

































 

 

First page  

1st Author name:-  

Dr Nandadeep V Chodankar 

Assistant Professor in department of Kayachikitsa 

RJVS Bhaisaheb Sawant Ayurved Mahavidyala, Sawantwadi, Maharastra. 

Email Id- dr.chodankar@gmail.com 

 

Address for correspondence:- 

Dr Nandadeep V Chodankar 

F 129 salaiwada, 

Panchayat samitti Road  

Sawantwadi, District- Sindhudurga 

Pin code- 416510 

Email Id- dr.chodankar@gmail.com 

 

2nd Author 

Dr Subodhan Kashalikar 

General Practitioner at Sawantwadi 

Email Id:-drsubodhan@gmail.com 

 

3rd Author 

Prajkta Gajanan Chaudhari 

Intern Doctor at R.J.V.S. Hospital, Sawantwadi. 

Email Id:- prajktachaudhari799@gmail.com 

 

4th Author 

Smita Nathilal Tiwari 

Intern Doctor at R.J.V.S. Hospital, Sawantwadi. 

Email Id:-Smitatiwari1998@gmail.com 

 

5th Author 

Dr Akbar R Walandkar 

Professor and HOD Shalyatantra 

Hon Shri Annasaheb Dange Ayurved Medical Collage, Ashta. 

Email Id- akbar.walandkar@gmail.com 

 

 

 

 

 

 

 

mailto:dr.chodankar@gmail.com
mailto:dr.chodankar@gmail.com
mailto:drsubodhan@gmail.com
mailto:Smitatiwari1998@gmail.com
mailto:akbar.walandkar@gmail.com


 

 

MANAGEMENT OF PSORIASIS (EKAKUSHTHA) ACCORDING TO AYURVEDIC PATHO-

PHYSIOLOGY:-A CASE STUDY 

 

ABSTRACT- 

Immune response of a human body to the uncertain factors leads to the accelerated inflammatory 

proliferation of the ailing cells of the skin known as psoriasis. Although the condition found described 

many decades ago, the etiology and treatment look under-researched. In Ayurveda many herbs have 

proven efficacy in psoriasis, but multifaceted etiology of the disease needs a multimodal treatment 

approach. We report about ayurveda treatment in 62 yrs old male patient with plaque psoriasis presented 

with erythematous patches. On the anterior surface of legs, hands, back of foot sole. The treatment 

protocol was adopted as per ayurvedic samprapti (pathophysiology) and patient was cured completely 

without reporting any adverse event or recurrence after the 6 month of therapy. 

INTRODUCTION- 

Psoriasis is a chronic immune-mediated inflammatory condition mainly affecting the skin and joints. Its 

prevalence in India is about 0.44-2.8 percent. Males are being affected by psoriasis two times more 

common than female1. Various sites of the body such as scalp, face, trunk, limbs, palms and soles involve 

in psoriasis. The diagnosis of psoriasis depends on tissue biopsy and distribution of skin damage. Plaque 

psoriasis (psoriasis vulgaris), Inverse psoriasis, Gutlate psoriasis, Pustular psoriasis And erythrodermic 

psoriasis are a few of the clinical patterns, reported in psoriasis cases2. The chronic nature, recurring 

pattern, and visibility of psoriasis produce a great adverse impact on the psychological and social aspects 

of patient’s life. Psychological disability affects their daily work, as well as social interactions. In recent 

studies, stress is found to be the important leading cause of psoriasis. In Ayurveda, all skin diseaseare 

described under the umbrella of kushta. Ekakushta is one of the kshudrakushta describe in Ayurvedic text. 

In charak Samhita chikitsasthan(chap.7)3,Ekakushta is described as vat-kaphaj disease. Ekakushta4 has 

signs and symptoms i.e.aswedanam(absence of sweating), mahavastu (big size lesions) and 

matsyashaklopaman(scaling) which can be compared with psoriasis. As in Ayurveda, Ekakushta is 

mention as krucchasadhya (difficult to treat). As in Modern medicine, the treatment approach is 

symptomatic and not focus to the root cause. So it leads to reaggravation of symptoms in favorable 

environment. As in Ayurveda our main aim is to focus on root cause of disease. And by destructive the 

root cause we can achieve the fruitful results. Ayuveda has good results in psoriasis. In ayurveda many 

herbs have proven effective in psoriasis; but the multifeatured etiology of disease need a multimodal 

treatment approach, in which Aampachak, Agnidipana, Dhatugatjwarchikitsa, Kushtachikitsa, is adopted. 

