International Journal of Trend in Scientific Research and Development (IJTSRD)

Volume 3 Issue 5, August 2019 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470

Management of Lichen Planus through Ayurveda

Dr. Deepti1, Dr. Sunil Kumar2, Dr. Anurag Singh Chandel3
1P.G.Scholar, 2Professor, 3Ph.D Scholar
1, 2, 3National Institute of Ayurveda, Jaipur, Rajasthan, India

How to cite this paper: Dr. Deepti | Dr. ABSTRACT

Sunil Kumar | Dr. Anurag Singh Chandel Lichen Planus is a papulosquamous disorder that may affect the skin, scalp,
"Management of Lichen Planus through nails, and mucous membranes. The primary cutaneous lesions are pruritic,
Ayurveda" Published polygonal, flat topped, violaceous papules. In Ayurveda, all skin diseases are
in International lined beneath the term Kustha Roga. Vitiated Dosha cause abnormal colour of
Journal of Trend in skin and produce degenerative changes called Kustha. CASE REPORT: A 50
Scientific Research year old female came to OPD of National Institute of Ayurveda, Jaipur having
and Development complains of black papules on her whole body for last10 years. Oral mucosa
(ijtsrd), ISSN: 2456- was also involved. Mahamanjishtha Kwatha, Trivrit Leha, Tikta Ghrita,
6470, Volume-3 | IJTSRD27908 Khadiradi Vati and a combination of Rasamanikaya, Shuddha Gandhaka,
Issue-5, August Manjishthadi Churna, was given orally, Eladi Taila was given for local
2019, pp.2348-2352, application and Irimedadi Taila was given for Gandusha . RESULTS: Patient got
https://doi.org/10.31142/ijtsrd27908 significant relief in itching and discolouration of skin. Ayurvedic principle of
Kustha is effective in the management of Lichen Planus.
Copyright © 2019 by author(s) and
International Journal of Trend in Scientific KEYWORDS: Dosha, Dushaya, Kustha , Lichen planus
Research and Development Journal. This
is an Open Access article distributed INTRODUCTION
under the terms of Lichen Planus is a papulosquamous disorder that may affect the skin, scalp,
the Creative nails, and mucous membranes. The primary cutaneous lesions are pruritic,
Commons Attribution polygonal, flat topped, violaceous papules. Purple polygonal papules marked by
License (CC BY 4.0) severe pruritus; lacy white markings, especially associated with mucous
(http://creativecommons.org/licenses/by membrane lesions. The skin lesions may occur anywhere but have a
/4.0) predilection for the wrists, shins, lower back, and genitalia.1
In modern science, lichen planus is treated mostly by vegetarian with reduced appetite, disturbed sleep and
corticosteroids but the steroids have side effects like having frequency of micturition 5-6 times per day and
hepatotoxicity and nephrotoxicity. Lichen planus is an having history of constipation. There was no any relevant
immune-mediated oral and cutaneous inflammatory disease, family history of skin diseases.
found in 0.5% to 2.6% of general population2 The prevalence
of oral lichen planus in Indian population is 2.6% with more Diagnostic Focus and assessment:
female predilection.3 The disease not only affects the patient Laboratory investigations were as follows (Hemoglobin
physically but also disturbs mentally, as the appearance is (12.8%), ESR (8mm/hr) and serum uric acid (3.9mg/dl)
very critical. In Ayurveda, all skin diseases are lined beneath were in normal range and RA Factor was negative (8.40
the term Kustha Roga. Vitiated Dosha cause abnormal colour IU/ml),CRP was (2.19mg/dl) was also under reference
of skin and produce degenerative changes called Kustha4. range. On 04/05/2019, histopathology examination was
Kustha is produced by the vitiation of seven factors i.e. three advised and it discovered epidermis with mild
Dosha and four Dushaya.5 Line of treatment was chosen hyperkeratosis, oedema and collagen deposition. Dermis
according to dominancy of Dosha involved. showed perivascular infiltration by nonspecific
inflammatory cells. (Figure 1)
Case Study
A 50 year old female presented the OPD of National Institute Therapeutic Intervention:
of Ayurveda hospital on dated 30.03.2019 complaining of Mahamanjishtha Kwatha, a combination of Rasamanikaya,
papules of blackish color on whole of the body with severe Shuddha Gandhaka, Manjishthadi Churna, Khadiradi Vati was
itching and oral mucosa was also involved. History of given orally, Eladi Taila was given for local application and
present illness uncovered that the patient was normal 10 Irimedadi Taila was given for Gandusha (Table No.1).
year back. All of a sudden, she suffered with severe itching Initially, this treatment was given for seven days to see
on her body with white patches. Gradually, she also got black initial response; on seventh day patient got 25% relief in
papules on the skin. Initially the papules appeared on thigh itching. So, this treatment was continued.
and then gradually spread on forearm and trunk region. She
took allopathic treatment and got relief. After three years, Follow up and Outcomes:-
again remission of disease occurred in winter season. Again The patient was on follow up on every fifteen days till two
she took treatment and got relief. Thus, there was a history months. Gradually papules and plaques started disappearing
of remission of disease after 3or 4 years in winter season. and there was relief in itching during follow up. After two
Since, last five years she also has a history of pain in both month of treatment, patient got complete relief from itching
knee joints. Personal history uncovered that the patient is a and new papules do not formed on the body. Old papules

