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DR.DNYANESHWAR JADHAV

Ayurveda Specialist, Australia

Ayurvedic management of vata-kafaj kushta W.S.R. contact allergic dermatitis” – A case study.
Ask a DoctorCategory: ContestAyurvedic management of vata-kafaj kushta W.S.R. contact allergic dermatitis” – A case study.
asked 6 months ago

ABSTRACT: In Ayurveda, all skin diseases have been described under the term of kushtha. All skin diseases come under kushtha but all kushtha not come under skin diseases.kushtha classified into Maha-kushtha and Kshudra Kushtha. Acharyas have described that all kushtha have Tridoshic involvement but the type of kushtha depends on the predominance of particular doshas. Contact allergic dermatitis (CAD) is an occupational disease.it is hypersensitivity reaction to plethora of antigen in the environments.The present case study is successful Ayurvedic management of a case of vata-kaphaj kushata. A 48 year old female patient came to us with chief compliant of ubhay hasat twakvaivrya, kandu since 1 month. She get relief within 7 days. Ayurvedic management involving sukshma trifala, gandharva haritaki, stanik snehan followed by Awagaha.
KEY WORD: Vata-kafaj kushta, contact allergic dermatitis, Ayurvedic management.
INTRODUCTION :kushta is group of skin disorders. All skin diseases come under kushtha but all kushtha not come under skin diseases. Vitiated doshas cause abnormal colour of skin and produced degeneration of skin, this condition called as kushta. Twakvaivrya (discoloration), kandu (itcing), strav(bleeding), puy uttpati (pus formation) are common symptoms found in the kushta.[1] Kushtha is produced invariably by the vitiation of the seven factors i.e. 3 Doshas and 4 Dushyas[2].Acharyas have described that all kushtha have Tridoshic involvement but the type of kushtha depends on the predominance of particular doshas. Changing life style invited many life style disease. Changing life style like eating ice cream at night, consumption of undigested & heavy food, unhealthy diet, stress enhance the cases of kushta.Contact allergic dermatitis is common in occupations that involve repeated hand washing or repeated exposure of the skin to water, food materials, and other irritants. High-risk occupations include cleaning, hospital care, food preparation, and hairdressing.[3] The hands are the most important sites of contact allergic dermatitis. Repeated workplace exposure of the hands to soaps, cleansers, and solvents is the source of most occupational skin disorders.Most cases found on contact dermatitis concern allergic contact dermatitis. Almost any material may be cause cutaneous allergic, if the exposure is sufficiently prolonged and/or the concentration of the substance sufficiently high. Environmental factors may enhance the effect of other irritants.Contact allergic dermatitis affects women almost twice as often as men, Due to greater role in housecleaning and the care of small children at home. The definitive treatment of Contact allergic dermatitis is the identification and removal of any potential causal agents.
A case report as follow: A 48 year old Female patient came to us with chief compliant of – ubhay hasat twakvaivryakandu Patient had above complaints since 1 month.
History of personal illness: The patient was normal 1 month back. Since then patient have been suffering from ubhay hasat twakvaivrya, kandu. For this patient took treatment from different Allopathy doctors but got no relief, then he came to our opd for Ayurvedic treatment.
Personal History: Occupation: House wife ( before 2 year ago she had house cleaning work as job).
O/E: Nadi (pulse) = 64/min. Mala (stool) = MalaVibandha Mutra (urine) = Normal. Jeeva (tounge) = Eshatha saam. Agni = Kshudhamandya. Shabda (speech) = Normal. Sparsha (skin) = Khar, twakvaivrya. Druka (eyes) = Drushtimandya. Akruti = Madhyama. Bala = Madhyama. Raktadaaba (B.P) = 100/70 mm/Hg.