In the present case, the multimodal Ayurveda treatment approach resulted in early recovery from psoriatic 

lesion with no recurrence so far. 

AIMS AND OBJECTIVES- 

To evaluate the role of Ayurvedic medicine in management of psoriasis.  

MATERIALS AND METHODS- 

Ayurvedicsamhita 



 

 

Ayurvedic research articles 

Ayurvedic journals 

Official records 

Photographs 

NEED OF STUDY- 

Psoriasis is recurring chronic disease for which it is difficult to treat. 

PLACE OF STUDY- 

The present case study done in department of Kaychikitsa RJVS Sawantwadi, Maharashtra. 

CASE REPORT- 

Information of patient- 

Patients OPD case Number:- 426383 

Age-62 yrs, sex- Male 

Religion- Hindu 

Socioeconomic status- lower class 

Occupation- cobbler 

Diet-mix diet pattern 

PRADHANVEDANA (Present Complaints)- 

Erythematous patches on both hands, legs, back and foot soles -: 3 yrs 

Itching and rashes with scaling on scratchingnodaha 

VARTAMAN VYADHIVRITTA (H/O PRESENT ILLNESS)- 

The patient was symptomatic before 3 yrs after that he developed complain of scaly rashes on his back 

and which gradually progressed and involved his both upper and lower extremities at anterior aspect of 

leg along with itching and scaling after scratching. He took allopathic medicine for 2 yrs, which provided 

symptomatic relief till treatment continues. On discontinuation of the treatment, again the symptoms 

aggravated. 

PURVAVYADHIVRITTA (HISTORY OF PAST ILLNESS)- 

Patient has no significant past history of any chronic illness. 

KULAJVRITTA (FAMILY HISTORY)- 



 

 

No any history. 

VYAKTIKA VRITTA (PERSONAL HISTORY)- 

Appetite was low. 

Predominant rasa in aahara was madhur, milk products, fish, excess drinking of water. 

sleep was disturbed due to itching. 

ON EXAMINATION- 

General condition was fair and afebrile 

vitals were normal 

S/E- 

CVS- S1S2 normal 

RS- AEBE clear 

CNS- NAD 

INVESTIGATIONS- 

General investigations like CBC, BSL, URINE ROUTINE AND MICROSCOPIC were completely under 

normal values. 

ASTHAVIDHA PARIKSHA- 

NADI-kaphaditridoshaj 

MUTRA-frequency and colour within normal range with no “daha” 

MALA-normal 

JIVHA-sama 

SHABDA-clear and fluent 

SPARSHA-Ruksha 

DRIK- H/O using spectacles since 20 yrs. 

AAKRITI- sthool 

LOCAL EXAMINATION- 

INSPECTION- 

-Scaly lesions present on back, both hands and legs 



 

 

-They were symmetrical and well demarcated. 

COLOUR- 

Initially it was reddish in appearance which by time changes to blackish. 

PROGRESSION- Slow 

DURATION- 

It increases in winter and hot climate. 

-AUSPITZ SIGN28- Present 

(appearance of small bleeding points after successive layers of scale have been removed from the surface 

of psoriatic papules or plaques) 

-CANDLE GREASE SIGN28- Present 

(when scratched, psoriatic scales fall off, revealing a shiny candle like surface) 

 

DIAGNOSIS-EKAKUSHTA (PSORIASIS) 

As per ayurvedic text, the symptoms of Ekakushta are 

Aswedanam 

Mahavastu 

Matsyashakalopaman 

SIGNS AND SYMPTOMS- 

1. Aswedanam(absence of sweat) - present at scaly region 

2. Mahavastu (big size legion) - Present 

3. Matsyashakalopaman(scaling)-Present 

4. Candle grease sign- Present 

5. Auspitz’s sign- Present 

NIDANPANCHAK- 

NIDAN- 

Viruddhaaaharsevaan27 - (simultaneous use of milk and milk product and fish) 

Raktadushtikaraahar and vihar 



 

 

Excessive use of salty food, curd, butter milk, sleeping after lunch 

SAMPRAPTI- 

Dosha- pitta, kapha, rakta 

Dushya- rasadhatu, raktadhatu, mansadhatu 

Agni- mand 

Aama- jatharagni and dhatwagnijanya 

Strotas- rasavaha, raktavaha, mansavaha 

Adhisthan- twaka 

Rogmarg- bahya 

Vyadhiswabhava- chirkari (Chronic) 

