Introduction

Kusta is a disease pertaining to skin and its appendages which also gives systemic symptoms. Apart from this due to cosmetic disfiguration there are disturbances in mental and social health of patient. Vicharchika is type of Kshudra Kusta, where Acharya Charaka^[1] has explained the symptoms like Kandu, Srava, Pidika and Shyava Varna. According to Sushruta^[2] cracks/eruptions over the palms and sole of the skin, along with Kandu, Ruja and Rukshata. Acharya Vagbhta^[3] has explained itching, blackish colored eruptions spreading all over the body and pus discharge, same is been explained by Madhava Nidana.^[4]

Vicharchika in modern terms is compared to Eczema.^[5] the term eczema refers to inflammation of the skin which manifests as erythema, vesiculation and oozing in the acute stage, scaling and crusting in subacute stage, thickening of skin in chronic stage.

Here it is compared to Dyshidrosis eczema^[6] lesions present as sudden eruption of bilaterally symmetrical tense vesicles, on the palms, soles, sides of fingers and toes accompanied by pruritus. Basically Chikitsa (treatment) has two classifications Shodhana (purification therapy) and Shamana (oral medication) which has been incorporated here for treating the patient.

Case Study

A patient aged 23 years presented Lakshanas

Chief complaints: Kandu, Ruja, Srava in both elbows, ankle joints, left thumb, index finger and left toe since 6 months.

Associated complaints: disturbed sleep due to itching.

History of present illness: Patient was healthy before one year and started with symptoms of Kandu, Ruja, Srava in both elbows and ankle joints. They have consulted dermatologist and took treatment and the symptoms was reduced for 4 months and again small blisters with fluid filling was started to appear on left thumb and left toe with sever Kandu and further exacerbations of previous lesions and symptoms appeared since 6 months. So, patient visited KPSVS Ayurvedic Medical College and hospital for future treatment.

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Tiryaka Gamana of Dosha into Sira
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Sthana Samshraya In Twak, Lasika, Raktha and Mamsa
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Vicharchika

Chikitsa

Table 1: Representing the treatment protocol

Results

After Shodhana Chikitsa large exudation filled lesion’s dried up, small blisters where present and mild oozing was also present. Boundaries of lesions were shrunken.

Table 2: Representing results before and after treatment

Where 3 = severe, 2 = moderate, 1 = mild, 0 = absent of symptoms

Image 1 (A, B, C, D): Showing before treatment

Dyshidrosis eczema is the comparison taken here and its features are lesions present as sudden eruption of bilaterally symmetrical tense vesicles, on the palms, soles, sides of fingers and toes accompanied by pruritus. Based on signs and symptoms diagnosis was made as Vicharchika. The patient was given Shodhana Chikitsa i.e., Virechana Karma was done to remove the Utklista Doshas, to clear the Srotoavrodha, followed by Shamana Aushadis to treat the other symptoms and Rasayana to bring up healthy development of cells and prevent the reoccurrence of disease.

Mahatiktaka Ghrita^[7] is indicated in Kusta, Visarpa, Arsha, Pama, Pidaka, Vispotta, Vatarakta, Raktapitta, Panduroga, Amlapitta. Nalpamaradi Taila^[8] is indicated in Tvagroga, Visarpa, Kusta, Pama, Kandu, Pidika. Trivruta Leha^[9] is indicated in Virechaka Arogyavardini Vati^[10] is indicated in Kusta Roga, Jwaropanasha, Pachaka, Deepana, Pathyakaraka, Hrudya, Medohara, Malashuddhikara, Atyanta Kshudha Vardhaka. Patolakaturohinyadi Kashaya^[11] is indicated in Kaphaja Roga, Pittaja Roga, Kusta Roga, Jwara, Vishaja Vikara, Aruchi and Kamala. Dooshivishari Gutika^[12] acts as Dushivisha Hara and Amavisha Hara, Dosha Harana. Manasamitra Vati^[13] is indicated in Manodosha, Unmada, Apasmara, Mandhabuddhitva, Vakdosha, Bhuta Badha, Sarpa Visha. Neemoderma^[14] has Krimihara and Kandugna Dravyas in it so indicated in eczema, psoriasis, fungal infection. Chandraprabhavati^[15] is indicated in Prameha, Mutrakruchra, Mutraghata, Ashmari, Vibanda, Anaha, Shoola, Katishoola, Swasa, Kasa, Vicharchika, Pandu, Kamala, Mandagni.

Madhusnuhi Rasayana^[16] is indicated in Deepana, Pachana, Ruchya, Vatapittaja, Rukshyaja, Kapha Kashya, Prameha, Gulma, Soola, Dhatu Vardhaka, Bala Pradha. The above mentioned Aushadhis has direct indications in Kusta Rogas, Kaphaja Pittaja Vikaras, hence was taken as consideration in this case study, which reduced the symptoms and treated the Roga.

Conclusion

Vicharchika is one of the Kusta Roga. This case study proves that Shodhana is more effective in Kusta Roga and drugs used here possess qualities, which are helpful in reliving the symptoms of Vicharchika.