Ayurvedic Management of Kitibha Kushta (Guttate Psoriasis with Secondary Lichenification): A Case Report

Abstract

Guttate psoriasis, characterized by abrupt onset of multiple small scaly lesions, can be correlated with Kshudra Kushta conditions such as Kitibha Kushta with Vata-Kapha predominance. Secondary lichenification reflects chronicity and repeated irritation, indicating deeper Doṣha-Dhatu involvement. This is a case report of a 15-year-old female patient presenting with multiple blackish, scaly papular lesions predominantly over the lower and upper limbs, associated with severe itching, skin thickening, discoloration, and dryness for 1 month duration. Clinical features such as Syava, Kina Khara Sparsha, Parusha (dry and scaly), Kandu, and Tvak Rukshata supported the Ayurvedic diagnosis. Assessment was carried out using the Psoriasis Area and Severity Index (PASI) and Dermatolology Life Quality Index Questionnaire (DLQI). The treatment protocol included Deepana, Pachana, Purvakarma followed by Sodhana in the form of Virecana, along with Samana therapies such as external applications and Rasayana Yoga as internal medication during follow up. The treatment was administered for 17 days with regular follow-up. Marked improvement was observed in scaling, erythema, induration, discolouration and pruritus, reflected by a significant reduction in PASI score from 9.2 to 2.6 and DLQI score from 13 to 7 by the end of treatment. Although classical Ayurvedic texts describe comprehensive therapeutic approaches for Kushta, systematic clinical documentation using objective assessment tools is limited.  This case report highlights the potential role of a systematic Ayurvedic treatment approach in managing guttate psoriasis with secondary lichenification by addressing underlying Doṣha imbalance, improving Agni, purifying Rakta, and restoring skin integrity using standardized assessment parameters.