Abstract

Dr. C. Shristy Shetty*, Dr. Savitha K. Bhat, Dr. Rachana C.

ABSTRACT

Background: Lichen Planus Pigmentosus (LPP) is an acquired pigmentary disorder characterized by brown, grey or blackish pigmentation, commonly involving the face and neck.[1,2] In Ayurveda, LPP does not have a direct one-to-one equivalent as an independently named disease. Its clinical presentation may be interpreted within the broader spectrum of Kushtha, particularly Kshudra Kushtha, considering the predominant involvement of Tvak and Rakta and manifestations such as Vaivarnya, Kandu, Daha and Vedana. Method: A 65-year-old male presented with blackish-grey discoloration over the cervical region for 4–5 months, associated with pain, itching and burning sensation. Clinical examination revealed diffuse blackish-grey to brownish pigmentation over the cervical region extending towards the upper presternal region with tenderness. The patient was assessed from an Ayurvedic perspective, including Prakriti, Nidana, Dosha, Dushya and Samprapti. The patient was clinically diagnosed with LPP and was managed sequentially with internal and external Ayurvedic medications over three treatment phases. Results: Following the initial 15-day treatment with internal and external medications like Skimmune, Aogyavardhini vati, Triphala churna, Patolakaturohinyadi Kashaya, with local application of Six - C ointment and Manjishta choorna, symptoms like burning sensation and pain completely resolved, while occasional itching persisted and slight improvement in discoloration was observed. After the second treatment phase, pain, itching and burning had completely resolved, with significant reduction in cervical discoloration. Following the third treatment phase, where only Arogyavardhini vati, Khadirarishta and Manjishta Taila application was prescribed, complete clinical resolution of the previously documented cervical discoloration was observed on 15 April 2026. No further medication was prescribed and the patient was kept under observation. Conclusion: This case documents progressive symptomatic improvement and complete clinical resolution of cervical pigmentation during sequential Ayurvedic management. The case supports a possible Ayurvedic interpretation of clinically diagnosed LPP within the broader Kushtha/Kshudra Kushtha spectrum, with consideration of Vata-Pitta predominance and Tvak-Rakta involvement. The observed outcome was interpreted as a case experience and cannot establish efficacy or causality because multiple interventions were administered sequentially. Further systematic studies using standardized outcome measures and longer follow-up are required.