E-ISSN:2456-3110

Case Report

Shaman Chikitsa

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 7 JULY
Publisherwww.maharshicharaka.in

Ayurvedic management of Psoriasis with Shaman Chikitsa in Children - A Case Study

Bhandari M1*, Tewari M2, Dixit R3
DOI:10.21760/jaims.10.7.52

1* Megha Bhandari, Post Graduate Scholar, PG Department of Kaumarbhritya, Rishikul Campus, Haridwar, Uttarakhand Ayurved University, Dehradun, Uttarakhand, India.

2 Mansi Tewari, Post Graduate Scholar, PG Department of Kaumarbhritya, Rishikul Campus, Haridwar, Uttarakhand Ayurved University, Dehradun, Uttarakhand, India.

3 Reena Dixit, Professor, PG Department of Kaumarbhritya, Rishikul Campus, Haridwar, Uttarakhand Ayurved University, Dehradun, Uttarakhand, India.

Introduction: Skin diseases significantly affect a child’s physical and emotional well-being, impacting self-esteem and daily activities. Psoriasis is a prevalent, chronic, immune-mediated inflammatory skin disorder with nearly one-third of cases beginning in childhood. Ek Kushtha, a subtype of Kshudra Kushtha, is caused by the imbalance of Vata and Kapha doshas and resembles psoriasis in its clinical presentation. Since children are in Sukumaravsth, Mridu, and Shaman Ausadhis are used followed by Rasayana Ausadhis to strengthen the body and prevent a recurrence. Ayurveda places significant emphasis on the role of diet and lifestyle management.

Aim and Objectives: The efficacy of Ayurvedic formulations in Ekkushtha addressing underlying imbalances in the body's Dosha.

Patient Information: A 6-year-old girl presented in the Outdoor department of Kaumarbhritya, Rishikul Campus (UAU), Haridwar, Uttarakhand, on 10/4/2023 with complaints of - Red papules and plaques over neck, both legs, umbilicus, and foot region with itching since 1.5 years.

Therapeutic Intervention: The patient was treated with Ayurvedic oral medications and external local applications along with the instructions of Pathya and Apathya for 4 months.

Result: This case report showed that consolidated Ayurvedic modalities gives significant result in patient of Ekkustha.

Conclusion: This case underscores the efficacy of Ayurvedic interventions in managing psoriasis in the paediatric age group by restoring Doshic imbalance and implementing dietary and lifestyle modifications.

Keywords: Ekkustha, Kshudra Kushtha, Rasayana Ausadhis, Apathya, Psoriasis

Corresponding Author How to Cite this Article To Browse
Megha Bhandari, Post Graduate Scholar, PG Department of Kaumarbhritya, Rishikul Campus, Haridwar, Uttarakhand Ayurved University, Dehradun, Uttarakhand, India.
Email: 		Bhandari M, Tewari M, Dixit R, Ayurvedic management of Psoriasis with Shaman Chikitsa in Children - A Case Study. J Ayu Int Med Sci. 2025;10(7):335-340.
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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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None Nil Not required 12.98

© 2025 by Bhandari M, Tewari M, Dixit R 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)335
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Megha B et al. Management of Psoriasis with Shaman Chikitsa in Children

Introduction

Psoriasis is a common papulosquamous condition characterized by well–demarcated, erythematous, scaling papules and plaques. The lesions are covered with fine, silvery, white scales with pinpoint bleeding points revealed on gentle removal of the scales (Auspitz sign).[1] Commonly involved sites are the scalp, upper back, sacral region and extensor surfaces of the extremities, especially the knees and the elbows.[2] The increasing prevalence of dermatological disorders, such as psoriasis, is attributed to multifactorial etiologies including genetic predisposition, environmental factors, and immunological components. In Ayurveda all skin disease has been classified under the broad heading of Kushtha. Acharya Charaka mentioned it in Astahtamahagada. In the classical Ayurvedic literature Kushtha is divided into 2 major forms – Maha Kushtha and Kshudra Kushtha. Viruddha Annapana, excessive intake of Drava, Snigdha and Guru Dravyas, restraining natural urges like vomiting, exercise and heat after eating meal and Ajirna (Ch.chi 7/4).

