E-ISSN:2456-3110

Research Article

Psoriasis

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 3 MARCH
Publisherwww.maharshicharaka.in

To evaluate the efficacy of Aaragwadh Amritadi Kashayam and Khadir Snana in management of Ek Kustha w.s.r. to Psoriasis - A Pilot Clinical study

Dungarwal S1*, Dash B2
DOI:10.21760/jaims.10.3.11

1* Sonali Dungarwal, Post Graduate Scholar Final Year, Department of Panchkarma, Pt Khushilal Sharma Govt Ayurveda College and Hospital, Bhopal, Madhya Pradesh, India.

2 Babita Dash, Assissant Professor, Department of Panchkarma, Pt Khushilal Sharma Govt Ayurveda College and Hospital, Bhopal, Madhya Pradesh, India.

Psoriasis is a long-lasting autoimmune and chronic inflammatory skin disorder with rounded plaques and erythematous, sharply demarcated papules covered in silvery micaceous scale that primarily affects the skin of the scalp, knees, elbows, and gluteal region. These symptoms mimics with Ekkustha in ayurveda. The incidence of psoriasis varies globally, but it is estimated that around 2-3% of the population worldwide is affected by the condition. Psoriasis can occur at any age, but it most commonly appears between the ages of 15 and 35 and again between 50 and 60. The treatment of psoriasis in modern medicine includes steroid creams, PUVA and immune system suppressing medications which focuses on reducing inflammation, controlling symptoms, and improving quality of life but with having its own limitations and hazardous effects. Various treatment options can help to manage the condition effectively by Ayurveda. Though Ekkustha is Tridoshaj Vyadhi but the specific Doshika involvement is Vata and Kapha. Bahirparimarjan Chikitsa is well established in treating any skin disease in Ayurveda. The present pilot study has been performed on 10 patients with oral administration of Aaragwadh Amritadi Kashayam 20 ml bd and Khadir Snana for a period of 21 days. Assessment was done by using PASI SCORE for Psoriasis. After the completion of treatment patient got significant results in symptoms, hence this treatment protocol can be used in managing this disease.

Keywords: Ekkustha, Aaraghwadh Amritadi Kashayam, Psoriasis, autoimmune disorder, chronic inflammatory skin disease

Corresponding Author How to Cite this Article To Browse
Sonali Dungarwal, Post Graduate Scholar Final Year, Department of Panchkarma, Pt Khushilal Sharma Govt Ayurveda College and Hospital, Bhopal, Madhya Pradesh, India.
Email: 		Dungarwal S, Dash B, To evaluate the efficacy of Aaragwadh Amritadi Kashayam and Khadir Snana in management of Ek Kustha w.s.r. to Psoriasis - A Pilot Clinical study. J Ayu Int Med Sci. 2025;10(3):76-80.
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Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-02-16 2025-02-25 2025-03-05 2025-03-15 2025-03-25
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© 2025 by Dungarwal S, Dash B 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(3)76
Download PDFBack To ArticleIntroductionAim and ObjectivesMaterials and MethodsObservations and ResultsDiscussionConclusionReferences
Sonali D et al. A Pilot Clinical study on Ek Kustha w.s.r. to Psoriasis

Introduction

Among the Ksudra Kushtha, Ekkushtha is characterized by the predominance of the doshas Kapha and Vata in particular, and a generally vitiated Rakta in its etiology. The cause of psoriasis is not exactly known, but it is believed to have an autoimmune, genetic component.[1]

Psoriasis is a chronic, non-infectious inflammatory skin disease that has a tendency to affect the scalp and extensor area. Psoriasis commonly affects the skin of the elbows, knees, and scalp It is characterized by well-defined erythematous plaques with silvery white scale.[2]

Psoriasis is a common autoimmune disorder, affecting up to 1% of the world ‘s population. In Ayurveda psoriasis is corelated with Eka Kustha.

The main symptoms of Eka Kushtha according to Charak are, Aswedanam (lack of sweating), Mahavastu (Extended skin lesions), Matsyashakalavat skin (Resemblance of the fish skin) and Krishna Arun colour of affected area.

Kushtha is produced invariably by the vitiation of the seven factors i.e. 3 Doshas and 4 Dushyas. But different types of pain, colour, shape, specific manifestation etc. are found in Kushtha.

Ayurvedic texts have described Samanya Nidana for all types of Kushtha instead of specific Nidanas for any particular type of Kushtha. Thus, Nidanas can be categorized as follows: 1. Aharaja - diet and dietetic pattern 2. Viharaja - faulty lifestyle 3. Miscellaneous

Among the Ksudra Kushtha, Ekkushtha is characterized by the predominance of the Doshas Kapha and Vata in particular, and a generally vitiated Rakta in its etiology. The cause of psoriasis is not exactly known, but it is believed to have an autoimmune, genetic component.[2]

It produces severe psychological impact and badly hampers the quality of life and there is a limitation of modern medicine too for treating this disease.

