ROLE OF SHODHANA CHIKITSA (VAMANA AND VIRECHANA KARMA) IN THE MANAGEMENT OF EKAKUSHTHA W.S.R. TO PSORIASIS: A REVIEW

Background: Psoriasis is a chronic, immune-mediated, inflammatory skin disease with a relapsing course, affecting about 2–3% of the population in many regions. It causes considerable physical, psychological and social burden. In Ayurveda, its clinical features closely resemble Ekakushtha, a Kshudra Kushtha of Vata–Kapha predominance, described with the cardinal features Asvedana, Mahavastu and Matsyashakalopama. Aim: To review the classical concept of Ekakushtha and critically analyse the role of Shodhana Chikitsa — particularly Vamana and Virechana Karma — in its management, with correlation to modern understanding of psoriasis. Materials and methods: Brihattrayi, Laghuttrayi and their commentaries were reviewed for Nidana, Samprapti and Chikitsa of Kushtha and Ekakushtha. Standard dermatology texts and indexed literature were reviewed for the pathogenesis and management of psoriasis. Conclusion: The classics give primacy to repeated Shodhana in Kushtha because Doshas eliminated by Samshodhana do not recur. Vamana addresses the Kapha component responsible for Mahavastu and scaling, while Virechana addresses Pitta–Rakta Dushti and helps prevent relapse. Shodhana followed by Shamana and Rasayana offers a rational, holistic approach to psoriasis, which needs to be validated through well-designed clinical trials.