Role Of Agnikarma In Management Of Cutaneous Horn W.S.R To Charmakeela Review Article

Abstract

Background: Cutaneous horn (cornu cutaneum) is a conical hyperkeratotic projection that may overlie benign, premalignant, or malignant lesions—most commonly actinic keratosis and squamous cell carcinoma (SCC). Correct diagnosis requires histopathologic evaluation of the base of the horn. In Ayurveda, analogous exophytic, keratotic lesions are described as Charmakila under Kshudra Rogas, with Agnikarma (thermo-cauterization) recommended as a prime parasurgical intervention.

Objective: To synthesize classical Ayurvedic foundations of Agnikarma, its probable mechanisms, and contemporary clinical evidence relevant to cutaneous horn and Charmakila, and to identify best-practice considerations that align with modern dermatologic standards.

Methods: Narrative review of dermatology sources on cutaneous horn and Ayurveda Reviews on Agnikarma for Charmakila/warts.

Results: Dermatologic reviews report malignancy beneath cutaneous horns in ~16–30% of cases, emphasizing biopsy/excision of the base. Ayurveda reviews conceptualize Agnikarma as targeted thermal cauterization with analgesic and anti-recurrence claims; case reports document favorable outcomes for warts/Charmakila. Mechanism (Ayurveda: pacification of Vata–Kapha; biomedicine: protein denaturation, nociceptive gate control) support its role for localized keratotic lesions.

Conclusions: Agnikarma serve as a complementary modality for select benign keratotic lesions and for postoperative hemostasis; however, when managing cutaneous horns, mandatory histopathology of the base and oncologic pathways must guide care. Integrative protocols can be designed to align Agnikarma with surgical standards (proper excision, margins, sterility, informed consent), while prospective studies are needed to validate efficacy and recurrence rates against conventional methods.