E-ISSN:2456-3110

Case Report

Tinia Corporis

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 11 NOVEMBER
Publisherwww.maharshicharaka.in

Role of Nitya Virechan and Shaman Aushadhi in Dadru Kushtha w.r.t. Tinia Corporis - A Case Study

Zanwar AC1*, Muley SP2
DOI:10.21760/jaims.9.11.53

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 Sanskruti P Muley, Assistant Professor, Dept of Samhita Sidhhant, B R Harne Ayurvedic Medical College, Karava Dist Thane, Maharashtra, India.

Ayurveda have been classified all the skin diseases under the broad heading of ‘Kushta’ which were sub classified into Mahakushta and Kshudrakushta. Hetu (Causative factors) of Dadru Kushta involves Vishamashana (Incompatible food), Vegavidharana (suppression of natural urges), Diwaswapa (daytime sleeping), intake of Atilavana, Atitikshnaahar (excessive salty or spicy food), intake of contaminated food, drinking cold water just after physical work or Atapsevana (exposure to sunlight). Lakshanas of Dadru include Kandu (Itching), Utsanna (elevated circular lesions), Mandala (Circular Patches), Raaga (Erythema), and Pidakas (Papule). The Samprapti of Dadru mainly involves vitiation of Pitta-kapha Doshas and Dushti of rasa and Raktavaha Strotas. A 56 year old male patient, came to OPD with the complaints of reddish circular patch on chest and back with sever itching and burning sensation since last 3 months. After examination patient was diagnosed as case of Dadru Kushth and was treated with Ayurvedic management protocol i.e., Abyantar Snehan with Nitya Virechan, Shaman Aushdhi and Bahirparimarjan Chikitsa for 1 month and was taken follow up after 14days. Dietary restriction was advised to avoid spicy and junk food along with personal hygiene to be maintained. After complete treatment of 1 month patient was assessed with parameter like raga (redness), Kandu (itching), Daha (burning sensation), and Utsana Mandal on a grade from 0 to 3 and there was significant improvement was noted. From this case study it can be concluded that use of Nitya Virechan with Snehapan with Panchatikta Ghruta and Shaman Aushdhi along with Bahya Chikitsa can treat Dadru Kushta.

Keywords: Dadru, Kushtha, Nitya Virechan, Bahirparimarjan Chikitsa

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: 		Zanwar AC, Muley SP, Role of Nitya Virechan and Shaman Aushadhi in Dadru Kushtha w.r.t. Tinia Corporis - A Case Study. J Ayu Int Med Sci. 2024;9(11):353-358.
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Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-10-15 2024-10-25 2024-11-05 2024-11-15 2024-11-24
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© 2024by Zanwar AC, Muley SPand 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(11)353
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Ashish CZ et al. Role of Nitya Virechan and Shaman Aushadhi in Dadru Kushtha

Introduction

Ayurveda have been classified all the skin diseases under the broad heading of ‘Kushta’ which were sub classified into Mahakushta and Kshudrakushta.[1] Acharya Charak has included Dadru in Kshudrakushta,[2] whereas Acharya Sushruta and Acharya Vagbhata have explained under Mahakushta.[3,4] Hetu (Causative factors) of Kushta involves Vishamashana (Incompatible food), Vegavidharana (suppression of natural urges), Diwaswapa (daytime sleeping), intake of Atilavana, Atitikshnaahar (excessive salty or spicy food), intake of contaminated food, drinking cold water just after physical work or Atapsevana (exposure to sunlight).[5] The major Lakshanas of Dadru include Kandu (Itching), Utsanna (elevated circular lesions), Mandala (Circular Patches), Raaga (Erythema), and Pidakas (Papule). The Samprapti of Dadru mainly involves vitiation of Pitta-Kapha Doshas and Dushti of Rasa and Raktavaha Strotas.[6] Due to similarity of symptoms Dadru can be correlated with Tinea corporis, which is a fungal skin infection. The related fungi are dermatophytes capable of causing skin changes of the type known as Tinea or ringworm or dermatophytosis or Mycosis.[7] In modern medical science, it is managed with topical and systemic antifungal agents and use of corticosteroids. In Ayurveda Chikitsa Sutra of Dadru Kushtha involves Shodhan, Shaman and Bahirparimarjan (topical) Chikitsa.[8] For Shodhana Nitya Virechana with Gandharv Haritaki was given. In Shamana Chikitsa formulations like Arogavardhini Vati and Gandhaka Rasayana having Kushtaghna, Krumighna and Kandughna properties were used. Bahiparimarjana Chikitsa was given in the form of Lepa of S-kin powder with Gomutra and local application of Karanj oil.

