Role of Haratala Shodhana in the therapeutic efficacy of Rasamanikya along with Guduchi Ghana in the treatment of Ekakushtha (psoriasis): A double-blind randomised clinical trial

INTRODUCTION: Rasamanikya (RM) and Guduchi Ghana (GG) are well-known formulations for treating skin disorders in Ayurveda. The drug RM is prepared from Shuddha Haratala (processed orpiment) as a single ingredient. In the present study, RM was prepared from the Haratala, which was Shodhita, with two different media, viz., Kushmanda Swarasa and Churnodaka. In the classics, the preparation of RM is mentioned in the Kushmanda Shodhita Haratala. However, the availability and cost of Kushmanda are the main points of concern in the present era. Shodhana of Haratala by Churnodaka is more cost-effective than Kushmanda Swarasa. AIM: The aim of this study is to evaluate the comparative efficacy of RM prepared by Churnodaka Shodhita Haratala (CSHRM) and RM prepared by Kushmanda Shodhita Haratala (KSHRM) with GG in Ekakustha (psoriasis). MATERIALS AND METHODS: The study was a randomized double-blind study involving 76 patients with Ekakushtha that were randomly divided into two groups. Patients registered in group A (n = 37) were treated with CSHRM with GG (125 mg + 375 mg) and group B (n = 36) with KSHRM with GG (125 mg + 375 mg) for 8 weeks. The Wilcoxon signed rank test and paired t-test were applied to evaluate the effect of therapy in the individual group for subjective criteria like the PASI score, Matsyashakalopamam (looks like the scales of a fish), Rukshata (dryness), Aswedanam (anhydrosis), Daha (burning), Strava (discharge), Unnati (raised patches), Kandu (itching), Mahavastu (broad-based), and Vaivarnya (discoloration), while the comparison of results between the groups for the same was done by applying the Coefficient of Variation (CV). RESULT: CSHRM with GG showed better results in all signs and symptoms except Matsyaskalopamam, Aswedanam, Strava, Mahavastu, Nindra and DLQI in terms of the coefficient of variation. In both groups, statistically highly significant (P > 0.001) improvement was found in the signs and symptoms of Ekakushtha. However, the difference between the groups was statistically nonsignificant. CONCLUSION: Rasamanikya prepared with both media Shodhita Haratala along with Guduchi Ghana was discovered to be a safe and effective psoriasis treatment.