Acharya Charaka states that Nidana Sevana leads to Tridosha Parakopa. These aggravated Doshas get Ashrayain (lodge) in Twak, Rakta, Mamsa and Ambu, causing Shaithilyata (loss of tone or structural integrity) in these Dhatus, resulting in the manifestation of Kushtha Roga (skin disease). Ek Kushtha, a subtype of Kshudra Kustha, is caused by the imbalance of Vata and Kapha Doshas and resembles psoriasis in its clinical presentation. Clinical manifestation of Ek-kushtha is Aswedana (absence of perspiration), Mahavastu(extensive location), Matsyashakalopam(scaling) (Ch.ch 7/21).

Modern medical science treats psoriasis with PUVA and corticosteroids. In the Samhitas the line of treatment for Kushtha is determined by the patient’s Bala (strength), dosha, and the Vyadhi Avastha (disease condition); accordingly, both Shodhana and Shaman Chikitsa are advocated.

Case Report

A 6-year-old female patient with her mother was brought to the outpatient department of Kaumarbhritya, Rishikul Campus Haridwar, with the complaint of – Red papules and plaques over the neck, both legs, umbilicus, and foot region with itching in the last 1.5 years.

According to the patient's mother, she was asymptomatic before 1.5 years. Then her mother noticed the gradual appearance of rashes over her neck, buttocks, and around the umbilicus with itching and skin scaling which aggravated on taking a non-vegetarian diet and spicy food. She took topical corticosteroid ointment for 1 month but got symptomatic relief.

So, the Patient came to Rishikul Campus on 16th March 2024 for further management. There was no evident family history. She had neither a history of drug allergy, autoimmune disorder, or addiction. Dietary history shows consumption of a non-vegetarian diet.

Baseline Findings: The patient's general condition was average, with the following anthropometry and vitals:

Anthropometry

Weight: 23kg (Expected Wt. :20 kg)
Height: 114cm (Expected Ht. :113cm)
Head Circumference: 53 cm
Chest Circumference: 55 cm
Mid-upper arm circumference: 18 cm (Rt.), 18cm (lt.)

Vitals

Temperature: 98.10°F
Pulse Rate: 86/min
Respiratory Rate: 28/min
SpO2: 95%
Blood pressure: 100/70 mm Hg

On examination, the patient was conscious and well oriented; the cardiovascular, respiratory, and gastrointestinal systems are within normal limits.

Skin Examination:

InspectionFindings
LesionsPlaques
ColourRed
Shape & sizelarge oval - circular
BorderDistinct
PatternGrouped
Other featuresScale present
Candle grease sign +
Auspitz sign +

Clinical Findings

Physical examination - The patient was examined according to Ayurvedic Pariksha, as follows-


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Megha B et al. Management of Psoriasis with Shaman Chikitsa in Children

Ashtavidha Pariksha (eight-fold examination)

Nadi: Vata Pradhana Kapha
Mala: Nirama
Mutra: Samanya Pravritti, Peetabh Varna
Jihwa: Lipta
Shabda: Spashta
Sparsha: Snigdha, Samsheetoshana
Drikka: Samanya
Aakriti: Samanya

Dashavidha Pariksha (ten -fold examination)

Prakriti: Kapha-Vataj
Vikriti: Tridoshaj
Sara: Madhyama
Pramana: Madhyama
Satmya: Madhyama
Satva: Madhyama
Aharashakti: Madhyama
Vyayama Shakti: Avara
Vaya: Balyavastha

Samprapti Ghataka

Dosha: Vata Kapha Pradhana
Dushya: Twacha, Rakta, Mamsa, Lashika
Srotasa: Rasavaha, Raktavaha, Mamsavaha, Swedavaha
Srotodushti: Sanga
Roga Marga: Abhyantara
Udbhavasthana: Aamashya, Pakwashya
Vyaktasthana:Twacha
Rogamarga: Bahya
Agni: Agnimandhya
Vyadhi Swabhava: Chirakari, Yapya

Treatment Protocol

After thorough interrogation with patient and his mother regarding diet, lifestyle, and habits of child and history of present illness, and after proper evaluation regarding present condition of child, treatment was planned with internal medications along with Yoga & Marma therapy.

