E-ISSN:2456-3110

Case Report

Acne Conglobata

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 4 April
Publisherwww.maharshicharaka.in

Role of Ayurveda treatment protocol in the management of Yuvanpidika w.s.r. to Acne Conglobata – A Single Case Study

C Zanwar A1*, D Ingole S2
DOI:10.21760/jaims.9.4.45

1* Ashish C Zanwar, Assistant Professor, Department of Kayachikitsa, Sau Shantadevi Vedprakash Patil Ayurvedic College Research Institute Hatta Tq, Basmat Dist Hingoli, Maharashtra, India.

2 Sumit D Ingole, Consultant, Department of Panchakarma, Smt Sumitrabai Thakare Ayurvedic Hospital MIDC Lohara B, Yavatmal, Maharashtra, India.

Acne Conglobata refers to the severe form of acne characterized by large polyporous comedon, severe inflammatory lesions including abscesses and cysts, marked scarring and sinus formation. The etiology of acne involves the interplay of multiple factors, including hormonally-induced sebum production, and inflammation. The gram-positive microaerophilic/anaerobic rod called Cutibacterium acnes (formerly Propionibacterium acnes) is a commensal organism of the skin found deep within the sebaceous follicle and mediates a portion of the inflammatory component. In Ayurveda, AC can be correlated with Mukhadushika which was explained under Kshudra Rogas. Due to vitiation of Kapha, Vata and Rakta, small or medium sized eruptions appeared on the face of adolescents. Classical text explains treatment plan for Mukhadushika is of two types Shodhana Chikitsa and Shamana Chikitsa including Vamana, Nasya, Siravedha, Lepa and Pralepa. A 27 year old male patient came with complaints of Pidaka (glandular and papular swelling) all over the face, Todavat Pida (pricking pain) with oiliness of face, Malabadhata (constipation), improper sleep pattern since last 2 months. After detailed examination and history taking Hetu of the disease were evaluated and patient treated with Shodhan and Shaman for 2 months along with Jalukaavcharan 2 times in treatment duration & was also advised to follow Pathya-Apathy. After completion of treatment patient was got relief of all the complaints and get rid of disease.

Keywords: Youvanpidika, Nitya Virechan, Jalukaavcharan, acne congoblata

Corresponding Author How to Cite this Article To Browse
Ashish C Zanwar, Assistant Professor, Department of Kayachikitsa, Sau Shantadevi Vedprakash Patil Ayurvedic College Research Institute Hatta Tq, Basmat Dist Hingoli, Maharashtra, India.
Email: 		C Zanwar A, D Ingole S, Role of Ayurveda treatment protocol in the management of Yuvanpidika w.s.r. to Acne Conglobata – A Single Case Study. J Ayu Int Med Sci. 2024;9(4):279-282.
Available From
https://jaims.in/jaims/article/view/3103

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-02-14 2024-02-24 2024-03-04 2024-03-14 2024-03-23
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 20.33

© 2024by C Zanwar A, D Ingole Sand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2024;9(4)279
Ashish C. Zanwar et al. Management of Yuvanpidika w.s.r. to Acne Conglobata

Introduction

Acne Conglobata refers to the severe form of acne characterized by large polyporous comedon, severe inflammatory lesions including abscesses and cysts, marked scarring and sinus formation. It usually presents with tender, disfiguring, double or triple interconnecting Comedones, cysts, inflammatory nodules, and deep burrowing abscesses on the face, shoulders, back, chest, upper arms, buttocks, and thighs.

The Comedones often occur in groups of three, and the cysts often contain purulent, foul-smelling material that is discharged on the skin surface. It is a chronic inflammatory disease that inevitably leads to scar formation and disfigurement.[1] The etiology of acne involves the interplay of multiple factors, including hormonally-induced sebum production, and inflammation. The gram-positive microaerophilic / anaerobic rod called Cutibacterium acnes (formerly Propionibacterium acnes) is a commensal organism of the skin found deep within the sebaceous follicle and mediates a portion of the inflammatory component.[2]

AC presents with deep burrowing abscesses that interconnect with each other via sinus tracts. Initially, the nodular lesion may mimic a pimple, but underneath there is a vigorous inflammatory reaction and pus formation. Over time, the pus pushes into the adjacent tissues and extrudes on the skin's surface. Scar formation and disfigurement of the body are common with this type of acne.

