A COMPREHENSIVE CONCEPTUAL AND PHARMACOLOGICAL EVALUATION OF KITIBHA KUSHTA AND ITS THERAPEUTIC MODALITIES IN AYURVEDA WITH SPECIAL REFERENCE TO PLAQUE PSORIASIS - AN INTEGRATIVE REVIEW

Background: Plaque psoriasis is a chronic immune-mediated inflammatory dermatosis affecting approximately 2–3% of the global population and significantly impairing quality of life. In Ayurveda, similar clinical features are described under Kitibha Kushta, a Vata–Kapha predominant Tridoṣhaja disorder involving Tvak, Rakta, Mamsa, and Lasika. Objective: To critically evaluate the Ayurvedic concept of Kitibha Kushta and correlate its etiopathogenesis, clinical features, and therapeutic principles with contemporary understanding of plaque psoriasis. Methods: A narrative review of classical Ayurvedic texts (Brihattrayi and Laghutrayi) was undertaken to analyse Nidana, Samprapti, Lakshana, and Chikitsa. Relevant biomedical literature was reviewed to examine the immunological and molecular mechanisms of psoriasis and the pharmacological actions of selected Ayurvedic drugs. Results: The Ayurvedic pathogenesis involving Agnimandya, Ama formation, Rasa Rakta srotodushti, and Dosha–Dushya sammurchana parallels modern concepts of metabolic inflammation, oxidative stress, keratinocyte hyperproliferation, and Th17-axis activation (TNF-α, IL-17, IL-23). Classical features such as Shyava varna, Khara/Parusha sparsha, and Ugra kandu closely resemble psoriatic plaques. Therapeutic measures including Nidana parivarjana, Shodhana (Virechana, Raktamokshana), Shamana, and Rasayana demonstrate multi-target actions. Phytoconstituents such as curcumin, psoralen, nimbolide, guggulsterone, catechins, fulvic acid, and sulphur derivatives exhibit NF-κB, STAT3, and MAPK inhibition with cytokine suppression and antioxidant effects. PASI scoring provides an objective tool for integrative assessment. Conclusion: Significant conceptual and mechanistic alignment exists between Kitibha Kushta and plaque psoriasis. Ayurvedic management offers a holistic, multi-target approach that warrants further systematic clinical validation.