Case Study

A 56 year old male patient, came to OPD with the complaints of reddish circular patch on chest and back with sever itching and burning sensation since last 3 months, he had took medications and tropical creams for local application but got no relief so consulted for further management. He was known case of hypertension was on telmisartan 40mg OD.

On Examination

PR - 75/MIN
RR - 22/MIN

BP - 130/90 MMHG

Asthavidh Pariksha

Nadi - 75/Min, Vatapittaj
Mala - Constipated, improper evacuation
Mutra - Samayak, 5-6 Times/Day
Jivha - Saam,
Shabda - Spastha
Sparsh - Ruksha
Druk - Samyak
Akruti - Madhyam

Local Examination

A Large Circular Patch Around 12-13cm in Diameter
On Chest and Back with Elevated Margins
Redness - + +
Dryness -+ +

Personal History

Diet - Mixed
Habit - Tobacco Chewing
Sleep - Disturbed due to itching.

After examination patient was diagnosed as case of Dadru Kushth and was treated with Ayurvedic management protocol i.e., Abyantar Snehan with Nitya Virechan, Shaman Aushdhi and Bahirparimarjan Chikitsa for 1 month and was taken follow up after 14 days. (Table 1)

Table 1: Treatment plan

SNName of medicineDoseRout of AdministrationAnupanaDuration
1.Panchatikta Ghrita[9]10ml early morning empty stomachOralKoshna Jala
2.Arogyavardhini Vati[10]500mg twice a day after mealOralKoshna Jala
3.Gandhak Rasayan[11]500mg twice a day after mealOralKoshna Jala1 month
4.Gandharv Haritaki Churna[12]5gm at bed timeOralKoshna Jala
5.S-Kin Powder[13]q.s. in morningLocal applicationGomutra
6.Karanj Tailq.s. in nightLocal application-
Kandu (itching)Raga (Erythema)Daha (burning sensation)Utsanna Mandala (Elevated circular skin lesion)
BT Garde 3Grade 2Grade 3Grade 2
AT Grade 1Grade 0Grade 1Grade 0

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Ashish CZ et al. Role of Nitya Virechan and Shaman Aushadhi in Dadru Kushtha

Follow up after 14 days and dietary restriction advice - avoid spicy and junk food along with personal hygiene to be maintained.

Results

After complete treatment of 1 month patient was assessed with parameter like Raga (redness), Kandu (itching), Daha (burning sensation), and Utsana Mandal on a grade from 0 to 3 and there was significant improvement was noted.

Assessment parameters with their grading

1. Kandu (Itching)

  • Grade 0 - Absent
  • Grade 1 - Mild or Occasional Itching
  • Grade 2 - Moderate Itching
  • Grade 3 - Severe Itching

2. Raga (Erythema)

  • Grade 0 - Absent
  • Grade 1 - Mild redness (pinkish appearance)
  • Grade 2 - Moderate redness
  • Grade 3 - Deep brown appearance

Before Treatment After Treatment
jaims_4002.01.JPG

3. Daha (Burning sensation)

  • Grade 0 - Absent
  • Grade 1 - Mild burning sensation
  • Grade 2 - Moderate burning sensation
  • Grade 3 - Severe burning sensation

4. Utsanna Mandala (Elevated circular skin lesion)

  • Grade 0 - Absent
  • Grade 1 - Mild elevated lesion
  • Grade 2 - Moderate elevated lesion
  • Grade 3 - Severe elevated lesion

Discussion

Probable mode of action of drugs

Panchatikta Ghruta - Nitya Snehapana with Panchatikta Ghruta is an herbal Ghruta used most often in skin disorders and has a best result in skin diseases. It contains Five Tikta Rasa Dravya Like Nimb, Patol, Kanthakari, Guduchi, Vasa etc. This improves digestion by its sharp and penetrates action which clarifies perception of skin. It moreover reduces Kapha and aggravates Pitta.[14] It is considered as best for all skin diseases as mentioned in Bhaisajya Ratnavali Kushta Adhikara.

Arogyavarhini Vati - a herbo-mineral drugs having Kusthanasaka (can alleviate all types of skin disorder) action, balancing Tridoshas, and is also good antioxidant, anti-hepatotoxic and immune-modulator needed for early healing and avoid recurrence.