MATERIAL & METHODS :Material :
Table 1 : Showing internal medicineINTERNAL MEDICINE
SR.NODRUGDOSEDURATIONANUPAN
1Sukshma trifala250 mg1 BDLuck warm water
2gandharva haritaki500 mg2 HSLuck warm water
Table 2 :Showing panchakarma.PANCHAKRMA
KARMADRUGDURATION
Stanik snehan (hastanguli pradeshi)Karanja tail + nimba tailWith Koshana tail for 10 min
AvagahanaChoorna of (Trifala + khadir + nimba)For 15-20 min
Local application of CreamPentaphye p5 cream.twice in days
Methods :Centre of study: Nakshatra Ayurved clinic & Research canter. Type of study : Simple random single case study.
DISCUSSION:Discussion on vhyadhi :-Hetu of vata-kaphaj kushata as (4) – 1) Ahar : – Improper and irregular diet causes the disturbance of vatadosha. – Abhishandi food product like Dadhi in daily diet. – Grains: Navadhanyak. (Daily plenty of rice in diet)
2) Vihar : – Working in water with different types of soap & detergent powder.- Suppression of natural urge (Mala-muta vega dharan). – Diwaswap.
3) Manasika nidan- Chinta and vegavrodha causes vata vrudhi.
Table 3 : Showing samprapti Ghatak.SANPRAPTI GHATAK:
DoshVataSheet, Ruksha, khar – guna vrudhi
KafaSheet, guru – guna vrudhi.
DushyaRasa, Rakta.
AdhishtanaTwaka
Table 4: Showing sampraptiSANPRAPTI
Hetu sevan
Rakta dushti
Vata-kafa prakop
Jala sampark (prolonge work in water)
sheet guna of Jala cause Vata-kafa prakop
hastapradeshi khavaigunya
hastapradeshi prakrupit Dosha stansanshrya
ubhay hasat twakvaivrya, kandu
vata-kaphaj kushata
Causes of Contact allergic dermatitis (CAD) as –Common causes of Contact allergic dermatitis (CAD) are Dry air and temperature variation, Solvents, water, Metalworking fluids, Micro trauma, Mechanical trauma, Rubber gloves, Sodium lauryl sulphate, Hydrofluoric acid, Alkalis. In this case study main cause of disease are water & solvents.
Pathophysiology of Contact allergic dermatitis (CAD) as (5)-Contact allergic dermatitis (CAD) is the clinical result of sufficient inflammation arising from the release of pro-inflammatory cytokines from skin cells (principally keratinocytes), usually in response to chemical stimuli. Different clinical forms may arise. The three main pathophysiological changes are skin barrier disruption, epidermal cellular changes, and cytokine release.Solvents cause cutaneous irritation because they remove essential fats and oils from the skin, which increases trans-epidermal water loss and renders the skin susceptible to the increased direct toxic effects of other previously well-tolerated cutaneous exposures. The alcohol propanol is less irritating to the skin than the detergent sodium lauryl sulphate.p Ka , an acid dissociation constant, is a quantitative measure of the strength of an acid in solution. p K a has been shown to be highly predictive of acute skin irritation for acids and bases: acids with a p K a of less than 4 and bases with a p Ka of less than 8 are highly irritative.
