A single case study of Ayurvedic management of Vicharchika w.s.r. to Weeping Eczema

PK Reshmi

A single case study of Ayurvedic management of Vicharchika w.s.r. to Weeping Eczema

Reshmi P.^1*

DOI:

^1* PK Reshmi, Assistant Professor, Department of Panchakarma, Ramakrishna Ayurvedic Medical College, Hospital and Research Center, Bangalore, Karnataka, India.

In the present case study, a 4 years old girl consulted in the Ayurvedic clinic after a spectrum of allopathic treatment with huge disappointment. The girl was with the presenting complaints of recurrent skin rashes over dorsal part of upper ankle joints bilaterally with redness, skin edema, itching, skin flaking, blistering, oozing and bleeding of upper layer of skin. In the present case, parents of patient was intended to treat with Ayurveda. By examining the patient, the signs and symptoms was diagnosed as Vicharchika which has similarities with eczema as per modern medicine. As per Ayurveda, Vicharchika is one among Kshudrakusta with dominance of Kaphadosha. The patient was treated with Gudoochyadi Kashaya, Manjishtadi Kashaya, Aragwadharista, Gorochanadi Gutika, Triphala Churna and Mahatiktaka ointment along with strict restrictions of diet. This study is carried out as per International conference of Harmonization – Good Clinical Practices Guidelines as per Declaration of Helsinki guidelines.

Keywords: Eczema, Vicharchika, Kshudra Kusta, Triphala Churna

Corresponding Author	How to Cite this Article	To Browse
PK Reshmi, Assistant Professor, Department of Panchakarma, Ramakrishna Ayurvedic Medical College, Hospital and Research Center, Bangalore, Karnataka, India. Email:	PK Reshmi, A single case study of Ayurvedic management of Vicharchika w.s.r. to Weeping Eczema. J Ayu Int Med Sci. 2022;7(7):181-184. Available From https://www.jaims.in/jaims/article/view/1999

Introduction

As per Ayurveda, Vicharchika is a type of Kshudra Kusta involved with all the Tridoshas with predominance of Kaphadosha along with the Dushyas like Twak, Lasika, Rakta and Mamsa.^[1]Vicharchika can be correlated with eczema as per modern medicine which is a type of dermatitis caused by the inflammation of epidermis.^[2] Weeping eczema is the one with pus filled blisters. The pus is usually yellow or clear in color and eventually dries up as a crusty layer on skin which was characterized by recurrent skin rashes over dorsal part of upper ankle joints bilaterally with redness, skin edema, itching, skin flaking, blistering, oozing and bleeding of upper layer of skin. Here, the adopted treatment methods are as per the treatment principles mentioned in Classical Ayurvedic texts. A substantial reduction in all the symptoms and improvement in the skin lesion were observed after a period of 4 months of regular treatment and 2 months follow up. The improvement was observable through the follow up photographs.

Case Report

A 4 year old female patient diagnosed as Weeping Eczema by a dermatologist, with complaints of recurrent skin rashes over dorsal part of upper ankle joints bilaterally with redness, skin edema, itching, skin flaking, blistering, oozing and occasional bleeding of upper layer of skin. The symptoms were occurring on and off for the past 2 years including a recurrence 2 months ago.

Clinical Findings

General Examination: The general condition of the patient was good and there were no alterations in vital signs. She had good appetite, regular bowel and bladder habit and sound sleep. In clinical examination, patient is moderately built and moderately nourished with no other symptoms of any systemic illness. On local examination, there could be observed that severe degree of inflammation with multiple irregular sized ulcers and vesicles with slight pus discharge and occasional bleeding on left leg. None of the family members of the patient had this ailment or similar other dermatological complaints. Patient has not reported any other medical or surgical illness apart from the present complaints.

Treatment adopted: Before planning the treatment, the condition was diagnosed as Vicharchika as the patient presented with all the classical symptoms. The features of recurrent skin rashes over dorsal part of upper ankle joint of left leg with redness, skin edema, itching, skin flaking, blistering, oozing and bleeding of upper layer of skin enabled in diagnosing the ailment with Kapha and Vata dominance.

The treatment planned for this condition was Prakshalana and Lepa of Triphala Churna, topical administration of Mahatiktaka Gritha ointment and internal administration of Guduchyadi Kashaya, Manjishtadi Kashaya, Gorochanadi Gutika, Aragwadharista and Triphala Churna. Dosage of the internal medicines as decided by considering the age of the patient as per clinical practice.