Factors that may aggravate Psoriasis include stress, withdrawal of systemic corticosteroid, excessive alcohol consumption, and smoking. There are many treatments available, but because of its chronic recurrent nature Psoriasis is a challenge to treat.

Modern medical science treats psoriasis with corticosteroids but the therapy gives serious side effects with the limitations. Hence it is the need of the time to find out safe and effective medicine for Psoriasis. The unique treatment modality of Ayurveda as mentioned in Classics may provide long lasting results and a better life to patients. Ingredients of Aaragwadh Amritadi Kashayam possesses Tridoshhamak effect. It is indicated in skin disease, Visha etc. Charaka has mentioned Aragwadha as mild purgative and emphasized its utility in Kushtha.

The present work has been undertaken to check the efficacy of Aaragwadh Amritadi Kashayam, Khadir Snana and Pathya-Apathya in the management of Ek Kushtha.

Aim and Objectives

1. To assess the efficacy of Aaragwadh Amritadi Kashayam and Khadir Snana in

Materials and Methods

The patients having classical signs and symptoms of Ekakushtha (psoriasis) were selected. A special proforma including all the etiological factors of Kushtha with Dushti Lakshana of Dosha, Dushya, and Srotasa etc. was prepared for assessment.

Source of data

The patients suffering from Ek Kustha (psoriasis) attending the OPD of Pt. Khushilal Sharma Government Ayurvedic Hospital, Bhopal were screened and allocated to the study. Overall, 8 patients were included in the study fulfilling the diagnostic, inclusion and exclusion criteria.

A detailed history taking and physical examination were carried out in these patients. The clinical data along with the elaborated assessment of the condition were recorded in specially designed case proforma.

Among 10 patients, all completed the treatment regimen.

Study Design

The present study is a pilot clinical study conducted in the department of Panchakarma of Pt. Khushilal Sharma Govt. Ayurvedic college and Institute Bhopal.


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Sonali D et al. A Pilot Clinical study on Ek Kustha w.s.r. to Psoriasis

Samprapti Ghatakas

Dosha - Tridosha - Vata Kapha Pradhana Pitta
Dushya - Twak, Rakta, Mamsa, Lasika, Ambu.
Srotodushti - Sanga and Vimargagamana
Agni - Jatharagni and Dhatvagni Mandya
Ama - Jataragni, Dhatvagnimandhyajanya
Udbhavasthana - Amashaya, Pakvashaya
Sanchara - Tiryaga Sira
Adhisthana - Twacha
Vyadhimarga - Bahya
Vyadhi Swabhava - Chirakari

Diagnostic Criteria

1. Sharply defined erythmatous squamous lesion
2. Presence of erythma
3. Presence of scaling
4. Candel grease sign
5. Koebners phenomenon

Inclusion Criteria

1. Duration of the disease being 1 to 2 years.
2. Age between 16 and 50 years.
3. Patients who are willing to participate in the study.

Exclusion Criteria

1. Patients with any chronic disease that needs regular medication.
2. Psoriasis with involvement of HTN, T.B, carcinoma and other life threatening and complicated diseases and major systemic illness

Treatment regimen

Aaragwadh amrutadi kashyam 40 ml B.D.

Khadir Snana - twice a day

Ingredients of Aaragwadh Amrutadi Kashyam ( Shashtra Yoga)

Aaragwadh - Cassia fistula
Amrita - Tinospora cordifolia
Pathya ( Haritaki) - Terminalia chebula
Khadir - Acacia katechu

Ingredients of Khadir Snana (Ch.Chi.7)

Khadir

Procedure, Drug, Dose and Duration

  • Aaragwadh Amrutadi Kashyam - Herbal ingredients (coarse powder) of the drug boiled in 16 parts of water and reduced to 4 parts.

  • Aaragwadh Amrutadi Kashyam was given in dose of 40 ml twice a day (Empty stomach) for 21 days.
  • Khadir Snana - Khadir boiled in 16 parts of water and reduced to 4 parts. The affected area was washed twice a day with decoction for 21 days.

Pathya Apathya

Pathya: Sadvrita Palana, Vyayama, Yoga, Satvika Ahara, Meditation, Healthy Food Habits

Apathya: Junk food, Consuming sour, salty, meat & alcohol, excessive sleep.

