From Flare to Freedom: Managing Erythrodermic Psoriasis (Kitibha Kushta) through Panchkarma (Ayurvedic Detoxification) and Polyherbal Therapy: A Case Report

Abstract

Background: Erythrodermic psoriasis is a form of psoriasis that affects more than 90% of the body's surface area. It has systemic complications like thermoregulatory dysfunction, fluid imbalance, and secondary infections. Contemporary treatments, such as systemic immunosuppressants offer symptomatic management, but they produce adverse effects and cause relapse. Ayurveda classifies this condition under Kitibha Kushta, a type of Kshudra Kushta (minor skin disorders), and favours a approach of detoxification (Shodhana) followed by palliation (Shamana).
Case Presentation: A 36-year-old male presented with a 4-year history of generalized erythematous, scaly patches with severe pruritus over the entire body. He had scoring of 45.2 on the Psoriasis Area and Severity Index (PASI) and 25 on the Dermatology Life Quality Index (DLQI). This indicated severe disease with an extremely large impact on quality of life. The patient was managed with a 90-day integrated Ayurvedic protocol including Deepana-Pachana, internal and external oleation (Snehana), whole-body sudation (Sarvanga Bashpa Sweda), therapeutic purgation (Virechana) with Trivritta Leha, triphala kwath and manuka phanta, post-purgation diet (Samsarjana Krama), and oral polyherbal formulations including Kaishor Guggul, Patolkaturohinyadi Kashay, Manibhadra Gulam, Aarogyavardhini Vati, and Tab. Allerco, and topical Psorolin oil.
Outcomes: At the end of the 90-day treatment, the PASI score reduced from 45.2 (severe) to 5.6 (mild) at Day 17 and to 0 (clear) at the last follow-up. The DLQI score improved from 25 (large effect) to 6 (moderate effect) at Day 17 and reached 0 (no effect) at the 90-day. Complete clinical improvement was achieved with no relapses. No adverse effects were noticed throughout the treatment.
Conclusions: This case shows that a planned Ayurvedic approach combining Panchakarma with individualized polyherbal therapy may result in full and lasting recovery in severe erythrodermic psoriasis.