Integrative Ayurvedic Management Of Kitibha Kushtha (Psoriasis): A Case Report Assessed Using PASI And Semi-Quantitative Skin Analysis

Abstract

Background: Kitibha Kushta is described under Kshudra Kushta in Ayurveda and is characterized by features such as dryness, itching and roughness.¹˒² .These manifestations may clinically resemble psoriasis, a chronic immune-mediated inflammatory skin disorder.³ The recurrent nature and chronicity of psoriasis make its management challenging.⁴

Objective: To document the clinical response to Ayurvedic management in a chronic case of Kitibha Kushta clinically correlated with psoriasis using serial Psoriasis Area and Severity Index (PASI) assessment and semi-quantitative skin analysis.

Case description: A 26-year-old female with a 6-year history of scaly lesions involving the back, legs, chest and hands presented with marked flaking, itching and burning after sun exposure. Ayurvedic assessment indicated Kitibha Kushta with Pitta-predominant Prakriti. Baseline PASI was 18.2. Baseline skin analysis showed Fitzpatrick type III skin, moderate free radical index, high grease and sensitivity indices, low immunity index, moderate erythema, moderate scaling with thick adherent scales⁵, moderate dryness, and Prithvi-Aap predominance.

Intervention: The patient received internal Ayurvedic medicines, external therapies, dietary modification and Raktamokshana by venesection. Treatment was continued for 7 months with monthly follow-up. The same medication regimen was maintained throughout the treatment period. Treatment was planned according to principles of Dosha Shamana, Agni Deepana, Raktashodhana, and Srotoshodhana.¹˒⁶

Outcome: PASI decreased progressively from 18.2 at baseline to 10.5, 8.2, 7.5, 4.0, 3.0 and 0.9 at successive assessments, corresponding to a 95.1% reduction from baseline. Clinical photographs showed marked regression of active erythematous and scaly lesions. Post-treatment skin analysis demonstrated normal free radical index, balanced grease index, low sensitivity, normal-to-high immunity index, absent erythema, smooth skin texture, normal moisture and balanced Pancha Mahabhuta status.

Conclusion: This case report highlights the potential role of Ayurveda in chronic dermatological disorders. Integrative assessment using skin analysis and PASI scoring demonstrated significant improvement following Ayurvedic management.