Criteria for assessment of Ek Kushtha (Psoriasis)

Kandu (Itching)

No Kandu0
Occasional1
On and off without disturbed sleep2
Continuous with disturbed sleep3

Matsyashakal

Normal skin0
Scalling on vigorous rubbing1
Scalling on light pressure2
Scaling on wearing clothes3

Aswedanam

Sweating0
Mild sweating1
Mild sweating after exercise2
No sweating after exercise3

Mahavastu

No lesion0
Lesion on 1/3 Rd hand/ leg/ scalp/ ear lobules1
Lesions on most part of the body 2/32
Lesion on whole body3

Erythma

Normal skin colour0
Faint and near to skin1
Blenching2
Total red3

Candel Grease Sign

Absent0
Present1

Koebners Phenomenon

NegativeO
Positive1

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Observations and Results

SymptomsBTATMean DifferenceSDSE% of relieft valueP value
Kandu1.570.571.000.790.30-63.69%2.3770.034
Matshakal1.861.000.860.580.2246.23%2.1210.054
Aswedan0.710.290.430.490.1860.56%1.060.309
Mahavastu1.861.000.860.580.2246.23%2.120.0554
Erythma1.860.861.000.690.2653.7%2.330.0378
Candel Grease Sign0.860.570.290.530.2033.7%1.150.2707
Koebners Phenomenon0.710.140.570.380.1480.28%2.440.036

In present pilot study, the effect of therapy was analyzed by computed statistically using Paired t test for subjective parameter the obtained result was interpreted as follow

Kandu: the mean score of pain in this study, before treatment was 1.57 and after treatment it was reduced to 0.57. So, the mean difference was 1.0, with percentage relief of 63.69% which was statistically extremely significant (P=0.034).

Matsyhakal: the mean score of Matsyhakal in this study, before treatment was 1.86 and after treatment it was reduced to 1.00. So, the mean difference was 0.86, with percentage relief of 46.23% which was statistically very significant (P=0.054).

Aswedan: the mean score of Aswedan in this study, before treatment was 0.71 and after treatment it was reduced to 0.29. So, the mean difference was 0.43, with percentage relief of 60.56% which was statistically very significant (P=0.309).

Mahavastu: the mean score of Mahavastu in this study, before treatment was 1.86 and after treatment it was reduced to 1.00. So, the mean difference was 0.86, with percentage relief of 46.23% which was statistically very significant (P=0.0554).

Erythema: the mean score of pain in this study, before treatment was 1.86 and after treatment it was reduced to 0.86. So, the mean difference was 1.00, with percentage relief of which was statistically extremely significant (P= 0.0378).

Candel grease sign: the mean score of Candel grease sign in this study, before treatment was 0.86 and after treatment it was reduced to 0.57.

So, the mean difference was, with percentage relief of 33.7% which was statistically extremely significant (P=0.2707).

Koebners phenomenon: Table no. 4 shows that the mean score of Koebners phenomenon in this study, before treatment was 0.71 and after treatment it was reduced to 0.14. So, the mean difference was 0.57, with percentage relief of which 80.28% was statistically extremely significant (P=0. 0.036)

Adverse Effects: There were no any adverse effects or adverse drug reaction was noted during and after the study duration Psoriasis is a proliferative, inflammatory and autoimmune skin disease resembling Ek Kustha of Ayurveda.

Discussion

Ekakustha is a Vata Kapha predominant skin disorder. Vata Kapha clinically expresses the major features of Asvedana, Mahāvastu, Matsaśakalaupama including some other features like Ruksha, Kharabhava (roughness), Shaitya (coldness), Utseda (elevation), Parushya, Gaurava (heaviness) etc.[3]

Aaragwadh Amritadi Kashayam[5] contains Aaragwadh Fal Majja and Haritaki which pacifies aggravated Pitta Dosha and expels it out from the body and also having Guduchi and Khadir Sara which purifies the blood. So that helps in purification of blood which ultimately improves the Rasa and Rakta Dhatu. Aragwadhadi Kashayam is mentioned in Ashtanga Hridaya 15th chapter Shodhanadigana Sangraha. The drugs mentioned in these have Vishahara, Kushta, Kaphahara properties. It has mild laxative effects and it aids to eliminate accumulated toxins through stools. In skin diseases it works as the principles of detoxification. It reduces itching and burning sensation of skin. It is anti-microbial, anti-bacterial Ayurvedic medicine.

Aaragwadh is used for the management of Kushtha, Aruchi, Vibandha, etc. The most significant components of Aaraghwadh are Anthraquinone, Gluten, Tannins.

Khadira contains Tikta-Kashaya Rasa (bitter and astringent taste).

Khadir is one of such drugs that is easily available with excellent results in skin diseases and so also called as Kushtaghna.


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Khadira contains Tikta-Kashaya Rasa (bitter and astringent taste). These two Rasas by the virtue of their pharmacological properties like Soshana (absorption), Vishaghnatva (anti-poisonous), Kandu Prashamana (reduce itching sensation), Tvakmamsa, Sthirikarana (nourishment and strengthening of skin and muscle) and Pidana, Ropana (wound healing), Kledaupashosana (dry of exudation).

All these pharmacological properties as a whole are able to exert an anti-inflammatory action on the affected areas of skin, which is beneficial to cure psoriasis,

Khadira Sara (catechu) is Ushna (hot potency),[6] Agneya Guna (hot and heavy) pacifies aggravated Kapha and Vata

Conclusion

Ekkustha (Psoriasis) is the skin disease which is more difficult to cure even in modern science. This study showed that Ayurveda medicine has hope for such cases. Even though the sample size is small it will be the platform for the researcher to do more study in more number of patients

References

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