Discussion on Medicine (Sampraptibhnga) :-
Sukshma trifala :it consist of medicinal plant namely terminalia chebula, terminalia beleria and emblica officinalis with that small quantity of kajjali.it has been used extensively as drug against number of diseases(6). Trifala strengthen the different tissue of body. Prevent ageing, promotes health and immunity. Kajjali is yogavahi and it claimed to improve the activity of trifala. its correct constipation, cleanses and detoxifies the whole body. Improve digestion (7). Ultimately its removes aam from body which is root of most of skin disease.it exhibits anti-viral, anti-bacterial, anti-fungal, anti-allergic properties.(8).trifala show immunomodulatory properties and helps in improving the body’s defence system(9)Gandharva haritaki(10) : Gandharva haritaki is polyherbal ayurvedic medicine.Its contains erand tail,bal haritaki,sunthi,sandhav and savarchal lawana.it has purgative and laxative action. Gandharva haritaki evacuates bowel and removes toxins from body.Main cause of this disease is vata-kafa prakop & raktadushti.rakat dusthi present in this disease. Rakat-pitta have closed relation. virechana is best treatment for pitta. There are two types of virechan as ruksha & sasneha.as there is vataprakop so Gandharva haritaki is given as sasneha virechan. Stanik snehan : Stanik snehan is done with mixture of Karanja tail(11)& nimba tail(12). Mixture of this two tail taken as warm & applied on both hand & kept for 15 min.Its act as Vata shaman, kandughna, Decreases dryness Avagahana : In avagahana we use triphala, khadir, nimba kwatha which is kandughna, tridoshaghna, vranya, raktashodhaka.(13) This procedure brings sweat on the skin through hair follicle by opening the pores of the skin. Due to Avagahana agni is incesses & the fatty tissue get mobilised. While throwing out waste as Ama (toxin) through the skin it also helps liquefy aggravated doshas, dilating all body channels for cleaning. For Local application pentaphyte p5 cream is advised. Which contains panchwalkal. This help for heeling skin.
OBSERVATIONS AND RESULT :
Table 5 : Showing Result of Twakvaivaryna in Gradation form.Twakvaivrya
18.2.2017
25.2.2017
++
0

Table 6 : Showing Result of Kandu in Gradation form.
Kandu
18.2.2017
25.2.2017
+++
0
Clinical examination of the patients revealed regression of symptom due to our Ayurvedic management.
CONCLUSIONS : Since the therapy for vata-kafaj kushta (CAD) has limitation in other pathies, Ayurvedic management can be effective therapy.
REFRENCES:
Dr.Ganesh Krushana garde, (12th Ed.), Sarthavagbhat,vagbhtakrytaashtangrudhaya and its Marathi translation, nidanstan; kushat-switra-krumiAdhya ; chapter 14. verse no.1 ; pune : profesent publishing house,2009 ; page no.233.
Dr.Brahmanand tripathied, 1sted, Charak samhita, volume 1, Nidan sthana, Adhya.no 5, verse no.1-3, pub by Chaukhamba Surabharati prakashan, reprinted 2009, page no.623.
Skindiseases & sexually Trasmitted infection,dr.uday khopkar,(5th edi),balani publication,eczema,chapter no.9,page no.99.
BrhamanandaTripathi, (1stEd.).Charak samhita, Maharshi Charak. Nidanstan; Kushtanidanadhyaya : chapter 5. verse no.6.Varanasi : Chukhambha prakashan, 2011; page no.625.
Irritant contact dermatitis by Medscape, http://www.emedicine.medscape.com/article/1049353-overview (updated on 26th sep 2016 & downloaded on 27th feb 2017)
juss,s.s., indian med Gaz 1997,chapter-13,page no.194-196Nadkarni,A.K.popular press Ltd,Mumbai,1976,3rd edition, Page no.1308-1315
methata,B.K.,shitut.,wankhade,H., Fitoterapia 1999,64,371-372Naik, G-H., Priyadarshini, K.I, R.G., Mishra, B., Mishra.K.P., Banavalikar, M.M.,Hari mohan, phytother Res2005, chapter-19,page no.582-586
Gandharvaharitaki (https://www.bimbima.com/ayurved/gandhavra-haritaki-churna-benifits-ingredients-dosage/466/) : uploaded on 2 September 2014 & downloaded on 28 feb 2017.
TheAyurvedic pharmacopoeia of india-part-1, Gov.of india ministry of health & family welfare dep.of AYUSH.new delhi; vol-2, pg.no-84.
The Ayurvedic pharmacopoeia of india-part-1, gov.of india ministry of health & family welfare dep.of AYUSH.new delhi; vol-2, pg.no-136.