Gandhak Rasayan - is a polyherbal drug prepared by giving 12 Bhavanas of herbal drugs to Shuddha Gandhaka. It is mainly indicated in the management of Kushta Roga. It possesses antibacterial and antifungal properties. It mainly acts on Rakta Dhatu and causes Rakta Shodhan (purification of blood). It helps in reducing infection by its antifungal property. 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.[15]

Karanj Tail - It contains Karanj (Pongamia pinnata), Saptacchada (Alstonia scholaris),


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Ashish CZ et al. Role of Nitya Virechan and Shaman Aushadhi in Dadru Kushtha

Langali (Gloriosa superba), Arka (Calatropis procera), Chitraka (Plumbago zeylanica), Brungaraj (Eclipta alba), Vatsanabh (Aconitum ferox), Gomutra (Cow urine). It is widely used in various skin diseases. The Karanj-Oil contains medicinal properties and used in itches, abscess and other skin diseases.[16]

S- Kin Powder - contains Krumighna (antibacterial, antimicrobial, and antifungal), Raktashodhak (blood purifying) and Vranaropak (wound healing) properties of Manjistha (Rubia cordifolia Linn.), Amalaki (Emblica officinalis Gaertn), Haridra (Curcuma longa Linn.), Bibhitaka (Terminalia bellerica (Gaertn.) Roxb.), Nagarmotha (Cyperus rotundus R.Br.) and Shudha Gandhaka (Purified Sulphur). which is applied with Gomutra as Anupana which increases the absorption.

Hence topical application of it helps in reducing symptoms like Kandu, Raaga, Utsanna Mandala and Pidikas.[17]

Conclusion

Dadru Kushta can be correlated with Tinea corporis or dermatophytosis as symptoms and causative factor resembles. Personal hygiene is an important part as it is a contagious disease.

From this case study it can be concluded that use of Nitya Virechan with Snehapan with Panchatikta Ghruta and Shaman Aushdhi along with Bahya Chikitsa can treat Dadru Kushta.

References

1.Sharma PV, Charaka Samhita of Agnivesha with English Translation, 1st Edition-Reprint, Chaukhambha Orientalia,Varanasi. Vol-2, 2008:183

2. Sharma PV, Charaka Samhita of Agnivesa with English Translation, 1st Edition-Reprint, Chaukhambha Orientalia,Varanasi, vol-2,2008:184

3. Jadavaji Trikamji, Choukambha Orientalia, Sushruta Samhita (Commentary of Dalhanacharya) and the Nyaya Chandrika, Varanasi. 5th edition; 2005:37

4. Desai Ranajitaraya, AshtangaSangraha of Sarvanga Sundari Vyakhyaya Samhita Sutrasthana- Prathama Bhaga, Shri. Baidyanath Ayurveda Bhavana, pvt. Ltd Nagpur, 3rd edition; 1986:137

5. Desai Ranajitaraya, AshtangaSangraha of Sarvanga Sundari Vyakhyaya Samhita Sutrasthana- Prathama Bhaga, Shri. Baidyanath Ayurveda Bhavana, pvt. Ltd Nagpur, 3rd edition; 1986:137

6. Shukla Vidyadhar and Ravi Dutt Tripathi Charak Samhita of Agnivesha revised by Charaka Redacted By Drudbala with vaidya manorama’ hindi commentary, Chaukambha Sanskrit pratishthan, Delhi reprint-2011 chapter- 7 chikitsasthanshloka29-30 pp.185

7. Burns, Breathnach, Cox, Griffiths, Rook’s textbook of dermatology, Blackwell publishers, 7th edition2004, vol- 2, chpter-31.199. Kushwaha Harish Chandra Singh, Charaka Samhita, Ayurveda Dipika Ayushi, Hindi commentary edited by Vd. Vol-II 7/41, Varanasi: Chaukhamba Orientalia; 2009. p.209

10. Murthy K.R.S. Bhavaprakasha, Vol II, Chap 54, 4th Edition, Chaukambha Krishnadas Academy, Varanasi, India 2009.p-603-604.

11. Ambikadatta shastri. Rasaratna Samuchchya. 9th edition. Chapter no-20. Verse no-87. Varanasi: Chaukhamba Sanskrit Publisher;1994. p. 400

12. Gune Gangadhar shastri – ‘Aayurvediya Aushadhigunadharmashastra’- Part 2 – 30 Vaidyak Granth Bhandar Publication, 2011; p.271.

13. Tripathi B, editor. Sutrasthana; Doshopakramaniya Adhyaya.Vagbhata, Ashatang Hrudaya. Chapter 13, Verse 1–3. Delhi, India: Chaukhamaba Sanskrit Pratishthan; 2015. p. 185.

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

15. Deshmukh SG, Thakre T, Gupta J, Waskar R. A Case Study on Management of Tinea Cruris with Classical Vaman Karma. Journal of Pharmaceutical Research International. 2021 Jun 30;33(33B):195-202.

16. Saokar R et al, Screening of Antibacterial and Antifungal Activity of Gandhaka Rasayana- an Ayurvedic Formulation, International Journal of Recent Trends in Science And Technology, 2013, Vol. 8 (2), pp 134-137


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17. Shukla V, editor, Tripathi R, Charak samhita of Agnivesha, Varanasi Chaukhamba surabharati Prakashan. 2007;99

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

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