In Ayurveda, AC can be correlated with Mukhadushika which was explained under Kshudra Rogas. Due to vitiation of Kapha, Vata and Rakta, small or medium sized eruptions appeared on the face of adolescents.[3] Mukhadushika are known as Yuvan Pitika or Tarunya Pitika. These eruptions or Pitikas can not only destroy the beauty of the face but also cause disfigurement hence they are also called as Mukhadushika.[4] Classical text explains treatment plan for Mukhadushika is of two types Shodhana Chikitsa and Shamana Chikitsa including Vamana, Nasya, Siravedha, Lepa and Pralepa.[5]

Materials and Methods

Case Report

A 27 year old male patient came with complaints of Pidaka

(glandular and papular swelling) all over the face, Todavat Pida (pricking pain) with oiliness of face, Malabadhata (constipation), improper sleep pattern since last 2 months.

He had took various local application creams of modern medicine but got no relief so came to SSVP Kayachikitsa OPD for further management. Patient is student of competitive exams and having habit of tobacco chewing

History of past illness - No any h/o of major illness.

History of allergies - No h/o any allergies.

Family H/O - No any significant family history

Personal history

Bowel - Constipated, 1 time / day, unsatisfactory evacuation

Appetite - Reduced

Diet - Spicy and Sour food along with junk food once in week.

Micturation - Normal 3-4 times/day, 1-2times/night

Sleep - Disturbed sleep due to studies

Habits - Tobacco chewing since 3 years

Occupational history - Seating for long duration, Ratri Jagaran and stress

On Examination

Type of swelling - Glandular and pustular swelling,

Distribution - Uneven spread all over the Face

Ashthavidh Pariksha

  • Nadi - 78/Min
  • Mala - Asamayak (constipated)
  • Mutra - Samyak
  • Jivha - Saam
  • Shabda - Spashta
  • Sparsh - Anushan Shita, Khar Sparsh
  • Druk - Samyak
  • Akriti - Madhyam

Dietary advice

Pathya - Home cooked diet without


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Ashish C. Zanwar et al. Management of Yuvanpidika w.s.r. to Acne Conglobata

over spices, green leafy vegetables, salad, repeated face washes with face wash, Pranaym and Yoga to reduce stress.

Apathya - Avoid Abhishyandi Ahar, salty and junk food, spicy food, Ratri Jagaran, repeated expose to dirt and dust.

Table 1: Showing treatment plan.

SNDrugsDose / Route of administrationAnupanaDuration
1.Gandhak Rasayan250mg twice a day
Oral		Luke warm water2 months
2.Arogyavardhini Vati250mg twice a day
Oral		Luke warm water
3.Kaishor Guggul250mg twice a day
Oral		Luke warm water
4.Gandharv Haritaki Churna5 gm at bed timeLuke warm water
5.Amruta Churna
Musta Churna
Patol Churna
Haritaki Churna
Sriva Churna
Vacha Churna		5gm twice a day after mealLuke warm water
6.RaktamokshanWith Jalukaavcharan 2 time in 2 months

Assessment[6]

  • Grade-0: No any Acne
  • Grade-1: Comedones, occasional papules.
  • Grade-2: Papules, comedones, few pustules.
  • Grade-3: Predominant pustules, nodules, abscesses.
  • Grade-4: Mainly cysts, abscesses, widespread scarring.

Table 2: Showing day wise progress gradation

Duration0 day15 day30 day60 day
GradationGrade 4Grade 3Grade 2Grade 0

Table 3: Showing results before and after treatment

Before treatment
jaims_3103_01.JPG		After treatment
jaims_3103_02.JPG
jaims_3103_03.JPGjaims_3103_04.JPG

Discussion

Probable mode of action Gandhak Rasayan

Gandhak Rasayan is prepared by giving 12 Bhavanas of drugs to Shuddha Gandhaka. It is mainly indicated in the management of Kushta Roga it having antibacterial and antifungal properties along with acting on Rakta Dhatu and causes Rakta Shodhan (purification of blood). It also acts as Rasayana and helps in improving the digestion and skin complexion. Sulfur is used both internally and externally for treatment of diseases of skin. It reduces the Kandu, Pidika, Raaga and Daha by its Rakta Shodhak, Vranaropak, Krumighna and Kushthaghna properties.[7]