Brhamananda Tripathi, (1st Ed.).Charak samhita, Maharshi Charak. Chikitsa-stan;kushta chikitsa adhya : chapter 7. verse no.99.Varanasi : Chukhambha prakashan, 2011; page no.320.

ABSTRACT: In Ayurveda, all skin diseases have been described under the term of kushtha. All skin diseases come under kushtha but all kushtha not come under skin diseases.kushtha classified into Maha-kushtha and Kshudra Kushtha. Acharyas have described that all kushtha have Tridoshic involvement but the type of kushtha depends on the predominance of particular doshas. Contact allergic dermatitis (CAD) is an occupational disease.it is hypersensitivity reaction to plethora of antigen in the environments.The present case study is successful Ayurvedic management of a case of vata-kaphaj kushata. A 48 year old female patient came to us with chief compliant of ubhay hasat twakvaivrya, kandu since 1 month. She get relief within 7 days. Ayurvedic management involving sukshma trifala, gandharva haritaki, stanik snehan followed by Awagaha.
KEY WORD: Vata-kafaj kushta, contact allergic dermatitis, Ayurvedic management.
INTRODUCTION :kushta is group of skin disorders. All skin diseases come under kushtha but all kushtha not come under skin diseases. Vitiated doshas cause abnormal colour of skin and produced degeneration of skin, this condition called as kushta. Twakvaivrya (discoloration), kandu (itcing), strav(bleeding), puy uttpati (pus formation) are common symptoms found in the kushta.[1] Kushtha is produced invariably by the vitiation of the seven factors i.e. 3 Doshas and 4 Dushyas[2].Acharyas have described that all kushtha have Tridoshic involvement but the type of kushtha depends on the predominance of particular doshas. Changing life style invited many life style disease. Changing life style like eating ice cream at night, consumption of undigested & heavy food, unhealthy diet, stress enhance the cases of kushta.Contact allergic dermatitis is common in occupations that involve repeated hand washing or repeated exposure of the skin to water, food materials, and other irritants. High-risk occupations include cleaning, hospital care, food preparation, and hairdressing.[3] The hands are the most important sites of contact allergic dermatitis. Repeated workplace exposure of the hands to soaps, cleansers, and solvents is the source of most occupational skin disorders.Most cases found on contact dermatitis concern allergic contact dermatitis. Almost any material may be cause cutaneous allergic, if the exposure is sufficiently prolonged and/or the concentration of the substance sufficiently high. Environmental factors may enhance the effect of other irritants.Contact allergic dermatitis affects women almost twice as often as men, Due to greater role in housecleaning and the care of small children at home. The definitive treatment of Contact allergic dermatitis is the identification and removal of any potential causal agents.
A case report as follow: A 48 year old Female patient came to us with chief compliant of – ubhay hasat twakvaivryakandu Patient had above complaints since 1 month.
History of personal illness: The patient was normal 1 month back. Since then patient have been suffering from ubhay hasat twakvaivrya, kandu. For this patient took treatment from different Allopathy doctors but got no relief, then he came to our opd for Ayurvedic treatment.
Personal History: Occupation: House wife ( before 2 year ago she had house cleaning work as job).
O/E: Nadi (pulse) = 64/min. Mala (stool) = MalaVibandha Mutra (urine) = Normal. Jeeva (tounge) = Eshatha saam. Agni = Kshudhamandya. Shabda (speech) = Normal. Sparsha (skin) = Khar, twakvaivrya. Druka (eyes) = Drushtimandya. Akruti = Madhyama. Bala = Madhyama. Raktadaaba (B.P) = 100/70 mm/Hg.