Sadhyasadhyatva- krucchasadhya(difficult to treat) 

TREATMENT AND OBSERVATION- 

1ST VISIT- 

Table 1.1 (Treatment given on first visit) 

 FORMULATION DOSE TIME  ANUPANA DURATION 
 1.Kumariaasav+paripathadi kadha 15ml 

(1:1) 
M/E 
6am/6pm 

Koshnajala(luke 
warm water) 

2 weeks 

 2.Rasapachak 
(kalinga, patol, katukarohini)equal proportion 

250 mg BL/BD 
 

Koshnajala(luke 
warm water) 

2 weeks 

 3.Gokshuradi guggulu 
 

250 mg 8am/8pm  
Dhanyakphanta 

2 weeks 

 4. Shwetkutajsiddataila 
 

L/A Morning 
after bath 

- 2 weeks 

 5. Udwartana (Yashtimadhu+ 
Sariva+Vacha+Haridra+Manjishta) 

L/A Before bath - 2 weeks 

 

2nd visit- 

Observation seen:- 

Reduction in Dryness of skin, 

Agni- Agnivriddhi(Appetite increases);  

Jivha- Niram 

Table 1.2 (Treatment given on second visit) 



 

 

 FORMULATION DOSE TIME ANUPANA DURATION 

 1.Kumariaasav+paripathadi kadha 10 ML M/E 
6am/6pm 

Koshnajal 2 weeks 

 2. Raktapachak 250 mg BL/BD 
 

Koshnajal 2 weeks 

 3.Gokshuradi guggulu 
 

250 mg 8am/8pm Dhanyakphanta 2 weeks 

 4. Haridrakhandapak 2 tsp AL/AD  2 weeks 

 5. Udwartana (Yashtimadhu+ 
Sariva+Vacha+Haridra+Manjishta) 

L/A Morning 
before bath 

 2 weeks 
 

 6.Shwetkutajsiddataila L/A Morning 
after bath 

 2 weeks 

  

3rdvisit:- 

Observation seen:- 

kandureduced,dryness of skin reduced,  

scaly patches on elbow region decreased. 

Table 1.3 (Treatment given on third visit) 

 FORMULATION DOSE TIME ANUPANA DURATION 
1 Paripathadikadha 10 ML 6am/6pm Water 2 weeks 
2 Raktapachaka 250 mg BL/BD Koshnajala(luke 

warm water) 
2 weeks  

3 Udwartana 
(Yashtimadhu+ 
Sariva+Vacha+Haridr
a+Manjishta) 

L/A At the time of  
bath 

   - 2 weeks 

4 Shwetkutajsiddataila L/A After bath  2 weeks 
5 Haridrakhandapaka 2 tsp BL/BD  2 weeks 
4 th visit-  

Observation seen:- 

blakish discoloration on patches start changing to reddish, 

patch on Right leg reduced in size  

Table 1.4 (Treatment given on fourth visit) 

 FORMULATION DOSE TIME ANUPANA DURATION 
1. Raktapachak 250mg  Before Koshnjal(luke 2 weeks  



 

 

 

5th visit-  

Observation seen:- 

patches present on both hand and back reduced significantly, 

scale formation on both soles reduces  

Table 1.5 (Treatment given on fifth visit) 

 FORMULATION DOSE TIME ANUPANA DURATION 
1. Manshapachak 250 mg Before lunch/ Before 

dinner 
Koshnjal(luke 
warm water) 

2 weeks  

2. Dwipantarvacha 30 mg Morning/evening 2 tsp milk 2 weeks  
3. Udwartana 

(Yashtimadhu+ 
Sariva+Vacha+Harid
ra+Manjishta) 

L/A At the time of bath - 2 weeks  

4. shwetktajsidda 
Taila 
 

L/A After bath - 2 weeks  

 

 

6th visit- 

Observation seen:- 

scale formation on both soles start reducing with formation of healthy skin  

Table 1.6 (Treatment given on sixth visit) 

 FORMULATION DOSE TIME ANUPANA DURATION 
1. 1.Manshapachak 250 mg Before lunch/ Before 

dinner 
Koshnjal(luke 
warm water) 

2 weeks  

2. 2.Dwipantar vacha 30 mg Morning/evening 2 tsp milk 2 weeks  
3. 3.Udvartana L/A At the time of bath - 2 weeks  

lunch / 
before 
dinner  

warm water) 

2. Haridrakhand 2tsp  After lunch 
/ after 
dinner  

Koshnjal(luke 
warm water) 

2 weeks 

3. Shwetkutajsiddataila 
 

L/A After bath -  
2 weeks  

4. Udwartana (Yashtimadhu+ 
Sariva+Vacha+Haridra+Manjishta) 

L/A  At the time 
of  bath 

- 2 weeks  



 

 

4. 4.shwetktaj sidda 
 
Taila 

L/A After bath - 2 weeks  

  

7th visit- 

Observation seen:- 

After healing of all patches, 

discolouration of skin were there and preventing the recurrence of disease following medication 

given.  

