Introduction
Psoriasis and its Ayurvedic correlation
Psoriasis is a chronic, immune-mediated inflammatory skin disorder characterized by excessive keratinocyte proliferation, epidermal hyperplasia, and persistent activation of immune pathways involving T lymphocytes and pro-inflammatory cytokines. The disease significantly affects patients' quality of life owing to its visible cutaneous manifestations, chronic course, and recurrent nature.
In Ayurveda, skin disorders are broadly classified under Kustha, a group of chronic dermatological conditions described extensively in classical texts. Kustha has long been recognized as a challenging disease due to its persistent nature and considerable impact on physical appearance and social well-being. Eighteen varieties of Kustha are described in Ayurvedic literature, among which Ekakustha exhibits clinical features closely resembling psoriasis. Consequently, many Ayurvedic scholars correlate Ekakustha with psoriasis based on similarities in symptomatology and disease progression.
Ayurvedic perspective of Ekakustha
Ekakustha is considered a Tridoshaja disorder with predominant involvement of Vata and Kapha doshas. Classical texts describe its characteristic features as Aswedana (absence of sweating), Mahavastu (extensive lesions), and Matsyashakalopama (scaling resembling fish scales). These manifestations closely parallel the clinical presentation of psoriasis, which is characterized by dry, erythematous, and scaly plaques.
The diagnosis of Ekakustha is traditionally based on the assessment of clinical parameters such as lesion morphology (Akriti), discoloration (Varna), pain or discomfort (Vedana), extent of involvement, and associated systemic features.
Pathogenesis of psoriasis
Despite extensive research, the precise etiopathogenesis of psoriasis remains incompletely understood. Current evidence identifies psoriasis as a T-cell-mediated autoimmune disorder in which activated T lymphocytes trigger a cascade of inflammatory events. This process results in the overproduction of cytokines, accelerated epidermal turnover, and the development of characteristic psoriatic lesions.
The immunological mechanisms underlying psoriasis involve dysregulation of the Th1 and Th17 pathways, with increased expression of cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin (IL)-17, and IL-23. These mediators contribute to chronic inflammation, keratinocyte hyperproliferation, and sustained disease activity.
Relevance of Ayurvedic management
Ayurvedic management of Ekakustha is based on understanding the specific doshic involvement and underlying pathogenic factors. Unlike conventional approaches that primarily focus on immunosuppression, Ayurvedic interventions aim to restore physiological balance through immunomodulation, correction of doshic imbalance, detoxification, and enhancement of tissue health.
Rationale for the use of Khadira in psoriasis
In Ayurvedic literature, Khadira (Acacia catechu) is regarded as one of the most important medicinal plants for the management of Kustha (skin disorders) and is traditionally considered a drug of choice for various chronic dermatological conditions. In addition to its use in Kustha, Khadira has been extensively employed in the treatment of Prameha and Shvitra, highlighting its broad therapeutic applicability.
Pharmacological studies have demonstrated that Khadira possesses significant anti-inflammatory, antioxidant, antimicrobial, and immunomodulatory properties, which may contribute to its therapeutic efficacy in immune-mediated skin diseases. The heartwood extract of Acacia catechu, commercially known as black catechu (Kattha), contains bioactive constituents such as catechins, flavonoids, and tannins that exhibit potential protective effects against inflammatory and oxidative tissue damage.
