Maha Kushta: Major Skin Diseases, Symptoms, Prognosis

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Kushta means skin diseases. Depending on the nature of manifestation, complexities, the severity of presentation, prognosis and treatment options, the 18 types of Kushta have been sub-classified into
7 types of Maha Kushtas (major or greater skin diseases) and
11 Kshudra Kushtas (minor or lesser skin diseases). 

7 Maha Kushtas

  • Kaapaala (Kapala) Kushta
  • Audumbara (Oudumbara) Kushta
  • Mandala Kushta
  • Rushyajihwa (Rishyajihwa) Kushta
  • Pundareeka (Pundarika) Kushta
  • Sidhma Kushta
  • Kaakana (Kakana) Kushta

Kaapaala Kushta
Shape and appearance – Kaapaala means a piece of earthen pot, in the shape of a saucer. The Kushta in which the lesions or eruptions resemble a Kaapaala is called Kapala Kushta.

Signs –

  • Krishna-Aruna Kapaalabham – The lesions are either Krushna (blackish brown, grey) or Aruna (yellowish red, Golden yellow) in color or a mix of Krishna and Aruna varnas (all colors mixed together). They appear like a piece of earthen pot which is freshly made, with a muddy shine (reddish black or blackish red).
  • Rooksha-Parusham – They look dry (ruksha) and are rough and hard (parusham) on touch.
  • Tanu – They are thin (not protruded), on the surface and in level to the skin surface
  • Vishamam – Spreads abruptly, in a haphazard way

Predominant symptoms –
– Toda Bahulam – Typically characterized by excessive toda or pricking / throbbing pain
Dosha Predominance – Vata Dosha

Udumbara / Audumbara (Oudumbara) Kushta
Shape and Appearance – As the name indicates, this Kushta typically appears like a pakwa udumbara phala (ripe fruit of Ficus racemosa, Indian fig tree, and cluster fig tree)

Signs –
– Udumbara Phalabhasam – Appears like an Udumbara fruit
– Loma Pinjaram – The hairs in the region of kushta have golden yellow color

Predominant Symptoms
Daha – Burning sensation
Kandu – Itching
Rujaa – Pain
Raaga – Reddish discoloration
Dosha Predominance – Pitta Dosha

Mandala Kushta
Shape and Appearance – As the name indicates, this Kushta typically manifests in the shape of a Mandala, a circular raised patch.

Signs –
Shwetam – White in color
Raktam – Red colored
Sthira – Stiff, stable and unmovable
Snigdham – Unctuous, oily appearance, shiny
Utsannam – Elevated, raised over the surface of the skin
Mandalam – Circular in shape
Anyo anya samyuktam – Mingled with one another

Predominant Symptom – Styaanam – Feeling of heaviness in the site of lesion
Prognosis -Mandala Kushta is said to be Krichra Saadhya i.e. difficult to cure
Dosha Predominance – Kapha Dosha

Rushyajihwa (Rishyajihwa) Kushta
Shape and Appearance – As the name indicates, this Kushta typically resembles the shape of the tongue (jihwa) of a Rushya / Rishya (type of deer or bear).

Signs –
Karkasham – Rough or coarse in appearance and touch
Rakta Paryantam – Red colored at the margins
Antaha Shyaavam – Bluish black at the centre
Rushya Jihwa Samsthaanam – Resembles the shape of the tongue of a deer or bear

Predominant Symptom: Vedana – Pain
Dosha Predominance – Vata-Pitta Doshas

Pundareeka Kushta
Appearance, Signs and Symptoms –
Shape and Appearance – As the name indicates, this Kushta typically resembles a Pundareeka dala or petal of red variety of Lotus flower.

Signs –
Shwetam – White in color
Rakta Paryantam – Red colored at the center
Pundareeka Dala Upamam – Resembles the petal of a red colored lotus
Sa Utsedham – Elevated from the surface of the skin (raised)

Predominant Symptom: – Daaham – Burning sensation
Dosha Predominance – Kapha-Pitta Doshas

Sidhma Kushta
Shape and Appearance – Sidhma Kushta resembles (has the color of) Alabu Pushpa (flower of Lagenaria sicareria)

Signs –
Shwetam – White in color
Tamram– Copper color
Tanu– Thin lesions
Alabu Pushpa Varnam – Resembles the flower or petals of the flowers of Lagenaria sicareria
Rajo Ghrishtam Vimunchati – The lesions yield dusty particles (of skin, skin peel) on rubbing or scratching

Predominant Symptom:
Rajo Ghrishtam Vimunchati – The lesions yield dusty particles (of skin, skin peel) on rubbing or scratching
Specific location – Praayena Urasi – Sidhma can occur anywhere, but it generally manifests on the chest
Dosha Predominance – Vata-Kapha Doshas

Kaakana Kushta
Shape and Appearance – As the name indicates, this Kushta typically resembles the color of Kakanantika or Gunja (Abrus precatorius)

Signs –
Apaakam – The lesions do not get suppurated
Kaakanantika Varnam – Lesions resemble red color similar to that of seeds of Abrus precatorius

Predominant Symptom / Symptoms
Teevra Vedanam – Severe pain
Tridosha Lingam – Signs and symptoms of vitiation of all the 3 doshas can be seen in this Kushta

Prognosis – Asadhya – Kaakana Kushta is incurable
Dosha Predominance – vitiation of all the 3 doshas

Just Before Finishing –
The term Maha associated with Kushta means major or greater. They may possibly be involved with a difficult pathology and stubborn prognosis.
Click to Consult Dr Raghuram Y.S. MD (Ayu)


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