Table 1: Drugs administered with Posology

SN	Medications	Dose with Anupana
1.	Guduchyadi Kashaya[3]	10 ml bd with 25 ml luke warm water before food
2.	Manjishtadi Kashaya[4]	10 ml bd with 25 ml luke warm water before food
3.	Gorochanadi Gutika[5]	1 tab bd with luke warm water after food
4.	Aragwadharista[6]	5 ml bd with 10 ml luke warm water after food
5.	Triphala Churna[7]	5 gm at night with luke warm water after food
6.	Mahatiktaka ointment[8]	External application

Picture 1: Condition before treatment

Picture 2: After 1 month of treatment

Picture 3: After the completion of treatment

Discussion

Ingredients of Guduchyadi Kashaya are Guduchi, Padmaka, Nimba, Dhanyaka and Raktachandana. It possesses Pittahara and Kaphahara properties. In Vicharchika main symptoms are oozing, reddish discoloration, itching etc. and the mainly involved Doshas are Kapha and Pitta. So, we can choose Guduchyadi Kashaya here. Manjishtadi Kashaya contains drugs like Manjishta, Triphala, Katurohini,

Vacha, Devadaru, Haridra, Amritha and Nimba. These drugs together possess Kapha-Pittahara properties. So alternate use of Guduchyadi Kashaya and Manjishtadi Kashaya given good result in the treatment of Vicharchika.

Gorochanadi Gutika generally can be used in all the inflammatory conditions especially in children as it contains many auspicious ingredients like Rudraksha, Swarnabhasma, Ishwari etc. As per Ayurveda, in all the skin diseases involvement of Rakta is evaluated and so we can use Gorochanadi Gutika in skin diseases of children because of its anti-inflammatory properties.

As the ingredients of Aragwadharista possess Raktashodhaka properties and it has a key role in treating various types of skin diseases. Aragwadha possesses mild purgative action and all the skin diseases are fit for Shodhana therapies.^[9] So it can be used in Vicharchika also.

Anti-inflammatory, immune-modulating, laxative and Anti-oxidant properties of Triphala already proven in various case studies by various scholars. As per Susruta, Triphala Churna is very much useful for treating ulcers and wounds.

Conclusion

In this case study of Vicharchika, the given treatment intervention was completely followed by Ayurvedic treatment principles along with strict Pathyasevana. No other systems of medicine was given.

Reference

1. Agnivesha, Charaka Samhita, Vidyotini Hindi Commentary by Kashiram Shastri and Gorakhnath Chaturvedi, Chaukhambha Bharati Academy, Varanasi, Part 2, Reprint 2006, Chikitsa Sthana 7/30, pp 253

2. Harrison’s Principles of Internal Medicine, McGraw Hill Medical Publishing Division, New Delhi, 1036th Edition 2004, pp 289

3. Vagbhata, Astanga Hridayam, collated by Dr. Anna Moreswara Kunte and Krishna Ramachandra Sastri Navare, Edited by Bhishagacharya Harisastri Paradakara Vaidya, Chaukhambha Orientalia, Varanasi, Reprint 9th Edition, Sutrasthana 15/16, pp 235

4. Sahasrayogam with Sujanapriyavyakhya, Editers K V Krishnan Vaidyan and S Gopala Pillai, February 2006, 26th Edition, Vidyarambham Publishers, Vatarakta Adhyaya, pp 85

5. Vaidyayoga Ratnavali, Gutika Prakarana - 77, A1DS5f vol.1

6. Vagbhata, Astanga Hridayam, collated by Dr. Anna Moreswara Kunte and Krishna Ramachandra Sastri Navare, Edited by Bhishagacharya Harisastri Paradakara Vaidya, Chaukhambha Orientalia, Varanasi, Reprint 9th Edition, Sutrasthana 15/17,18, pp 235

7. Susruta, Susruta Samhita, Dalhana Commentary – Nibandha Sangraha, Chaukhambha Orientalia, Varanasi, 2002, Sutrasthana 38/56, 57

8. Proprietary medicine as per the reference ofVagbhata, Astanga Hridayam, collated by Dr. Anna Moreswara Kunte and Krishna Ramachandra Sastri Navare, Edited by Bhishagacharya Harisastri Paradakara Vaidya, Chaukhambha Orientalia, Varanasi, Reprint 9th Edition, Chikitsa Sthana 19/8-10, pp 711

9. Susruta, Susruta Samhita, Dalhana Commentary – Nibandha Sangraha, Chaukhambha Orientalia, Varanasi, 2002, Chikitsasthana 9/43, pp 446

Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2022-06-27	2022-06-28	2022-07-05	2022-07-12	2022-07-19
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	17%

Case Report

Eczema

Journal of Ayurveda and Integrated Medical Sciences