E-ISSN:2456-3110

Case Report

Guttate Psoriasis

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 7 JULY
Publisherwww.maharshicharaka.in

Ayurvedic approach to treat Kitibha Kushta (Guttate Psoriasis) - A Case Report

Chandil A1*, Rathor D2, Yadav V3, Meshram R4, Sharma V5
DOI:10.21760/jaims.10.7.45

1* Ayushi Chandil, Post Graduate Scholar, Department of Kayachikitsa, Pt Khushilal Sharma Govt Ayurveda College, Bhopal, Madhya Pradesh, India.

2 Deepak Rathor, Post Graduate Scholar, Department of Kayachikitsa, Pt Khushilal Sharma Govt Ayurveda College, Bhopal, Madhya Pradesh, India.

3 Veenu Yadav, Post Graduate Scholar, Department of Kayachikitsa, Pt Khushilal Sharma Govt Ayurveda College, Bhopal, Madhya Pradesh, India.

4 Rajesh Meshram, Professor, Department of Kayachikitsa, Pt Khushilal Sharma Govt Ayurveda College, Bhopal, Madhya Pradesh, India.

5 Vivek Sharma, Assosiate Professor, Department of Kayachikitsa, Pt Khushilal Sharma Govt Ayurveda College, Bhopal, Madhya Pradesh, India.

Psoriasis is a chronic inflammatory hyperproliferative skin disorder which particularly affects the extensor surfaces & scalp region. Its worldwide prevalence rate is 2% to 3% and in India prevalence rate is between 0.44% to 2.8%. Guttate psoriasis, mentioned in contemporary science, can be compared to Kitibha Kustha based on similar symptoms such as small, red or pink spots (Mandala Utapatti) appearing on the trunk, arms, and legs, scaly or crusty texture, and itching (Kandu) or burning (Daha). Although various treatments are available, they are often associated with side effects and medicine dependency. So, Ayurvedic treatment principle consists of Shodhana and Shamana Chikitsa which can be intervened in the management of Kitibha Kustha. Owing to this a case study comprising of Virechan Karma along with Shamana Aushadhi has been planned in the management of Kitibha Kustha. A 27-year-old male patient presented with symptoms of small red-pinkish patches spreading across the body, along with itching and burning sensation for the past 4 months. The patient visited our hospital and was diagnosed with Kitibha Kustha. Pre- and post-assessment was conducted using the PASI score to evaluate the severity of the condition. PASI score, which reduced from 56.8 to 8.3 after the completion of the therapeutic intervention.

Keywords: Shodhana Chikitsa, Shamana Chikitsa, Guttate Psoriasis, Kitibha Kushtha

Corresponding Author How to Cite this Article To Browse
Ayushi Chandil, Post Graduate Scholar, Department of Kayachikitsa, Pt Khushilal Sharma Govt Ayurveda College, Bhopal, Madhya Pradesh, India.
Email: 		Chandil A, Rathor D, Yadav V, Meshram R, Sharma V, Ayurvedic approach to treat Kitibha Kushta (Guttate Psoriasis) - A Case Report. J Ayu Int Med Sci. 2025;10(7):295-300.
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Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-05-15 2025-05-27 2025-06-07 2025-06-17 2025-06-27
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© 2025 by Chandil A, Rathor D, Yadav V, Meshram R, Sharma V and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2025;10(7)295
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Ayushi C et al. Ayurvedic approach to treat Kitibha Kushta (Guttate Psoriasis)

Introduction

Ayurveda, an ancient Indian system of medicine, emphasizes both the prevention and cure of diseases. Among the various disorders mentioned in Ayurvedic texts, Kitibha Kushtha is one of the subtypes of Kushtha and is closely correlated with psoriasis in modern medicine.

According to Acharya Sushruta, Kushtha is classified under Aupasargika Roga (contagious diseases). The root cause of most disorders in Ayurveda, including Kitibha Kushtha, is attributed to Agnimandya (digestive impairment), which arises from improper diet and lifestyle.

Psoriasis is a chronic, inflammatory, hyperproliferative skin disorder characterized by well-defined, erythematous, scaly plaques that predominantly affect the extensor surfaces and scalp.[1] It affects both sexes equally and can occur at any age. The etiology of psoriasis is multifactorial, involving genetic predisposition, environmental triggers, and psychological stress.[2] Like any Kushta, Kitibha Kushta is caused due to vitiation of Tridoshas but there is a predominance of Vata and Kapha.[3] Factors like Mithyaahara and Vihara vitiates Tridosha which leads to aggravation of Rasa, Rakta, Mamsa and Lasika. These seven entities viz. Tridosha, Rasa, Rakta, Mamsa, Lasika are called as the Sapta Dravya Sangraha (seven morbid factors) of Kushta.[4] Kitibha Kustha having Lakshanas like Shyava, Kina, Khara Sparsha and Parusha.[5]

In Ayurveda, Shodhana Chikitsa (purification therapy) is considered one of the most effective treatments for Kitibha Kushth.[6] This therapeutic approach aims to eliminate vitiated Doshas from the body, thereby alleviating symptoms and preventing disease progression. Additionally, Shamana Chikitsa (palliative therapy) and adherence to Pathya-Apathya (dietary and lifestyle guidelines) play a crucial role in holistic management.

