Effect of Ayurvedic interventions in the management of Erythema multiforme (Pittaja oshtharoga): A clinical documentation

Abstract: Erythema Multiforme (EM) is an acute mucocutaneous disorder, occurring as an immune-mediated hypersensitivity reaction, characterized by the appearance of painful, symmetrical lesions on skin and mucous membranes, particularly within the oral cavity and on the lips. The oral lesions can be severe, leading to difficulty in eating, drinking, speaking, and may require hospitalization. Conventional treatments are symptomatic, with antivirals administered in cases of Herpes Simplex Virus reactivation. A 27-year-old female presented with painful, burning ulcers on her lips for the past 25 days, following fever. Initial treatments with conventional medications included oral vitamins and mouth ulcer gels, with no improvement. Following this, a diagnosis of EM was made after thorough evaluation, and Ayurvedic interventions were initiated. It included oral administration of Triphala guggulu, Haridrakhanda, Avipattikara churna , and Rasayana churna , along with local application of Madhuyashti churna (powder of Glycyrrhiza glabra L.) with honey and Panchvalkala kwatha for Dhawana (~therapeutic irrigation). There was improvement in the condition of the patient after 26 days of treatment, with complete resolution of ulcers, pain, and burning sensations. The Visual Analog Scale score for pain dropped from 9 to 1, indicating a substantial reduction in discomfort. No recurrence of symptoms was noted during three months of follow-up visits, and the patient reported complete satisfaction with the outcome. This case demonstrates a successful therapeutic approach of Ayurveda in EM, showcasing its potential role in providing substantial clinical improvement in cases of oral lesions and pathologies. However, further studies are needed to assess the generalizability of the findings.