The patient was assessed at the interval of 15 days for 4 months as follows,

Advice:

1. Increase water intake.
2. Avoid consuming packed and junk food.
3. Follow diet advised (avoid Viruudh Ahara Sevan).
4. Practice regular Yoga: Anuloma-Viloma, Bhramari Pranayama

OPD visitMedicationDuration
First Visit1. Panchtikta Ghrita Guggulu- 65mg
Praval Pishti -65mg
Giloy Satva -65mg
Haridra Khanda -1gm
1*2 with honey bid
2. Mahamanjisthadi Kwath + Khadiraristha - 10ml with 10 ml water bid
3. 777 oil - For LA
4. Cutis soap - For LA		15 days
Second VisitRepeat same Tt.15 days
Third Visit1. Panchtikta Ghritam - 5 ml bid (empty stomach)
2. Mahamanjisthadi Kwath + Khadiraristha -10ml with 10 ml water bid
3. Haridra Khanda -1gm with milk bid
4. Tab Psorogrit - 1 tab od
5. Syp Purodil - 5ml bid
6. 777oil - LA (night time)
7. Lippu oil - LA (day time)
8. Cutis soap - LA		15 days
Fourth VisitRepeat same Tt.15 days
Fifth Visit1. Panchtikta Ghritam - 5 ml bid (empty stomach)
2. Mahamanjisthadi Kwath + Khadiraristha -10ml with 10 ml water bid
3. Haridra Khanda - 1gm with milk bid
4. Tab Psorogrit - 1 tab od
5. 777oil - LA (night time)
6. Lippu oil - LA (day time)
7. Psorolin soap - for bathing		15 days
Sixth VisitRepeat same Tt.15 days
Seventh Visit1. Panchtikta Ghritam - 5 ml bid (empty stomach)
2. Mahamanjisthadi Kwath + Khadiraristha -10ml with 10 ml water bid
3. Haridra Khanda - 1gm with milk bid
4. Tab Psorogrit - 1 tab od
5. 777oil - LA (night time)
6. Lippu oil - LA (day time)
7. Syp Amlycure -5ml bid
8. Psorolin soap - for bathing		15 days
Eight Visit1. Panchtikta Ghritam - 5 ml bid (empty stomach)
2. Mahamanjisthadi Kwath + Khadiraristha -10ml with 10 ml water bid
3. Haridra Khanda - 1gm with milk bid
4. Tab psorogrit - 1 tab od
5. 777oil - LA (night time)
6. Lippu oil - LA (day time
7. Syp. amlycure - 5ml bid
8. Psorolin soap - for bathing
9. ImmDis drops - 5 drops with water		15 days

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Megha B et al. Management of Psoriasis with Shaman Chikitsa in Children

Results

All the signs and symptoms before treatment are likely to be pacified by Shamana Chikitsa. According to her mother, all symptoms were absent at the last follow-up. Treatment was continued for 6 months to get complete relief with no recurrence, and the patient was advised to follow the Pathya and Apathya in her daily schedule.

