A 34-year-old woman presented with reddish elevated patches on her face and neck for 3 months. The patches caused intense itching and appeared more commonly in the afternoons. She is a theatre actor with no medical history but reports anxiety about her work. Examination found 10-12 reddish wheals on her face and neck. She was diagnosed with shitapitta (urticaria) due to aggravation of pitta dosha from improper diet, stress, and possible allergens like her cat. Treatment included detoxification, herbal medications, dietary changes, and lifestyle advice to reduce pitta and avoid triggers.

1. Case presentation
1. A 34 yr lady visited our clinic with following complaints-:
 Reddish elevated patches over face and neck since
 Itching and burning sensation over the patches 3 months
2. History
 Where else do these patches appear?
They appear most commonly on my face and neck region but
sometimes were also seen on my arms.
 How do they start appearing?
There is an intense sense of itching initially forcing me to scratch
that region following which there is redness and appearance of
these patches
 How long do they remain?
They remain for 1 - 2 hrs and then start disappearing gradually.
 Can you make out at what time of the day they usually
appear?
More commonly in the afternoons
 Did you have any sort of fever or infection in the last few
months and taken treatment for the same?
No

2.  Has anyone else in your family been suffering from the same
complaint?
No
 Are you known to have any drug allergy?
No
 Do you have a pet?
Yes, I have a cat
 Tell me something about your profession?
I am a theatre actor
 Do you have any psychological issues
Not as such, but I am just anxious about getting new projects and
sometimes too nervous about my performance. Besides I get very
annoyed due to these patches as it affects my work.
 Do you have your meals at regular times?
No, I don’t get to eat at any fixed timings as such. Just find the
time in between my work.
 What does your diet includes?
Preferably non veg, fish, prawns, eggs, bread, fruits.
3. Examination
 Local-
10-12 reddish elevated wheals with well defined edges seen
scattered over face and neck. Blanching was present.

3.  General examination
Pulse – 78/ min
B.P. - 130/90 mm of hg
Temp – Afebrile
 Systemic examination
R.S-
Normal
C.V.S. -
C.N.S. -
 Prakruti as examined by questionnaire method
Pitta predominant
4. Diagnosis
Shitapitta (urticaria)
5. Treatment
As shitapitta is a disease occurring due to aggravation of pitta
dosha due to
• improper dietary habits
• mental stress and
• exposure to any allergen
Hence measures should be adopted to avoid these and pacify the
pitta.

4.  Shodhan
• Pre procedure – internal oleation with panchatikta ghtita
• Main procedure – Virechan ( a detox therapy that expels out
pitta dosha)
• Post procedure – dietary, physical and psychological rules.
 Shaman- following drugs were used
• Manjishtha
• Patola
• Guduchi
• Haridra
• Trivrut
 Dietary advice
• Try having the meals at regular time.
• Completely give up sea-food like fish, prawns, shellfish etc. as
these may act as allergens.
• Restrict use of hot spices in the diet which can aggravate your
pitta like pepper, chillies etc.
• Have a glass of warm milk with turmeric daily.
 Lifestyle advice
• Practice Shitali Pranayam daily.
• If possible avoid being with any pet.
• Avoid exposure to cold blowing wind may be from an air
conditioner as this has been mentioned as a triggering factor
of shitapitta.
• Avoid using deodorant sprays, opt for a perfume instead.
• Don’t wear any jewellery preferably around your neck.
• Use loose and light clothing.
• Prefer using cool colours like blue, green etc to balance your
pitta.