MATERIAL & METHODS :Material :
Table 1 : Showing internal medicineINTERNAL MEDICINE
SR.NODRUGDOSEDURATIONANUPAN
1Sukshma trifala250 mg1 BDLuck warm water
2gandharva haritaki500 mg2 HSLuck warm water
Table 2 :Showing panchakarma.PANCHAKRMA
KARMADRUGDURATION
Stanik snehan (hastanguli pradeshi)Karanja tail + nimba tailWith Koshana tail for 10 min
AvagahanaChoorna of (Trifala + khadir + nimba)For 15-20 min
Local application of CreamPentaphye p5 cream.twice in days
Methods :Centre of study: Nakshatra Ayurved clinic & Research canter. Type of study : Simple random single case study.
DISCUSSION:Discussion on vhyadhi :-Hetu of vata-kaphaj kushata as (4) – 1) Ahar : – Improper and irregular diet causes the disturbance of vatadosha. – Abhishandi food product like Dadhi in daily diet. – Grains: Navadhanyak. (Daily plenty of rice in diet)
2) Vihar : – Working in water with different types of soap & detergent powder.- Suppression of natural urge (Mala-muta vega dharan). – Diwaswap.
3) Manasika nidan- Chinta and vegavrodha causes vata vrudhi.
Table 3 : Showing samprapti Ghatak.SANPRAPTI GHATAK:
DoshVataSheet, Ruksha, khar – guna vrudhi
KafaSheet, guru – guna vrudhi.
DushyaRasa, Rakta.
AdhishtanaTwaka
Table 4: Showing sampraptiSANPRAPTI
Hetu sevan
Rakta dushti
Vata-kafa prakop
Jala sampark (prolonge work in water)
sheet guna of Jala cause Vata-kafa prakop
hastapradeshi khavaigunya
hastapradeshi prakrupit Dosha stansanshrya
ubhay hasat twakvaivrya, kandu
vata-kaphaj kushata
Causes of Contact allergic dermatitis (CAD) as –Common causes of Contact allergic dermatitis (CAD) are Dry air and temperature variation, Solvents, water, Metalworking fluids, Micro trauma, Mechanical trauma, Rubber gloves, Sodium lauryl sulphate, Hydrofluoric acid, Alkalis. In this case study main cause of disease are water & solvents.
Pathophysiology of Contact allergic dermatitis (CAD) as (5)-Contact allergic dermatitis (CAD) is the clinical result of sufficient inflammation arising from the release of pro-inflammatory cytokines from skin cells (principally keratinocytes), usually in response to chemical stimuli. Different clinical forms may arise. The three main pathophysiological changes are skin barrier disruption, epidermal cellular changes, and cytokine release.Solvents cause cutaneous irritation because they remove essential fats and oils from the skin, which increases trans-epidermal water loss and renders the skin susceptible to the increased direct toxic effects of other previously well-tolerated cutaneous exposures. The alcohol propanol is less irritating to the skin than the detergent sodium lauryl sulphate.p Ka , an acid dissociation constant, is a quantitative measure of the strength of an acid in solution. p K a has been shown to be highly predictive of acute skin irritation for acids and bases: acids with a p K a of less than 4 and bases with a p Ka of less than 8 are highly irritative.
Discussion on Medicine (Sampraptibhnga) :-
Sukshma trifala :it consist of medicinal plant namely terminalia chebula, terminalia beleria and emblica officinalis with that small quantity of kajjali.it has been used extensively as drug against number of diseases(6). Trifala strengthen the different tissue of body. Prevent ageing, promotes health and immunity. Kajjali is yogavahi and it claimed to improve the activity of trifala. its correct constipation, cleanses and detoxifies the whole body. Improve digestion (7). Ultimately its removes aam from body which is root of most of skin disease.it exhibits anti-viral, anti-bacterial, anti-fungal, anti-allergic properties.(8).trifala show immunomodulatory properties and helps in improving the body’s defence system(9)Gandharva haritaki(10) : Gandharva haritaki is polyherbal ayurvedic medicine.Its contains erand tail,bal haritaki,sunthi,sandhav and savarchal lawana.it has purgative and laxative action. Gandharva haritaki evacuates bowel and removes toxins from body.Main cause of this disease is vata-kafa prakop & raktadushti.rakat dusthi present in this disease. Rakat-pitta have closed relation. virechana is best treatment for pitta. There are two types of virechan as ruksha & sasneha.as there is vataprakop so Gandharva haritaki is given as sasneha virechan. Stanik snehan : Stanik snehan is done with mixture of Karanja tail(11)& nimba tail(12). Mixture of this two tail taken as warm & applied on both hand & kept for 15 min.Its act as Vata shaman, kandughna, Decreases dryness Avagahana : In avagahana we use triphala, khadir, nimba kwatha which is kandughna, tridoshaghna, vranya, raktashodhaka.(13) This procedure brings sweat on the skin through hair follicle by opening the pores of the skin. Due to Avagahana agni is incesses & the fatty tissue get mobilised. While throwing out waste as Ama (toxin) through the skin it also helps liquefy aggravated doshas, dilating all body channels for cleaning. For Local application pentaphyte p5 cream is advised. Which contains panchwalkal. This help for heeling skin.
