Dadru is one of the common form of Skin disease affecting all age groups. Dadru is a Tridosha vitiated condition. Dadru is closely associated with Tinea infection. The present case of Dadru shows remarkable results by combination of Internal and external treatment by Ayurveda drugs

Dr. Krishna Kiran Kokate

Dr. Vivek Murlidhar Chaudhari

English

Journal of Ayurveda and Integrated Medical Sciences (JAIMS)

                                                      CASE REPORT May-June 2020  Journal of Ayurveda and Integrated Medical Sciences | May - June  2020 | Vol. 5 | Issue 3 164  Management of Dadru Kushtha with Ayurveda Intervention - A Case Study Dr. Vivek Murlidhar Chaudhari1, Dr. Krishna Kiran Kokate2 1Asst. Prof. Dept. of Dravyaguna Vidnyan, S.S.A.M. Hadapasar, Pune, 2Ayurveda Consultant, Shashwat Ayurveda Multispecialty Clinic and Panchakarma Center, Pune, Maharashtra, INDIA.           INTRODUCTION Skin is the largest sensory protective organ of the body reflecting health of an individual. Skin is most susceptible to the fungal infection. Skin diseases are classified as Kushtha in Ayurveda. Kushtha is also mentioned in eight Mahagad (dreadful diseases). Kushtha is further categorized in to Mahakushtha and Kshudra Kushtha.[1] Dadru is one of the common form of the skin disease affecting all age group. Acharya Charaka described it under Kshudra Kushtha[2] while Acharya Sushruta[3] and Acharya Vagbhata[4] categorized it under Mahakushtha. Dadru is Tridoshaja disease in which Pitta and Kapha are mainly vitiated Doshas with Rasa and Rakta Dhatu, Lasika and Tvak are Dushyas. Dadru is characterized by association of Kandu which indicates  increased  Kleda  of Kapha  Dosha  in  Rakta  Address for correspondence:  Dr. Vivek Murlidhar Chaudhari Asst. Prof. Dept. of Dravyaguna Vidnyan, S.S.A.M. Hadapasar, Pune, Maharashtra, INDIA. E-mail: vivekmchaudhari9982@gmail.com  Submission Date: 23/05/2020 Accepted Date: 26/06/2020 Access this article online Quick Response Code Website: www.jaims.in  Published by Maharshi Charaka Ayurveda Organization, Vijayapur, Karnataka (Regd) under the license CC-by-NC-SA and Rasa Dhatu, (itching over the lesion), Raga (Reddish Discoloration/erythema), Pidaka (Papule over lesion/eruptions), Utsanna Mandalam (elevated circular lesion)[5] Dadru is closely related with Tinea infection / Dermatophytosis commonly referred as Ringworm infection.[6] Etiological factors (Hetu) for Dadru[7]  Diwaswapa (daytime sleeping), Atilavana Sevana (excessive salt intake) Ati Tikshnaahar (excessive intake of spicy food), Vishamashana (Incompatible food), Paryushit Annapana (intake of contaminated   food and drinks), Vegavidharana (suppression of natural urges), Atapsevana (excessive exposure to sunlight) are causative factors of Kushta. In Allopathy it is treated with topical and systemic antifungal agents and use of corticosteroids.  According to Ayurveda protocol, treatment is done with Shodhana, Shamana and Bahirparimarjana (topical) Chikitsa for Dadru.[8],[9] Here with details of Dadru, case was effectively treated with Ayurveda modalities have been described.  CASE REPORT Presenting concern A 21 year old patient pursuing engineering, complaining of Kandu (itching sensation ) over groin region, buttock, Twak Vaivarnya (reddish to black A B S T R A C T  Dadru is one of the common form of Skin disease affecting all age groups. Dadru is a Tridosha vitiated condition. Dadru is closely associated with Tinea infection. The present case of Dadru shows remarkable results by combination of Internal and external treatment by Ayurveda drugs. Key words: Asanas, Obesity, Sthaulya, Shaileyadi Churna, Udvartana. Dr. Vivek Murlidhar Chaudhari et al. Management of Dadru Kushtha with Ayurveda Intervention - A Case Study ISSN: 2456-3110                                                             CASE REPORT May-June 2020  Journal of Ayurveda and Integrated Medical Sciences | May - June  2020 | Vol. 5 | Issue 3 165  discoloration with mild discharge over the gluteal region on both sides and other associated symptoms like Anidra and restlessness irregular and incomplete bowel evacuation since 15 days visited for Ayurveda treatment.  