Case Report

Patient Details:

  • Name: ABC (Anonymized for confidentiality)
  • Age: 27 years
  • Gender: Male
  • Occupation: Farmer

Chief Complaints

1. Small, red-pinkish patches (Mandala Utapatti) observed on the scalp, hands, and abdominal regions, with drop-shaped lesions progressively spreading across the trunk over the past four months.

2. Intense itching (Kandu) localized to the lesions, exacerbated by exposure to wind.

3. Burning sensation (Daha) experienced at the site of the lesions.

Ashtavidha Pariksha

  • Nadi (Pulse): 78 beats/min
  • Shabda (Voice): Prakruta (Normal)
  • Mala (Stool): Samyaka (Normal)
  • Sparsha (Skin Texture): Ushna (Warm)
  • Mutra (Urine): Samyaka (Normal)
  • Druka (Eyes): Prakruta (Normal)
  • Jivha (Tongue): Sama (Coated)
  • Akruti (Body Build): Madhyam (Moderate)

General Examination

  • Pulse Rate (PR): 78 beats/min
  • Blood Pressure (BP): 110/78 mmHg

Personal History

  • Daily Routine (Dinacharya):
  • Wakes up at approximately 6:00 AM
  • Experiences Ratrijagarana (late-night awakenings) and late sleep patterns
  • High stress levels
  • Dietary habits include consuming Ruksha (dry), spicy, and fast foods

Present Medical History

The patient reported being in good health until four months ago when he began experiencing small, red, blister-like lesions over the abdomen and back, accompanied by itching. Over time, these lesions spread across the trunk and hands, with increasing pruritus, followed by a burning sensation. The patient sought treatment with allopathic medications but found them unsatisfactory, prompting his visit to the dermatology outpatient department of our hospital for further evaluation and management.


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Ayushi C et al. Ayurvedic approach to treat Kitibha Kushta (Guttate Psoriasis)

This report highlights the detailed clinical profile of a patient with features suggestive of Kitibha Kushtha (Ayurvedic correlation) or guttate psoriasis (modern dermatological correlation).

Skin Examination

A. Inspection

  • Size and Shape: Lesions range from 0.8 mm to 11 mm in diameter, distributed across the abdomen, chest, back, and both upper limbs.
  • Color: Red
  • Thickness:8 to 1.2 mm
  • Lesion Type: Small, blister-like red lesions

B. Palpation

  • Moisture: Dry
  • Temperature: Warm to touch.
  • Texture: Rough and scaly, with dandruff-like scaling on the lesions.

Diagnosis:

  • Kitibha Kushtha (Ayurvedic diagnosis) or guttate psoriasis (modern correlation).
  • The diagnosis is based on clinical features, including small, drop-shaped, scaly spots predominantly observed on the trunk, scalp, hands, and abdomen.[7]

Management

Shodhana Chikitsa

Table 1: Shodhan Chikitsa - Purvakarma, Pradhankarma and Paschat Karma

ProcedureMedicineDoseDurationRoute
Deepan, PachanLahashunadi Vati and
Panchakola Phanta		tablet, three times daily (TDS).
And
10 ml, twice daily (BD).		3 days.Oral
SnehapanaPanchatikta Ghrita[8]Starting from 30 ml in increasing order up to 150ml (empty stomach at morning time with luke warm water)5 daysOral
Sarvang Abhyang F/B SwedanBala oilQuantity sufficientFor 3 days (After completion of 5 days of Snehapana)External application
Virechan(F/B Sansarjan Karma for 5 days)Draksha, Arghwadha, Haritaki, Katuki, Trivritta Kwath120 ml Kwath with 100ml Eranda tail.For 1 day after following Purvakarma procedureOral

According to Charaka Samhita (Kustha Adhyaya), the management of Kustha involves both Shodhana (purification therapy) and Shamana Chikitsa (palliative therapy). The patient was initiated on a combination of these therapies.

1. Snehapana (internal oleation therapy) is recommended by Acharyas for the management of Vataj Kushtha.

2. The patient underwent this therapy to prepare the body for Shodhana Chikitsa.

Table 2: Shamana Chikitsa (Palliative Treatment)

SNMedicineDoseAdministrationAnupana
1.Arogyavardhini Vati500mg BDAdhobhaktaUshnodaka
2.Gandhaka Rasayana125mg BDAdhobhaktaUshnodaka
3.Dushivishari Agada125mg BDAdhobhaktaUshnodaka
4.Sarivadyasava40ml BDPurva Bhakta-
5.Bruhata Marichyadi TailLocal application, quantity sufficient (Q.S.)Applied topically at night-

Patient Follow-Up

The patient was monitored on the 13th, 16th, and 18th days of treatment. Progressive improvement in symptoms was observed during each follow-up visit.