Given the immunological and inflammatory basis of psoriasis, Khadira has attracted interest as a potential therapeutic agent for modulating disease activity. Therefore, the present study was undertaken to evaluate the clinical efficacy of Khadira (Acacia catechu) in the management of Ekakustha, the Ayurvedic condition commonly correlated with psoriasis.1
Different compounds present in different parts of Acacia catechu in different extracts2
|
Plant part |
Type of extract used |
Different compounds present in Acacia catechu |
|
Leaves |
Methanol |
Camphor, Phytol |
|
Leaves |
Ethanol |
(+)-Catechin, (–)-Epicatechin, (+)-Afzelechin, (–)-Epiafzelechin, (+)-Mesquitol, Kaempferol, Quercetin, Quercetin 3-methyl ether, Ellagic acid, Caryatin |
|
Leaves |
Ethanol |
Rutin, Quercetin |
|
Leaves |
Methanol (hexane fraction) |
Gallic acid, Catechin, Chlorogenic acid, Epicatechin, Coumaric acid, Rutin, Ellagic acid, Quercetin, Kaempferol |
|
Leaves |
Methanol |
Caprylic acid methyl ester, Lauric acid methyl ester, 2-ethyl-3-methyl-1-butene, Myristic acid methyl ester |
|
Leaves |
Ethanolic |
L-(+)-lactic acid, L-alanine, L-valine, urea, pipecolic acid, glycerol, phosphoric acid, L-threonine, glycine, succinic acid, glyceric acid, beta-alanine, D-malic acid, O-acetylsalicylic acid, L-glutamic acid, 4-guanidinobutyric acid, phenylalanine, phenylethylamine, meleamic acid, L-asparagine, xylitol, arabitol, putrescine, methyl-beta-D-galactopyranoside, quinic acid, allantoin, tyramine, D-sorbitol, D-mannitol, gallic acid, palmitic acid, dopamine, L-tryptophan, stearic acid, serotonin, sucrose, (-)-epicatechin, catechin, isoquercitrin |
|
Bark |
Methanol, ethyl acetate |
Catechin, quercetin, rutin, kaempferol |
|
Bark |
Ethyl acetate, aqueous fraction |
Catechin, epicatechin, gallocatechin, epigallocatechin, procyanidin B1, procyanidin B3, emodin, afzelechin, epiafzelechin, maclurin, irisflorentin, naringenin, isoquercetin, diosmetin, chrysin, myricetin, kaempferol, avicularin, prodelphinidin B3, quercetin, taxifolin, acacetin, gossypin, pterocarpin, isorhamnetin, flavonoid derivatives |
|
Heartwood |
Ethanol, methanol, petroleum ether |
Gallic acid, protocatechuic acid-4-glucoside, quercetin, quercetin 3-rhamnoside, quercetin 3-glucuronide, epicatechin |
|
Heartwood |
Methanol |
Catechin |
|
Catechu |
Aqueous |
Rhamnetin, 4-hydroxyphenol, pentahydroxyflavane derivative, fisetinidol derivative |
|
Seed |
Methanol |
Catechin, quercetin |
Therapeutic implications of Khadira in psoriasis
Multi-target disease modulation:
The wide spectrum of bioactive compounds in Acacia catechu allows simultaneous modulation of inflammation, oxidative stress, and immune dysregulation, making it a multi-target therapeutic agent for psoriasis.
Support for Ayurvedic disease framework:
Khadira is classically indicated for Kustha, and its pharmacological properties strongly align with the Tridoshaja (Vata-Kapha predominant) pathology of Ekakustha, supporting its traditional use.3
Adjunct role in chronic plaque psoriasis:
Given its immunomodulatory and anti-inflammatory profile, Khadira may serve as a supportive or adjunct therapy alongside conventional or Ayurvedic treatment regimens for chronic plaque psoriasis.
Conclusion
Khadira (Acacia catechu) demonstrates significant therapeutic potential in psoriasis due to its rich phytochemical composition and multifaceted pharmacological actions. The presence of flavonoids, polyphenols, and tannins contributes to its anti-inflammatory, antioxidant, immunomodulatory, and keratinocyte-regulating effects. These properties collectively support its traditional Ayurvedic use in Kustha and justify its clinical exploration in Ekakustha (psoriasis). Further well-designed clinical and mechanistic studies are required to establish standardized therapeutic protocols and confirm long-term efficacy.
References:
- Sengupta A, Nath R. Therapeutic effect of Khadira (Acacia catechu) in ekakustha vis-a-vis (psoriasis). International Journal of Science and Research Methodology. 2017;6(3):77-87. https://www.wjpls.org/download/article/49022020/1583564774.pdf
- Kumari M, Radha, Kumar M, et al. Acacia catechu (L.f.) Willd.: A Review on Bioactive Compounds and Their Health Promoting Functionalities. Plants (Basel). 2022;11(22):3091. Published 2022 Nov 14. doi:10.3390/plants11223091. https://pmc.ncbi.nlm.nih.gov/articles/PMC9697042/
- Devi BM, Verma RC, Rana S, Sabharwal S. Acacia catechu (Khadira): A Comprehensive Review of Its Traditional and Modern Therapeutic Potential. Journal of Ayurveda and Integrated Medical Sciences. 2026. DOI: 10.21760/jaims.11.5.44. https://jaims.in/jaims/article/view/6168/10996#info