Background: Ekakustha, characterized by aswedana (absent sweating), mahavastu (large lesions), and matsya-shakalopama (fish-scale appearance), correlates with plaque psoriasis. Classical Shodhana-Shamana remains underexplored in modern clinical practice. Objective: Evaluate integrated Shodhana-Shamana protocol efficacy in treatment-resistant Ekakustha. Case Presentation: A 33-year-old male with 12-month widespread psoriasis resistant to antihistamines, steroids, and vitamin D analogues presented with bilateral erythematous plaques, severe pruritus, and alopecia. Treatment: Nidana parivarjana, Deepana-Pachana (Days 1-3), Snehapana with Mahatiktaka Ghrita (Days 4-8), Abhyanga-Swedana with Dashamoola (Days 8-10), Virechana with Trivrit-Triphala (Day 11), followed by 30-day Shamana with Potala Katuruhinyadi Kashaya, Arogyavardhini Vati, Dusivishari Gutika, Gandhaka Rasayana, and topical Brihat Dantapala Taila. Results: Psoriasis Area and Severity Index (PASI) score declined from severe (>20) to absent (0) at Day 45. Complete resolution of erythema, induration, scaling, and pruritus with significant hair regrowth. No relapse at follow-up. Conclusion: Integrated Shodhana-Shamana chikitsa effectively addresses Samprapti through sequential Ama pachana, Kleda soshana, and Raktashodhana, providing sustainable Ekakustha management. Multicentric trials recommended.
Dr. Subham Pradhan1, Dr. Swetanjali Behera2, Dr. Soumya Ranjan Das3, Dr. Jitendra Samal*4, Dr. Lijina Swain5 (Thu,) studied this question.