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 International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
were slightly reduced and colour of papules also become References
faint. There is no reoccurrence of disease even after four [1] Tinsley R. Harrison. Harrison’s Principles of Internal
months. (Table No.2) Medicine. 16th edition Mcgrew hill medical publishing
division p.349
Discussion
[2] Kanemitsu S. Oral lichen planus: malignant potential
Diagnosis in this case was made on the basis of classical
and diagnosis. Oral Sci Int. 2014; 11:1–7. doi:
black to purple papules on thigh, forearm, wrists, ankle and
10.1016/S1348-8643(13)00030-X.
oral mucosa accompanied with severe itching. In Ayurveda,
all skin diseases are lined beneath the term Kustha Roga. [3] Murti PR, Daftary DK, Bhonsle RB, Gupta PC, Mehta FS,
Vitiated Dosha cause abnormal colour of skin and produce Pindborg JJ. Malignant potential of oral lichen planus:
degenerative changes called Kustha. Kustha is produced by observations in 722 patients from India. J Oral
the vitiation of seven factors i.e. three Dosha and four Pathol. 1986; 15:71–7. doi: 10.1111/j.1600-
Dushaya. Due to Ahitakara Nidana Sevana, first these three 0714.1986.tb00580.x
Dosha Vata, Pitta and Kapha get vitiated and that they
[4] Kaviraj Atridev Gupt:2012 Astangahrdayam Nidana
additionally vitiate Twak, Rakta, Lasika and Mamsa.
.Aacharya Charaka while describing Kustha treatment very Sthana; Kustha shwitra krimi Nidana chapter14 verse3;
Chaukhambha Prakashana; Varanasi, india p. 369
firstly has mentioned that all Kustha are Tridoshaja in nature
and should be treated according to dominancy of Dosha. First [5] Pandit KashinathShastri & Dr. GaurakhnathChaturvedi:
treat the dominant Dosha then rest of the vitiated Dosha 2011CarakaSamhita, ChikitsaSthana; KusthaChikitsa;
should be treated6. Patient was treated on the principle of Chapter 7; verse 9-10Chaukhambha Bharati Academy,
management of Kushtha Roga. In the present case patient Varanasi, india, p. 248
had symptoms of mainly vitiated Kapha Dosha i.e. severe
[6] Pandit KashinathShastri & Dr. Gaurakhnath
itching, hyperkeratosis on whole of the body associated with
Chaturvedi2011 CarakaSamhita, ChikitsaSthana;
symptoms of Vitiated Vata Dosha (Karshnyata). So, we
KusthaChikitsa; Chapter 7; verse 31-32 Chaukhambha
advised drug according to dominancy of Dosha involved.
Bharati Academy, Varanasi, indiap. 253
some of these drug were Kusthahara (Rasamanikaya,
Manjishthaadi Kshaya, Panchtikta Ghrita, eladi Taila), [7] Ayurved Sara Sangraha2016, Shri Baidyanath Ayurved
Raktaprasadak( Manjishthadi Churna), Kaphashamaka Bhawan limited naini Allahabad, india, p. 445
(Rasamanikaya, , Manjishthaadi Kshaya,Eladi Taila),
Vatashamaka(Rasamanikaya, Panchtikta Ghrita, Eladi Taila), [8] Ayurved Sara Sangraha2016, Shri Baidyanath Ayurved
Trivrit leha is Mridu Virechaka ,it is used for Nitya Shodhana Bhawan limited naini Allahabad, india, p. 770
and because oral mucosa was also involve; so, Khadiradi Vati [9] Ayurved Sara Sangraha2016, Shri Baidyanath Ayurved
and Irimedadi Taila was also advised for Gandusha(Gargles) Bhawan limitednaini Allahabad, india, p. 683
because both of these drug are drug of choice of treatment in
Mukha Roga(Table No.3). By this treatment, vitiated Dosha [10] Ayurved Sara Sangraha2016, Shri Baidyanath Ayurved
comes in balance state and symptoms of vitiated Dosha Bhawan limited naini Allahabad, india, p. 813
subside gradually. And patient got significant relief. [11] Ayurved Sara Sangraha2016, Shri Baidyanath Ayurved
Bhawan limited naini Allahabad, india, p. 797
Conclusion
Lichen Planus is an autoimmune disease involving skin and [12] Ayurved Sara Sangraha2016, Shri Baidyanath Ayurved
oral mucosa; it is notorious for its reoccurrence. Treatment Bhawan limited naini Allahabad, india, p. 876
options of conventional system of medicine in lichen planus [13] Ayurved Sara Sangraha2016, Shri Baidyanath Ayurved
have very side effects. Line of treatment of Kustha is safe and Bhawan limited naini Allahabad, india, p. 990
effective in Lichen Planus symptomatically.
[14] Ayurved Sara Sangraha2016, Shri Baidyanath Ayurved
Bhawan limited naini Allahabad, india, p. 567

