A Distinct Case Study on Exultant and Effective Ayurvedic Management of Mandala Kushtha w.s.r Guttate Psoriasis

A BSTRACT Guttate psoriasis is characterized by the sudden onset of multiple, small (0.5–1.5 cm), scattered, tear-drop-shaped, scaly, erythematous, pruritic papules and plaques, predominantly affecting the trunk and proximal extremities. It frequently occurs in young adults. In Ayurveda, similar symptoms are described under Mandala Kushtha , characterized by Shwetam , Raktam , Sthiram , Styanam , and Utsanna Mandalam lesions. A 30-year-old male presented to the Agadatantra outpatient department with complaints of erythematous annular skin lesions distributed across the ankles, chest, abdomen, back, head, and hands, associated with severe itching and occasional bloody discharge, persisting for 2 months. The condition was clinically correlated with Mandala Kushtha as per Ayurvedic texts. The patient was treated with Shodhana Chikitsa (purification therapy), specifically Virechana Karma (therapeutic purgation), followed by Shamana Chikitsa (palliative therapy), as per classical Ayurvedic guidelines described by Acharya Charaka for Kushtha Roga . Clinical assessment was conducted using the Psoriasis Area and Severity Index score and photographic documentation before and after treatment. Posttreatment evaluation revealed a 95% improvement in chief complaints and associated symptoms. Significant improvement in the quality of life was observed, with minimal recurrence during and after the treatment course. This case demonstrates the efficacy of Shodhana and Shamana Chikitsa in the management of Mandala Kushtha (guttate psoriasis), providing substantial symptomatic relief and enhancing the patient’s quality of life.