OBSERVATIONS AND RESULT :
Table 5 : Showing Result of Twakvaivaryna in Gradation form.Twakvaivrya
18.2.2017
25.2.2017
++
0

Table 6 : Showing Result of Kandu in Gradation form.
Kandu
18.2.2017
25.2.2017
+++
0
Clinical examination of the patients revealed regression of symptom due to our Ayurvedic management.
CONCLUSIONS : Since the therapy for vata-kafaj kushta (CAD) has limitation in other pathies, Ayurvedic management can be effective therapy.
REFRENCES:
Dr.Ganesh Krushana garde, (12th Ed.), Sarthavagbhat,vagbhtakrytaashtangrudhaya and its Marathi translation, nidanstan; kushat-switra-krumiAdhya ; chapter 14. verse no.1 ; pune : profesent publishing house,2009 ; page no.233.
Dr.Brahmanand tripathied, 1sted, Charak samhita, volume 1, Nidan sthana, Adhya.no 5, verse no.1-3, pub by Chaukhamba Surabharati prakashan, reprinted 2009, page no.623.
Skindiseases & sexually Trasmitted infection,dr.uday khopkar,(5th edi),balani publication,eczema,chapter no.9,page no.99.
BrhamanandaTripathi, (1stEd.).Charak samhita, Maharshi Charak. Nidanstan; Kushtanidanadhyaya : chapter 5. verse no.6.Varanasi : Chukhambha prakashan, 2011; page no.625.
Irritant contact dermatitis by Medscape, http://www.emedicine.medscape.com/article/1049353-overview (updated on 26th sep 2016 & downloaded on 27th feb 2017)
juss,s.s., indian med Gaz 1997,chapter-13,page no.194-196Nadkarni,A.K.popular press Ltd,Mumbai,1976,3rd edition, Page no.1308-1315
methata,B.K.,shitut.,wankhade,H., Fitoterapia 1999,64,371-372Naik, G-H., Priyadarshini, K.I, R.G., Mishra, B., Mishra.K.P., Banavalikar, M.M.,Hari mohan, phytother Res2005, chapter-19,page no.582-586
Gandharvaharitaki (https://www.bimbima.com/ayurved/gandhavra-haritaki-churna-benifits-ingredients-dosage/466/) : uploaded on 2 September 2014 & downloaded on 28 feb 2017.
TheAyurvedic pharmacopoeia of india-part-1, Gov.of india ministry of health & family welfare dep.of AYUSH.new delhi; vol-2, pg.no-84.
The Ayurvedic pharmacopoeia of india-part-1, gov.of india ministry of health & family welfare dep.of AYUSH.new delhi; vol-2, pg.no-136.
Brhamananda Tripathi, (1st Ed.).Charak samhita, Maharshi Charak. Chikitsa-stan;kushta chikitsa adhya : chapter 7. verse no.99.Varanasi : Chukhambha prakashan, 2011; page no.320.

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