Table No. 1 showing days and dosage of Shaman treatment

Route of
Name of the Drug used Dose
administration
Rasamanikaya+Shuddha Gandhaka+Manjishthadi Churna 125mg+250mg+5gm twice a day Oral
Panchtikta Ghrita 10 ml twice a day Oral
Manjishthadi Kasaya 20 ml twice a day Oral
Khadiradi Vati 6 tablet in a day Oral
Trivrit Leha 5gm twice a day Oral
Eladi Taila - Local application
Irimedadi Taila 10 ml Oral (Gandushartha)

Table No.2: Improvement in complaints of Lichen planus patient after Shaman chikitsa
Symptoms Before treatment After one month of treatment After two month of treatment
Papule size 2-3 mm Same Slightly reduced
Colour Dark black Slightly faint Slightly faint
Itching ++++++ +++ +
New papule formation 2-3 per week Nil Nil

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 International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
Table No.3 showing ingredients, properties and action of the drugs given.
Drug Ingredients Properties and action
VataKaphashamaka, useful in
Rasamanikaya7 Hartala(Arsenic Sulphde) skin disease like Kustha,
Visharpa, Vipadika, Vicharchika
Neem(Azadirachta indica), Patola(Trichosanthes dioica), Ushna, Tikshna, Vyavayi, Vikasi,
Kateri(Solanum indicum),Vasa(Adhatoda vasica), Katu , Tikta Rasa and Katu
Panchatikta
Giloya(Tinospora cordifolia), Amalaki(Emblica officinalis), Vipaka, useful in Kustha,
Ghrita8
Haritaki(Terminalia chebula) and Baheda(Terminalia Vattapittakapha Vikara, Dustha
bellirica),Goghrita(cow ghee) Rakta Vikara.
Manjishtha(Rubia Cordifolia), Choti elaichi( Elettaria
Manjishthadi cardamomum), Saunf(Foeniculum Vulgare), Saunageru(Red
Raktashodhaka,Pittashamaka
Churna9 Ochre), Pashanbheda(Bergenia Ligulata), Sanaya(Cassia
Angustifolia)
Manjishta(Rubia cordifolia),Musta (Cyperus
rotundus),Kutaja(Holarrhena antidysenterica),
Guduchi(Tinospora cordifolia), Kushta(Saussurea
lappa),Nagara (ginger), Bharngi(Clerodendron serratum),
Kshudra(Solanum xanthocarpum), Vacha(Acorus calamus),
Nimba (Azadirachta indica) ,Haridra(Turmeric), Daruharidra(
Berberisaristata), Haritaki(Terminalia chebula), Vibhitaki
(Terminalia bellirica),Amla (Emblica officinalis),
