Introduction:
Psoriasis is a chronic inflammatory skin disease affecting quality of life and associated with systemic comorbidities. Although conventional therapies can be effective, they are constrained by safety concerns, relapse after discontinuation, high costs, and limited accessibility in low-resource settings. Ayurveda offers a holistic approach to skin disorders; however, evidence mainly highlights purification therapies, which are not always feasible. To address this, the polyherbal compound Pathadi Yogah, referenced in Ashtanga Hridaya for treating skin disorders, was standardized into tablet and oil formulations, making psoriasis treatment more accessible.

Aim: To evaluate the clinical efficacy of Pathadi Tablet (oral) and Pathadi Oil (topical) in patients with plaque psoriasis.

Materials and Methods: A single-arm, open-label clinical trial was conducted with 50 patients (18–60 years) with mild-to-moderate plaque psoriasis. Patients received the Pathadi Tablet (500 mg, twice daily before meals with lukewarm water) and Pathadi Oil (topical, twice daily) for 30 days. Assessments were performed at baseline and on days 7, 14, 21, and 30 using the Psoriasis Area and Severity Index (PASI), Simplified PASI, Physician Global Assessment × Body Surface Area (PGA×BSA), and Dermatology Life Quality Index (DLQI). Laboratory parameters were measured at baseline and after treatment. Data were analyzed using Friedman test, paired t-test, and repeated-measures ANOVA.

Results: Fifty patients (25 males, 25 females; mean age, 32.4 ± 10.8 years) completed the study. Erythema, induration, scaling, and itching scores were significantly reduced (p<0.001). The mean PASI declined from 6.04 ± 2.61 to 1.46 ± 1.10 (75.8% reduction, p<0.001). DLQI improved from 17.74 ± 4.55 to 2.86 ± 2.55 (83.9% reduction, p<0.001). PASI 50 was achieved in 96% (n=48), PASI 75 in 68% (n=34), and PASI 100 in 18% (n=9) of the patients. The ESR decreased significantly. No adverse events were observed, and patient compliance was high.

Conclusion: Pathadi Tablet and Pathadi Oil significantly improved disease severity and quality of life in patients with plaque psoriasis within 30 days. The combined oral-topical approach proved safe, affordable, and easily accessible alternative. Further, larger randomized controlled trials with longer follow up are needed to validate the long-term efficacy and relapse prevention.