Table 1.5 (Treatment given on fifth visit) 

 FORMULATION DOSE TIME ANUPANA DURATION 
 1.Laghumanjishtadi 

kadha 
10 ml Morning/evening water 1 month 

 
 2.Haridra siddha taila L/A At night - 1month 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

Before treatment - 

 

 

 

 



 

 

After treatment- 

 

 
 

 

 

 

 

 



 

 

DISCUSSION- 

In the present case, pitta, kapha and rakta were the doshas and rasadhatu, raktadhatu, mansadhatu were 

the dushya.Doshadushyasamurchana was taken place due to the circulation of vitiated doshas and their 

sthanashanshraya at twaka with clinical presentation of vyadhilakshana. The treatment protocol was 

adopted for sampraptibhedana(to counter act the the pathophysiology). Where, pitta-kaphara, 

kushtaghana, kledanashak, aushadiyogas were performed. Alsoagnidipana,raktaprasadaka, 

rasaprasadaka were achieved with the help of all internal and external medicine. The treatment protocol 

was adopted for sampraptibhedana(to counter act the pathophysiology and dhatwagnivardhan). 

The intake of viruddhaaahara is one of the important causative factors in the etiopathogenesis of skin 

disease. The patient was told to avoid viruddhaaahara for better treatment response, speedy recovery and 

to avert the recurrence in chronic skin ailments. The ongoing pathological changes were attenuated and 

corrected following internal medications such as Kumriaasav, Paripathadikwath,Rasapachaka, 

Gokshuradiguggulu, Upatana, Shwetkuttaj siddha narikeltaila, Haridrakhandapaka, Dwipantervacha, 

Raktapachaka, Mansapachaka, Laghumanjishtadikwath and Hridra siddha taila. 

1st visit-   (Table 1.1) 

1. Kumariaasava +Paripathadikwath- 

As in kumariaasava9, the main content is kumari(Aloe vera tourn) having tikta rasa, katuvipaka and 

sitavirya. It mainly workon liver which is an important organ for normal functioning of pitta dosha and 

raktadhatu. It improves appetite and aids in digestion due to aamapachakaand jatharagnivardhaka 

properties. Also work as rechak. 

2. Paripathadikadha- 

In paripathadikadha the main content is paripatha(fumaria officinalis)20 having tikta rasa, 

ushnavirya,katuvipaka. It mainly reduces the excess heat present in the body especially in Rakta dhatu 

and also having the properties of vishaghna help in exfoliation of chronic dosha from body and maintain 

the anushanaguna of rakta dhatu. In combination with kumariaasavait work as dosha nashak and 

pittarechaka and by giving it empty stomach at kapha kala the effect of medicine occur faster. 

3.GOKSHURADI GUGGULU- 

 As gokshur(tribulus terrestris)16 comes under MutravirechakGana and work as kledakanashaka, Saraka, 

Bastishodhak with help of this properties. It help in exfoliation of kledafrom Mutra marg which is the 

faster and easiest passage to remove kleda from body. Gokshuradiguggulu with anupana of 

Dhanyakphant(Coridandrum Sativum) help in reducing the ushnagunadharma( heat) from body. 

4. RASAPACHAKA10- 

As according to pathophysiology patient having symptoms of agnimandya which leads vikrutito 

uttarakthordhatu utpatti and cause dhatwagnimandya. 

Rasapachaka contain kalinga(Holarrhena Antidysentrica)(9) Patola(Tricossanthes diociaroxb) 

Katurohini, Nimbapatra(Azardiracehta Indica)(26) 



 

 

As, we know this kalpa is use in Dhatugatjwar where, dosha mainly affecting Rasadhatuand cause 

Rasadhatwagnimandya(slow) leads to vikrut (Inapropriate) dhatu utpatti. As said by Aacharya. 

