Internal Ayurveda Management of Pityriasis Versicolor (Sidhma Kushta) in a High-humidity Occupational Setting: A Case Report

Background: Pityriasis versicolor is a superficial fungal infection caused by Malassezia species and is common in hot and humid climates.In Ayurveda, it is correlated with Sidhma Kushta and is managed with internal medicines and external applications.Case presentation: A 29-year-old male bakery worker presented with multiple hypopigmented macules over the neck and upper chest associated with mild itching for 6 months.Previous use of steroid-containing topical antifungal preparations had failed.A clinical diagnosis of pityriasis versicolor was made, corresponding to Vata-Kapha predominant Sidhma Kushta.Intervention: Considering the patient's humid occupational environment and the lipophilic nature of Malassezia, an internal-only Ayurvedic treatment approach was chosen.The regimen included Krimimudgar Rasa, Sameerpannaga Rasa, Mahamanjishthadi Kashayam, Kaishor Guggulu, Avipattikara Churna, and Brahma Rasayana for 45 days.Outcomes: Itching resolved within 15 days, lesions showed marked improvement by day 30, and complete resolution was achieved by day 45.No recurrence was observed during 11 months of follow-up.This case suggests that an internal-only Ayurvedic regimen may be a useful approach for similar presentations.Further controlled studies are needed to confirm these findings.