatic relief in chronic psoriasis, a condition with limited effective treatments in modern medicine. The two-phase oral regimen with localised oil application resulted in a marked reduction of lesions, itching and joint symptoms within 20 days, highlighting the potential of Ayurveda to manage both cutaneous and systemic manifestations.
The treatment’s focus on balancing Doshas, removing toxins and correcting Aama formation aligns with Ayurvedic principles and addresses psoriasis holistically. Patient counselling and reassurance also played a crucial role in adherence and psychological well-being.
CONCLUSION
This case demonstrates that Ayurvedic polyherbal formulations combined with dietary and lifestyle modifications can provide significant symptomatic relief in chronic psoriasis, a condition with limited effective treatments in modern medicine. The two-phase oral regimen with localised oil application resulted in a marked reduction of lesions, itching and joint symptoms within 20 days, highlighting the potential of Ayurveda to manage both cutaneous and systemic manifestations.
The treatment’s focus on balancing Doshas, removing toxins and correcting Aama formation aligns with Ayurvedic principles and addresses psoriasis holistically. Patient counselling and reassurance also played a crucial role in adherence and psychological well-being.
Integrative Ayurvedic Approach with Ojurra Capsule as an Adjunct in Refractory Cystic Acne: A Case Report with Immunological and Inflammatory Marker Correlation
Dr. Mansi Mathur
Assistant Professor, Department of Roga Nidana evum Vikriti Vigyan
Shree Ram Ayurvedic Medical College and Hospital, Meerut
Case Details(*******)
A 42-year-old male patient presented on 10 April 2016 with well-demarcated, raised, scaly, silvery patches on the chest, back, both legs and hands. He complained of itching all over the body; on scraping, white powder-like scales fell off, leaving a bleeding surface. Diagnosed with psoriasis by an allopathic physician, he had had the complaints for 20 years and taken allopathic and homeopathic medicines from various practitioners in U.P. and Delhi without relief.
He is a Brahmin who lives in a well-known temple in Delhi and visits homes for religious ceremonies. He feared that, as the disease continued to spread, he would be unable to work as a priest because people neglected him due to the disease. The disease was spreading over the body, involving nails and joints, with destruction of the nail plates of the hands and legs.
As the patient had lost trust after 20 years of unresolved illness, we first provided counselling, because reassurance and emotional support are invaluable; physical and mental rest enhance treatment effects. It is also important to inform patients that the disease is not contagious and is benign.
PRESENTING SYMPTOMS
Itching all over the body.
Silvery patches on the legs, chest and back, now spreading to the hands and scalp.
Destruction of the nail plates.
Swelling and pain in the left middle finger, with flexor deformity at the proximal interphalangeal joint.
Swelling and pain in the right middle metatarsophalangeal joint.
PRESENTING SYMPTOMS
CBC, LFT, KFT and serum uric acid were performed to rule out other pathologies; all were within normal limits. The patient was in good general health. Panchakarma along with oral medication was advised, but the patient refused, so internal medication was started.
Internal Medication
The medications were administered in two phases (table). In the first phase, a remarkable result was observed after five days: the rashes that had developed within the previous 4 to 5 months disappeared, and other rashes also subsided.
The patient returned on the 20th day with great results: rashes had almost subsided by 60%, and pain and swelling in the finger and ankle had reduced to a great extent. He was no longer taking any painkillers, and the nails of his legs had also improved. The same medicines were prescribed for one month along with physiotherapy for the finger deformity. After that, the patient reported 70–75% relief in symptoms and no additional rash during treatment. Dietary changes and living according to the rules of Ayurveda were also advised.