By correcting dhatuagni we can exfoliate the dosha out of the body. Top layer of skin is 

upadhatu(superior by product) of Rasadhatu. Considering that rasapachakwas given.  Kalinga reduces 

dravata,  Patola as Ushnatanashak(heat decreasing). Kutkiremovesdosha through mala( Defication). 

Nimbaworks as Krumighna and Vishagna. 

5.SHWETKUTAJSIDDA TAILA- 

Aacharyacharak has mentioned kutaj(Holarrhena Antidysentrica)9 in kandughnaGana. It is tikta in Rasa, 

katuVipaka and sitavirya work as vranshodhak and vranropan, kushtagna and pittasarak in nature. It is 

prescribe for external use in which coconutoil has processed with shwetkutaj. As shwetkutajsiddataila 

retards Hyperkeratinisation, silvery scales, inflamematory response, reduce exfoliation. It prevents itching 

and formation of scales and sores;  

Coconut oil improves symptoms of skin disorders by its moisturizing, soothing and emollient effects. 

6. UDVARTAN- 

In psoriasis, already the skin is dry with scale formation, on application of soap and chemical products ; it 

increase the dryness by replacing soap with udvartandravya which are Sariva(Hemidesmus Indicus)13, 

Manjishth(Rubia cordifolia)12, Yashtimadhu(Glycyrriza glabra)22, Lodhra(Symlocos Racemola roxb)21 , 

Vacha(acours calmus)14 comes under KushtagnaGana Maintain kanti(texture) of varnya (apperence) of 

skin. 

2nd visit-  (Table1.2) 

As patient has complain of kandu (itching) on patches. Haridrakhandwere added. 

HARIDRAKHANDAPAK- 

The main content is Haridra(Curcuma Longa)17. AacharyaCharak has mentioned Haridra in kushtaghna, 

kandughnaGana and AacharyaSushrut has mention it in shleshmashanshamana..Haridra is tikta ,katu in 

Rasa with ushnavirya. On internal use of Haridrakhand. It work as kaphaghna and 

kandughnawithpittarechaka and krumighna. 

3rdvisit-   (Table1.3) 

As discoloration of patches which are blackish color reduces. Raktapachak is added. 

RAKTAPACHAk10-  containsPato(Trichsanthes diocia), Sariva(Hemidesmus indicus)13, Musta(Cyperus 

rotundus), Kutaki(Picrorhiza kurrooa), Patha(Cissamplelos pareira)20 

This drug mainly work on Raktadhatu by exfoliating dosha and increasing Dhatu agni, which helps in 

formation of prakrutRaktadhatu. 

 



 

 

4th visit-    (Table1.4) 

As patient having good effects with no any other complain. The same medication is continues for 2 

weeks. 

5th visit-    (Table 1.5) 

MANSHAPACHAK10- 

As dosha were reach till mansadhatu.Mansdhatudushti was there to correct the dhatuagnimanshpachak 

were given which are- Patol(Trichosanthes dioica),Nimba(azadiracehta indica), Manuka(Vitis vinifera), 

Musta(Cyperus rotundus),Kutaj(Holarrhena antidysentrica) , Triphala-Haritaki(Terminelia 

chebula),Aamlki(Embilica offcinalis),Bibhitaki(Terminalia bellirica). 

DWIPANTERVACHA11-  

Dwipantervacha (Smilex china) works on Rasa-Rakta-Mansa dhatu.  If any kstrav( secretion) is present 

on patches. It helps in reducing and helps in fast healing of patches. 

6th visit – as patient having good recovery,continue the pervious treatment for next 2 weeks  

7thVisit-  (Table1.7)      

As psoriasis is relapsing disease to reduce the recurrence, Laghumanjishthadikadha5is continue for next 1 

month, which work as Raktaprasadaka. As after healing of psoriasis patch, discolouration of skin were 

there to make even tone of skin Haridra17siddataila was given for local application which act as varnya. 

 

 

CONCLUSION- 

In present case, the treatment protocolwere adopted as per Ayurvedic sampraptiand the treatment 

response was observed much earlier as compared to previous allopathic treatment. No recurrence reported 

after the end of active treatment. The importance of a wholesome diet as a health promoter is also 

revalidated. The external and internal medications of Ayurveda help to correct the complex patho-

physiology of psoriasis like chronic disease. Altogether, multimodal Ayurveda treatment lead to speedy 

substantial recovery from a chronic case of psoriasis. 

 

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