Patola (Luffa acutangula) ,Katuka(Picrorrhiza kurroa),
Murva (Marsdenia tenacissima),Vidanga(Embelia
ribes),Asana(Pterocarpus marsupium), Chitraka (Plumbago
zeylanica), Shatavari (Asparagus
Manjishthadi KaphapittaVikara and
racemosus),Trayamana(Gentiana kurroo)
Kasaya10 Kusthahara
Krishna(Long pepper),Indrayava (Holarrhena
antidysenterica),Vasa(Adhatoda vasica)Bhringaraja (Eclipta
alba), Mahadaru (Cedrus deodara), Patha(Cissampelos pariera),
Khadira(Acacia
catechu),Chandana(Santalumalbum),Trivrit(Operculina
turpethum),Varuna(Crataeva nurvala), Kiratatikta (Swertia
chirata), Bakuchi (Psoralea corylifolia), Kritamala (Cassia
fistula),Shakhotaka(Streblus asper), Mahanimba(Melia
azadirachata), Karanja(Pongamia pinnata), Ativisha(Aconitum
heterophyllum), Jala(Pavonia odorata), Indravaruni (Citrullus
cholocynthis),Ananta(Hemidesmus indicus),Sariva
(Hemidesmus indicus),Parpata (Fumaria indica)
Khadira (Acacia catechu),Arimeda( Acacia leucophloea
/farnesiana ),Chandana(Santalum album),Padmaka (Prunus
puddum/ cerasoides), Usheera(Vetiveria zizanioides),Manjishta
(Rubia cordifolia), Dhataki (Woodfordia fruticosa),Ghana
(Cyperus rotundus),Prapaundarika(Nymphaea stellata),Yashti
(Glycyrrhizaglabra), Twak (Cinnamomum zeylanicum),
Ela(Elettaria cardamomum), Padma (Nelumbium speciosum),
Nagakeshara (Mesua ferrea), Laksha(Laccifer lacca),Rasanjana
– Aqueous extract of Berberis aristata, Mamsi(Nardostachys
jatamansi),Haritaki (Terminalia chebula),Vibhitaki (Terminalia
Khadiradi bellirica),Amalaki (Emblica officinalis / Phyllanthus
Effective in Mukha Roga
Vati11 emblica),Lodhra (Symplocos racemosa), Balaka(Pavonia
odorata),Haridra (Curcuma Longa),Daruharidra (Berberis
aristata),Phalini (Callicarpa macrophylla),Ela(Elettaria
cardamomum),Samanga Rubia cordifolia), katphala(Myrica
nagi), Vacha(Acorus calamus), Yavasa(Fagonia
cretica/Arabica), Agaru(Aquilaria agallocha),
Pattanga(Caesalpinia sappan), Gairika(Purified red
ochre),Anjana – Aqueous extract of Berberis aristata),Lavanga
(Syzigium aromaticum),Nakha (Capparis zeylanica),
Kankola(Piper cubeba),Jatikosha (Myristica fragrans), Karpoora
(Cinnamomum camphora)
Trivrit Leha12 Trivrit (Operculina turpethum) Virechaka

