A 48-year-old male patient from Ukraine was admitted to Rajah Beach Hospital, Akalad, Thrissur, Kerala presented with complaints of thick, reddish patches covered with silvery scales over upper and lower limbs, abdomen, back and scalp in the past 25 years. Skin lesions are recurring in nature and are associated with severe itching sometimes. It seems to be aggravated during winter & autumn seasons. Itching with dryness and cracking of affected skin is worse for the last 1 month. Had disturbed sleep in the last 3 years and pain over the third toe of the right foot and medial side of the right elbow in the last 3 weeks.

The patient was examined followed by an initial assessment and detailed history of presenting complaints and personal history were taken. The patient was self-employed by occupation, well-nourished, following a mixed type of diet and did not have a family history or any addictions. The patient had undergone the conventional type of treatment before coming to our hospital. He used topical corticosteroid creams, Salicylic acid shampoos for external application and administered tablets such as infliximab or methotrexate to decreases the production of skin cells and suppresses inflammation. But skin lesions are recurring from time to time.

On examination: General condition -moderate, afebrile and stable person with Pitha Vata constitution. Pulse Rate - 76/min, regular, heart rate 70/min, respiratory rate 14/min, blood pressure 116/70 mmHg, body weight 79 kg, height 175 cm and BMI 25. The patient had a history of Psoriasis in the last 5 years no pallor, icterus was present. Routine investigations such as Complete Blood Count, Random Blood sugar and Urine Routine and Microscopic were in the normal range.

Yoga/ active exercise are necessary for the effective treatment of psoriasis as it is beneficial to keep flare-ups under control and to ease symptoms by relieving stress.

Patient was advised Meditation/ Pranayama at the beginning of the treatment course and mild to moderate yogaasanas along with different breathing exercises after Shodhana therapy according to his condition. Yoga also helps the patient cope with sleep disturbance, anxiety, and isolation related to the illness. The patient was discharged after 28 days of the treatment course.

Follow up Medicines for 2 months:

Advised review after 3 months.

The Complete Blood Count, Fasting Blood sugar, Liver function Test, Lipid Profile, Urine Routine and Microscopic all were found within the normal range.

In the above case study, the patient got complete relief from symptoms of Sidhma kushta (Psoriasis) Table 6.

This is achieved by a proper routine and removal of harmful factors from the patient's living environment. The treatment for psoriasis goes through several stages such as dipana/ pachana (Enhancing digestion & metabolism), Rukshana (drying therapy), Snehana (oleation), wedana (sweating therapy), Shodhana (purificatory therapy) and Rasayana (Rejuvenative Therapy). The treatment comprises dietary regulations, daily regimens, yoga that includes Asana, Pranayama and Meditation.

This Panchakarma treatment has its unique efficacy in eliminating unwanted toxins and normalizing bioenergies both mentally and physically. In this case study, Virechana (Purgation) showed good results along with Shamana Yoga consumption and Sarvanga Dhara therapy. Virechana Chikitsa helps to remove vitiated Dosha from the body. Administration of Shamana Yogas that is the combination of Maha thiktakam kwatham, Pancha dasanga kashyam and Madhusnuhi rasyana have Kushthaghna as well as Rasayana effect on skin. As Psoriasis is a psychosomatic disease, Takradhara and intake of Sumana tablets may help to relieve the stress. Many studies supporting our study result have shown that Takradhara has a significant role in relieving stress-induced disorder 11, 12, 13. Takradhara had Vata Pitta Shamaka property which not only reduces stress and tension but also enhances the circulation of the brain, improves memory, nourishes the hair on the scalp, calms the mind and body 14.

In this case study, we got good results from Panchakarma therapy and Ayurvedic medicine. The treatment given for Sidhmakushta (Psoriasis) was Pachana/ Rukshana, Shodhana, Shamana medicines and Sarvang Takradhara therapy; which helped in Aampachan, removal of vitiated Dosha from the body and to bring Samyavastha (balanced condition) of Doshas. Hence the above treatment helps to relieve symptoms of disease, to improve the quality of life and also attempt to provide safe and effective treatment to the patient. Randomised Clinical Trial needs to be conducted to validate results in the larger sample which will generate evidence for support.