EFFICACY OF VIRECHANA KARMA IN THE MANAGEMENT OF SHEETAPITTA (URTICARIA) – A CASE REPORT
DOI:
https://doi.org/10.5281/zenodo.23024193Keywords:
Sheetapitta, Urticaria, Virechana Karma, Panchakarma, Medicine, Case ReportsAbstract
Background : Chronic urticaria, an inflammatory disease of the skin characterized as a recurrent disease, is a closely related Tridoshaja vyadhi described in Ayurveda, with erythematous wheals, pruritus and loss of quality of life. Typical treatment is symptomatic and will have a tendency to recur. There is a limited clinical evidence for Virechana Karma, although the principle therapy for the pitta-predominant disorders as suggested by ayurveda.
Case Presentation : A 21 year old male with recurrent erythematous on face, hands, and thighs for 4 years and fever, cough with expectoration, vomiting, and constipation. Allopathic/ayurvedic therapies were providing only temporary relief and recurrent attacks. Clinical condition showed sheetapitta (urticaria) condition and it was planned for classical Virechana Karma.
Management and Outcomes : The patient was given Deepana–Pachana with Amapachaka Vati and then Snehapana with Panchatikta Ghrita in increasing doses and then Vishrama Kala with Sarvanga Abhyanga & Mridu Swedana followed by Virechana Karma using Trivrit Avaleha in 40 g dose with Triphala Kwatha (150 mL) in increasing dose. Then, the Samsarjana Krama and an appropriate shamana medicine was given. The treatment was well tolerated with no adverse events. The clinical evaluation showed complete resolution of erythema, itching, fever, vomiting and related symptoms, with total scores of symptoms improving from 8 before treatment to 0 after treatment. There was no recurrence noted during follow up.
Conclusions: This case illustrates how classical Virechana Karma, when applied based on the Ayurvedic principles could be a safe and effective management for recurrent Sheetapitta (urticaria) with sustained symptomatic remission. These findings are encouraging, but more controlled clinical studies are needed to confirm these results.
Downloads
References
Madhavakara. Madhava Nidana with Madhukosha Commentary, Vidyotini Hindi Tika and Vimarsha. Shastri S, Upadhyaya Y, editors. Reprint ed. Varanasi: Chaukhambha Prakashan; 2021. Part II (Uttarardha), Sheetapitta-Udarda-Kotha Nidanam; p. 200–201.
Kolkhir P, Giménez-Arnau AM, Kulthanan K, Peter J, Metz M, Maurer M. Urticaria. Nat Rev Dis Primers. 2022;8(1):61. doi: https://doi.org/10.1038/s41572-022-00389-z
Penman ID, Ralston SH, Strachan MWJ, Hobson R. Davidson’s Principles and Practice of Medicine. 24th ed. London: Elsevier Health Sciences; 2022. p. 1103.
Sánchez-Borges M, Ansotegui IJ, Baiardini I, Bernstein JA, Canonica GW, Ebisawa M, et al. The challenges of chronic urticaria part 1: Epidemiology, immunopathogenesis, comorbidities, quality of life, and management. World Allergy Organ J. 2021;14(6):100533. doi: https://doi.org/10.1016/j.waojou.2021.100533
Zuberbier T, Abdul Latiff AH, Abuzakouk M, Aquilina S, Asero R, Baker D, et al. The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77(3):734–766. doi: https://doi.org/10.1111/all.15090
Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, editors. Harrison’s Principles of Internal Medicine. 21st ed. Vol. 2. New York: McGraw Hill; 2022. p. 3198–3204.
Bamoriya H, Chandil S, Singh R. Clinical study on effect of Virechana Karma (therapeutic purgation). CellMed. 2022;12(1):2. doi: https://doi.org/10.5667/CellMed.2022.002
Yadav D, Sangwan AK. Management of Sheetapitta through Ayurveda – a case study. World J Pharm Res. 2025;14(10):1005–1011. 2171dfa23a41bd923428019f05981b1a.pdf
Krišto M, Lugović-Mihić L, Muñoz M, Pustišek N, Bešlić I, Babić L, et al. Gut microbiome composition in patients with chronic urticaria: A review of current evidence and data. Life (Basel). 2023;13(1):152. doi: https://doi.org/10.3390/life13010152
Cai R, Zhou C, Tang R, et al. Current insights on gut microbiome and chronic urticaria: Progress in the pathogenesis and opportunities for novel therapeutic approaches. Gut Microbes. 2024;16(1):2382774. doi: https://doi.org/10.1080/19490976.2024.2382774
Zhu L, Jian X, Zhou B, et al. Gut microbiota facilitate chronic spontaneous urticaria. Nat Commun. 2024;15:7288. doi: https://doi.org/10.1038/s41467-024-51564-8
Liu CW, Cheng YC, Yu YT, Huang YC. Roles of gut microbiota and probiotics in chronic urticaria: A systematic review and meta-analysis. Australas J Dermatol. 2022;63(2)–e170. doi: https://doi.org/10.1111/ajd.13807
Xu N, He Y, Yang G, Huang X. Exploring the role of gut microbiota in chronic spontaneous urticaria: Mechanisms and potential therapeutic implications. Probiotics Antimicrob Proteins. 2025. doi: https://doi.org/10.1007/s12602-025-10558-6
Agnivesha. Charaka Samhita with Ayurveda Dipika commentary of Chakrapanidatta. Acharya YT, editor. Reprint ed. Varanasi: Chaukhambha Surbharati Prakashan; 2023. Chikitsa Sthana, Chapter 7 (Kushtha Chikitsa Adhyaya).
Vagbhata. Ashtanga Hridaya with Sarvangasundara commentary of Arunadatta and Ayurveda Rasayana commentary of Hemadri. Paradakara HS, editor. Reprint ed. Varanasi: Chaukhambha Sanskrit Series Office; 2022. Sutra Sthana 18; Chikitsa Sthana.
Bashir F, Ahmad N, Parveen S, et al. Prophylactic aspects and therapeutic potential of Turbud (Operculina turpethum L.) in Unani medicine: An evidence-based appraisal. J Drug Deliv Ther. 2023;13(2):230–236. doi: https://doi.org/10.22270/jddt.v13i2.5947
Jantrapirom S, Hirunsatitpron P, Potikanond S, Nimlamool W, Hanprasertpong N. Pharmacological benefits of Triphala: A perspective for allergic rhinitis. Front Pharmacol. 2021;12:628198. doi: https://doi.org/10.3389/fphar.2021.628198
Alok S, Jain SK, Verma A, Kumar M, Mahor A, Sabharwal M. GC-MS-employed phytochemical characterization, synergistic antioxidant, and cytotoxic potential of Triphala methanol extract at non-equivalent ratios of its constituents. Saudi J Biol Sci. 2022;29(6):103287. doi: https://doi.org/10.1016/j.sjbs.2022.103287
Shu Y, Zhang Y, Li S, et al. Commiphora mukul (Hook. ex Stocks) Engl.: Historical records, application rules, phytochemistry, pharmacology, clinical research, and adverse reaction. J Ethnopharmacol. 2023;317:116717. doi: https://doi.org/10.1016/j.jep.2023.116717
Bhatt N, Deshpande M. A critical review and significance of lipid-based Ayurvedic dosage forms Ghrita and Taila: Part I—Review and status. Int J Curr Pharm Res. 2023;15(2):7–16. Available from:
https://journals.innovareacademics.in/index.php/ijcpr/article/download/47835/27888
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Riddhi Varan, Dr. Shivangi Choube
This work is licensed under a Creative Commons Attribution 4.0 International License.
