Traditional Siddha Therapy Using Sivappu Kukkil Thailam (Topical) and Seendhil Chooranam (Oral) for Chronic Plaque Psoriasis: A Single-Patient Case Following the CAse REport (CARE) Guidelines.

Psoriasis is a chronic inflammatory disease causing a significant impact on quality of life. We report a 57-year-old male with moderate-to-severe plaque psoriasis (Psoriasis Area and Severity Index (PASI) 18.6, body surface area (BSA) 22%, Dermatology Life Quality Index (DLQI) 24, pruritus 9/10), intolerant of methotrexate. Under dermatology supervision, he underwent 12 weeks of Siddha therapy (Siddha topical herbal oil (Sivappu Kukkil Thailam (SKT)) + Siddha oral powder (Seendhil Chooranam (SC))) with serial lab monitoring. Significant improvement was observed (PASI 2.4, BSA 3%, DLQI 3, pruritus 0/10), sustained at nine-month follow-up with no adverse effects. This real-world case highlights how patients can explore complementary medicine options, especially with the support of clinical supervision, and in this case, the results were quite positive. Serial photographs documented the significant resolution of plaques, although some residual post-inflammatory dyschromia remained. However, it is crucial to remember that guideline-directed therapy continues to be the cornerstone of psoriasis treatment. This uncontrolled, single-case observation does not establish Siddha therapy as a primary treatment or a valid alternative to evidence-based medicine. Instead, these findings should be viewed as preliminary data that require thorough validation. Further research, particularly randomized controlled trials that utilize standardized Siddha formulations, is essential to explore its potential role as a complementary approach within the established framework of evidence-based medicine, rather than as a replacement. Clinicians should continue prioritizing established guideline therapies while actively engaging patients in shared decision-making about complementary options.