Diagnostic and Treatment Challenges in Kapha-Pittaja Twak Vikara: A Case Study

Background: Kushta refers to chronic skin disorders affecting skin and its underlying tissues; considered one among the Ashtamahagada (eight major diseases) due to its complex pathogenesis and chronicity. Skin is the largest organ in the body which makes diagnosis related to its disorder a challenging task. This is understood through the primary and secondary lesions over it. One such manifestation called Acneiform eruption showing papulo-pustular lesions resembling other skin manifestations like acne vulgaris, hidradenitis suppurativa. Case presentation: A 37-year-old female having progressively increased number of reddish, pus and blood-filled eruptions over the back, buttocks and thighs, increasing during menstruation, severe itching and burning with a chronicity of 4 years. She took allopathic medications for 4 years and got temporary relief. Intervention: Patient underwent Sadyovirechana, Sadyovamana, Vamana, Siravyadha, Shamana Aushadi (oral medications and topical applications) and Naimittika Rasayana (disease specific immunomodulators). Outcome: After 5months significant reduction in number of eruptions, burning and itching were noted. DLQI (Dermatology Life Quality Index) score index reduced from score 38 to score 5. Conclusion: A case of chronic skin disease diagnosed as Kapha-Pittaja Pidaka administered Shodhana, Shamana and Naimittika Rasayana for a period of five months. In the chronic stubborn skin disease, the rational planning of Shodhana followed by Shamana and Pathyapathya has given excellent results. This case highlights the potential of a comprehensive Ayurvedic approach by integrating different modalities rationally helps in successful management of Kapha-Pittaja Pidaka.