Probable mode of action Kaishor Guggul

Kaishor Guggulu contents Tripahala, Guggul, Guduchi, Sunthi, Trivrut, Danti acts as Shothahar (anti inflammatory), Vrana Shodhak, Rasayan also acts as aging skin health promoter, natural blood cleanser.[8]

Probable mode of action Arogyavardhini Vati

Arogyavardhini Vati contains Kutaki,Triphala, Trikatu and other drugs helps to balance Tridosha, indicated in skin disorders, analgesic, wound healing, and antipruritic properties, Pachani (digestive), Dipani (appetizer), Pathya (wholesome for channel), Hridya (cardio protective) Malashuddhikari (cleaning of waste materials from body) which helps in reducing symptoms of Yuvanpidika. Pungent drugs are beneficial for reducing burning sensation and itching.[9,10]

Probable mode of action Nitya Virechan with Gandharv Haritaki Churna

Gandharva Haritaki Churna contents Erand Sneha, Sunthi Churna, Sauvarchal Lavan


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Ashish C. Zanwar et al. Management of Yuvanpidika w.s.r. to Acne Conglobata

and Haritaki Churna being Mrudu & Snigdha Anulomaka Guna it induces smooth & regular Stool elimination without causing Vata vitiation. Sunthi will help in Deepan and Pachan along with Nitya Virechana with Gandharva Haritaki resolves constipation in this case.[11]

Mode of action of Jalauka Avacharan

Jalauka Saliva contains number of component biologically active like Hirudine, inhibitors of kallikrein, hyaluronidase, histamins like vasodilators, anti-inflammatory and anaesthetic agent. Leech sucks the blood by piercing the skin in such way that these biologically active components can penetrate into the deep tissue. Anti-inflammatory component like Bdellins, Eglins can easily penetrate to give significant effect on intra-articular and periarticular myofascial structures also on inflammatory condition of skin. Vasodilators increases inflow of blood.[12]

Conclusion

In this case study, there was significant improvement was noted along with other GIT related problems and with this we can conclude that, Nitya Virechan and Raktamokshan along with internal medicine helps to disease condition of acne conglobata.

References

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2. Garcovich S, et.al, PASH, PAPASH, PsAPASH, and PASS: The auto inflammatory syndromes of hidradenitis suppurativa. Clin Dermatol. 2021 Mar-Apr;39(2):240-247.

3. Nidansthan, 13/38. In: Shashtri A, editor. Sushruta Samhita. Hindi commentary. Reprint ed., Varanasi: Chaukhambha Sanskrit Sansthan; 2005. p. 282.

4. Acharya Yadavji Trikamji, Sushrut Samhita, Nidansthan 13/39, Choukhamba publication 2005 Varanasi.

5. Hagone PA, Kuchewar

V. Effectiveness of Mukhaprakshalan by Varun Qwath & Jatiphaladi Lepa in Mukhadushika (Acne vulgaris). International Journal of Ayurvedic Medicine. 2020;11(3):563-67.

6. Adityan B, Kumari R, Thappa DM. Scoring systems in acne vulgaris. Indian J Dermatol Venereol Leprol 2009;75:323-326

7. Chavhan MH, Wajpeyi SM. Management of dadru kushta (tinea corporis) through ayurveda-A case study. International Journal of Ayurvedic Medicine. 2020;11:120-23.

8. Lather A, Gupta V, Bansal P, Sahu M, Sachdeva K, Ghaiye P. An Ayurvedic polyherbal formulation Kaishore Guggulu: a review. Int J Pharm Biol Arch. 2011;2(1):497-503.

9. Ambhore KP, Misar Wajpeyi SD. Comparative study of Lodhradi Lepa with and without Arogyavardhini Vati in the management of Yuvanpidika. J Indian Sys Medicine 2020;8:21-8.

10. Pal S, Ramamurthy A, Mahajon B. Arogyavardhini Vati: A theoritical analysis. Journal of Scientific and Innovative Research. 2016;5(6):225-7.

11. Girbide, S., Sutar, P., & Gudade, S. (2020, September 29). An Ayurvedic Management of Audumbara Kushtha (Psoriasis Vulgaris) - A Case Study. International Journal of AYUSH Case Reports, 4(3), 119-124.

12. Shekhar M. A literary review on Jalauka-Avacharana (Leech therapy)., The Pharma Innovation Journal 2020; 9(7): 428-431


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