jaims_4534_01.JPG
Figure a: Pictures of patient’s leg on first visit

jaims_4534_02.JPG
Figure b: Pictures of patient’s leg on third visit

jaims_4534_03.JPG
Figure c: Pictures of patient’s leg on fifth visit

jaims_4534_04.JPG
Figure d: Pictures of patient’s leg on seventh visit

jaims_4534_05.JPG
Figure e: Pictures of patient’s leg on eighth visit

Discussion

Ayurveda describes skin as a by-product of the Rakta Dhatu and skin disorders under the term Kushtha. Disease manifestation starts from Nidana Sevana; the first line of management is to avoid Nidana Sevana as it will stop further disease progression. Considering the Sukumara Avastha of children, classical texts like the Kashyapa Samhita (Kaashyapa Samhita, Khila Sthana: “Baalanam Sukumaratvaat, Laghvakarma Prashasyate) and Ashtanga Hridaya (Ashtanga Hridaya, Uttara Tantra 1/5: “Sukumaraashcha Te Sarve”) recommend Shamana Chikitsa over Shodhana.


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Megha B et al. Management of Psoriasis with Shaman Chikitsa in Children

Shamana Ausadhis are characterized by Tikta and Katu rasa and possess the properties like Agni Deepana (enhancing digestive fire), Aama Pachana (clearing of toxins or waste products), Rakta Prasadaka (blood purifier), Kandughna (anti-itching), and Vata-Kapha Shamaka pacifying Vata and Kapha.

All contents of Panchatikta Guggulu Ghrita have TiktaRasa, Laghu (light), and Rukshaguna (dry).This leads to Agni Deepana, Amapachana, consequently leads to Shrotoshodhaka resulting in Raktaprasadhana, Raktashodhaka, Kandughna. It helps decrease the vitiated Kleda and media and helps clear the lesion

Mahamanjisthadi Kwath and Khadirarista pacify Vata Pitta Dosha and directly act on Rakta Dhatu. Manjishtha is known for its Raktashuddhikara, Pitta-Kaphahara, Vranaropana (wound healing), and Kushthaghna properties. In an experimental study, the water extract of Acacia catechu (Khadir) showed inhibition of pro-inflammatory cytokine TNF-α and a significant increase in cytokine IL-10. IL-10 helps to control the secretion of pro-inflammatory cytokines by augmenting the proliferation of B cells, mast cells, and thymocytes.

In 777 Oil, a coconut oil-based herbal preparation for psoriasis, the leaf extract of W. tinctoria has been used. Coconut oil improves the symptoms of skin disorders by its moisturizing, soothing, and emollient effects. In psoriasis, epidermal keratinocytes react to pro-inflammatory cytokines like tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ). Interleukin 6 (IL-6) causes epidermal hyperplasia in the psoriatic epithelium. Coconut oil intervenes in anti-inflammatory activity by reducing the secretion of IL-6 levels. Uncontrolled cytokine expression can lead to dysfunction of the epidermal barrier as seen in psoriasis. The topical application of coconut oil inhibits the various cytokine levels including TNF-α, IFNγ, IL-6, IL-5, and IL-8.

Psoriasis is an immune-mediated disorder where dysregulated immune response triggers chronic skin inflammation and keratinocyte hyperproliferation. Drugs like Giloy Satva and Imdisdrops acts as immunomodulator and Rasayan. Haridrakhand is an anti-inflammatory, antioxidant, and Rakta Shodhaka which helps in modulating immune response. Syrup purodil has been proven as Raktashodhak (blood purifier), Twak Prasadakara and immunomodula-tors.

Praval Pishti, natural source of calcium with Sheetal & Pitta Shamaka properties which soothes inflammation & supports skin regeneration. Tablet psorogrit contains Neem that helps in blood purification. It helps in managing psoriasis & its related conditions. Psoralin bathy & Cutis soap open up skin pores to help take in moisture & clean skin.

Conclusion

Childhood psoriasis represents a special challenge to dermatologist. The manifestation of psoriasis differs from an adult. The findings of this case study evidence that Ek Kushtha therapy protocol may effectively treat psoriasis.

Declaration of patient consent

The authors certify that all the patient’s information was obtained from the patient’s legal guardian for the publication of this case report, including accompanying images and clinical information. The guardian has been informed that the patient's name and initials will not be published, and while efforts will be made to anonymised the patient's identity, complete anonymity cannot be guaranteed.

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