Observations and Results

The improvement of condition of the patient was assessed on the basis of PASI scale*

Before treatment

Head and neckArmsTrunkLegs
Redness4444
Thickening4334
Scaling3433
Skin area involved50-69%70-89%70-89%90-100%

Total PASI Score: 56.8

After 3 months

Head and neckArmsTrunkLegs
Redness0001
Thickening1122
Scaling1212
Skin area involved<10%10-29%10-29%10-29%

Total PASI Score: 8.3


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Ayushi C et al. Ayurvedic approach to treat Kitibha Kushta (Guttate Psoriasis)

jaims_4431_01.JPG
Figure 1: Before Treatment

jaims_4431_02.JPG
Figure 2: After Virechan

jaims_4431_03.JPG
Figure 3: After Treatment

Discussion

This study evaluated the effectiveness of Ayurvedic treatment for Kitibha Kushtha (guttate psoriasis) using observations recorded before and after treatment based on the PASI (Psoriasis Area and Severity Index) scale. The patient showed significant improvement, with over 85.35% relief from skin patches (Mandala Utapatti) on the scalp, hands, and abdomen, along with marked reduction in associated symptoms such as itching (Kandu) and burning sensation (Daha).

The treatment demonstrated that the disruption of the Samprapti (pathogenesis) of psoriasis/Kitibha Kushtha can be achieved through this Ayurvedic modality. The following aspects of pathogenesis and treatment mechanisms were noted:

Pathogenesis and Role of Doshas

  • Vitiated Pitta Dosha and Dushita Rakta lead to Mandala Utapatti (red, scaly patches) on the skin, which spread due to the aggravation of Vata Dosha.[11]
  • As the disease progresses, Kandu (itching) increases due to the vitiation of Kapha Dosha.
  • The use of therapies with Snigdha Guna (unctuous qualities) is vital in addressing the imbalance in Kitibha Kushtha.

Mechanism of Action of Treatment

1. Abhyantara Snehapana (Internal Oleation):

  • Administered on an empty stomach, Snehapana helps to enhance Agni Vruddhi (improvement in digestive fire) and reduce Vata Prakopa (aggravation).
  • This leads to decreased Mandala Utapatti, Kandu, and Daha.

2. Virechana (Purgation Therapy):

  • Action of Virechan Karma the Virechan Dravyas having properties like Ushna, Tikshna, Sukshma, Vyavayi, Vikasi reaches to the heart due to their potency it enters into the all over Dhamanis and circulates throughout the Sthula and Sukshma Then it does the liquefaction of the Dosha Sanghat due to its Agneya Guna.
  • The Virechan drug has the Adhobhagahara Prabhav due to the predominance of the Jala and Prithvi Mahabhuta. It does the elimination of the vitiated dosha from the Guda Marga.[9]

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3. Arogyavardhini Vati:

  • This formulation addresses Agnimandya (digestive impairment) and reduces Ama Dosha (toxic undigested metabolic by-products), which are pivotal in the formation of Kushtha.
  • It also prevents Kleda formation, maintaining Dosha Samyata (Dosha balance) and disrupting the pathogenesis (Samprapti) of Kushtha.[10]

4. Gandhaka Rasayana:

  • Bacterial infections are recognized as major triggers for guttate psoriasis.
  • Gandhaka Rasayana has Ushna (hot) and Tikshna (sharp) properties that reduce Kleda and act as an effective antibacterial agent.[11]
  • It is also Kandughna (anti-itching), helping to mitigate Kandu by addressing Vata Dushti.

5. Dushivishari Agada

  • Properties: Anti-poison (Vishahara) by virtue of its Prabhava (specific therapeutic effect).
  • Rakta Shodhana (Blood Purification): Contains predominantly Tikta Rasatmak (bitter-tasting) herbs that purify the blood and address underlying dosha imbalances.

6. Sarivadyasava

  • Properties: Raktashodhaka (Blood Purifier): Detoxifies the blood and removes impurities.
  • Pitta-balancing: Cools the body and manages conditions caused by excess heat.
  • Anti-inflammatory: Reduces inflammation in the skin and body.

7. Bruhata Marichyadi Taila

  • Properties: Antifungal and anti-itching (Kandughna).
  • Therapeutic Use: Provides symptomatic relief in conditions associated with itching and fungal infections.

Conclusion

Psoriasis is a chronic inflammatory disorder influenced by environmental and genetic factors. It is characterized by a relapsing and remitting course.

In Ayurvedic literature, psoriasis can be correlated with Kitibha Kushtha due to the similarity in signs and symptoms.

This case study highlights the efficacy of Shodhana Chikitsa (purification therapy) and Shamana Chikitsa (palliative therapy) in managing Kitibha Kushtha (psoriasis), along with adherence to Pathya (prescribed dietary and lifestyle practices) and avoidance of Apathya (prohibited practices). The treatment regimen resulted in significant improvement in clinical symptoms, including skin lesions, itching, and burning sensation.

References

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