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 International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
Yashti (Glycyrhiza glabra),Trijatha (Cinnamon, cardamom and
Cinnamomum tamala),Manjishta (Rubia cordifolia), Gayatri
(Acacia catechu),Lodhra (Symplocos racemosa),Katphala
(Myrica nagi),
Irimeda Twak (Acacia leucophloea /farnesiana),
Musta (Cyperus rotundus),Agaru (Aquilaria agallocha),Shveta
Chandana (Santalum album),Rakta Chandana (Pterocarpus
santalinus),Karpoora ( Cinnamomum camphora), Jati (Myristica
fragrans),Takkola (Illicium verum),Mamsi (Nardostachys
jatamansi),Dhataki (Woodfordia fruticosa),Gairika (Red
ochre),Mrinala (Cymbopogon jwarancusa),Mishi (Anethum
sowa), Vaidehi (Piper longum), Padmakesara(Nelumbo
Irimedadi
nucifera), Kumkuma (Crocus sativus), Laksha (Laccifer lacca), Effective in all Mukha Roga
Taila13
Manjishta(Rubia cordifolia),Brihati (Solanum indicum),
Bilvapatra(Aegle marmelos), Suradruma – Cedrus deodara),
Shaileya (Asphaltum), Sarala( Pinus roxburghi), Sprikka
(Frlphinium zalil), Palasha – Butea
monosperma),Rajani(Curcuma longa), Daruharidra (Berberis
aristata), Priyangu (Callicarpa macrophylla), Tejani (Clematis
triloba), Pradhakaleya (Coscinium fenestratum), Pushkara (
Inula raceomsa), Jaya(butilon theophrasti), Vyaghri(Solanum
xanthocarpum), Madana(Randia dumetorum), Tila Taila-
Sesame oil(Sesamum indicum), Arimeda(Acacia leucophloea),
Nyagrodha(Ficus bengalensis), Udumbara ( Ficus racemosa),
Ashwattha (Ficus religiosa), Plaksha( Ficus lacor
Tila taila (Oil of Sesamum indicum),
Ela (Elettaria cardamomum),Sthoola Ela (Amomum
subulatum), Turushka (Hydnocarpus laurifolia), Kushta
(Saussurea lappa), Phalini(Callicarpa macrophylla), Mamsi
(Nardostachys jatamansi), Jaladhyamaka (Coleus zeylanicus)
,Sprikka(Anisomeles malabarica), Choraka (Angelica
archagelica), Chochapatra (Cinnamomum zeylanicum),
VataKaphashamaka,
Tagara(Valeriana wallichii), Sthauneya – Taxus baccata, Jati(
Eladi Taila14 Varnaprasadana,
(Myristica fragrans) , Rasa( Commiphora myrrha),
Kandu,Pitika,Kothanashak
Shukti(Ostrea edulis), Vyaghranakha ( Capparis sepiaria),
Marahva (Cedrus deodara), Aguru (Aquilaria agallocha),
Shrivasaka (Pinus longifolia), Kumkuma (Crocus
sativus),Chanda (Costus speciosus),Guggulu (Commiphora
mukul),Devadhupa (Shorea robusta),Khapura (Boswellia
serrata),Punnaga (Calophyllum inophyllum),Nagahva – Mesua
ferrea

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Before treatment:-

After treatment:-

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