A Clinical Case Report on the Management of Unintended Adverse Reaction following Panchatikta Kashaya Basti Administration in Vicharchika (contact dermatitis)

Introduction: Cutaneous adverse drug reactions (CADRs) are the most common manifestations of drug hypersensitivity. Although Ayurvedic treatments are generally considered natural and safe, they may also result in adverse effects. This report highlights a case of a CADR potentially associated with the use of Niruha Basti, a therapeutic enema used in Panchakarma. Methods: A 56-year-old female with chronic skin lesions over the dorsum of the bilateral foot and ankle joints visited the Panchakarma OPD. She was treated with Panchatikta Kashaya Basti following the Kala Basti protocol and Anuvasana Basti with Tiktaka Ghrita. Results: Following the administration of the first Niruha Basti, the patient developed severe pruritus and generalised swelling, suggestive of a cutaneous adverse reaction. The condition was managed with Sarvanga Parisheka (full-body decoction pouring), followed by external application of Tiktaka Ghrita, and Yastimadhu Choorna Lepa mixed with Ksheera. The patient experienced significant symptomatic relief after the intervention. Conclusion: This case highlights the potential for adverse cutaneous reactions to Ayurvedic formulations, especially when ingredients with Tikshna (sharp) and Ushna (hot) properties are used in Basti. A detailed patient evaluation is important to help prevent adverse effects, particularly in susceptible individuals.