History taken for Hetu Sevan (etiological factors) showed following findings Viruddha Ahara Sevana, fast food, spicy and salty food, intake of curd, excess intake of pickle, stress. General examination ▪ Nadi - PittaKapha ▪ Purisha - Asamyak, Malabaddhata ▪ Mutra - Prakrut ▪ Jivha - Eshad Saam ▪ Kshudhaa - Prakrut ▪ Nidra - Samyak ▪ Bala - Madhyama ▪ Prakruti - Pitta Kapha ▪ Desha - Sadharan ▪ Koshtha - Krura ▪ Dosha - Tridosha ▪ Dushya - Rasa, Rakta Local examination Multiple erythematous patches with vesicle like eruptions on the gluteal skin. Some of the patches showed raised margins.  After careful examination patient is diagnosed with Dadru Kushtha.  Assessment Criteria for the evaluation of patient Grades of Signs Symptoms Grade 0  Grade 1 Grade 2  Grade 3  Kandu (Itching)  No Kandu Mild (No disturbance while doing work) Moderate (Disturbs the work) Severe  Raga (Erythema) Normal skin Mild redness Moderate red Severe/ deep brown Pidaka (Eruption) No Pidaka AlpaPidaka Madhyama Pidaka Bahu Pidaka Utsanna Mandalam (Elevation of lesion) No Mandala Mild Mandala  moderate Mandala Severe Mandala Srava (Secretion) No Srava Mild Srava Moderate Srava Severe Srava Therapeutic Intervention  Shodhana - Sadyovirechan - Aragvadha Kapila Vati 2 tab. Shamana - Internal medicine Duration - Day 1 to Day 14 1. Arogyavardhini 500mg twice a day after meal for 15 days 2. Gandhak Rasayan 500 mg twice a day after meal for 15 days  3. Rakta Pachak Vati 250 mg twice a day after meal for 15 days Duration - Day 15 to Day 30 1. Gandhak Rasayan 500 mg twice a day after meal for 15 days  2. Rakta Pachak Vati 250 mg twice a day after meal for 15 days 3. Avipattikar Choorna 3 gm twice a day after meal for 15 days Duration - Day 31 to Day 45 1. Gandhak Rasayan 500 mg twice a day after meal for 15 days  2. Rakta Pachak Vati250 mg twice a day after meal for 15 days 3. Avipattikar Choorna 3 gm twice a day after meal for 15 days Dr. Vivek Murlidhar Chaudhari et al. Management of Dadru Kushtha with Ayurveda Intervention - A Case Study ISSN: 2456-3110                                                             CASE REPORT May-June 2020  Journal of Ayurveda and Integrated Medical Sciences | May - June  2020 | Vol. 5 | Issue 3 166  External treatment 1. Triphala Kwatha Dhavan twice a day in the morning and before sleep 2. Gandhak Druti + Karanja Tail + Nimba Taila Case follow up - after every 7 days Duration of treatment - 45 days Dietary and lifestyle modifications - patient was advised to avoid Viruddha Aahara (incompatible food), fast food, and excessive salty, spicy, sour and excessive sweet food. Bakery products, oily food, day time sleep, yogurt.  Patient was advised to maintain Personal hygiene.    OBSERVATION AND RESULTS Sign and Symptom grades Day 1 Day 7  Day 15 Day 30 Day 45 Kandu 3 2 2 1 0 Raga  2 1 1 0 0 Pidaka 2 2 1 1 0 Utsanna Mandalam 2 2 1 0 0 Srava  1 1 1 o 0 DISCUSSION According to Ayurveda, Kushta Mahakushtha or Kshudra Kushta is very difficult to treat; Ayurveda treatment modality shows great results in this conditions. Tridosha involvement mainly Pitta and Kapha are mainly vitiated Doshas with Rasa and Rakta Dhatu and Lasika and Tvak are Dushyas in Dadru. In this case internal treatment with drugs like Aragvadha Kapila Vati for Virechana and Arogyavardhini, Rakta Pachak Vati, Gandhak Rasayan, Avipattikar Choorna as a Shaman treatment and external treatment with Triphala Kwath Dhavan and Gandhak Druti, Karanja Taila, Nimba Taila was applied externally.   Mode of Action Arogyavardhini (Rasa Ratna Samucchaya) Dravya Rasa Vipaka Veerya Guna Doshghnata Karma  Shilajatu Katu, Tikta, Kashay Katu Ushna Laghu, Ruksha Kapha Vata Shamak Medohara, Chedan, Sendriya Vishaghna, Rasayan, Shothahara Guggul Katu, Tikta, Kashay Katu Ushna Laghu, Ruksha, Teekshna, Vishad, Sukshma, Sara, Sugandhi Kapha Vata Shamak Balya,  Rasayana,  Varnya,  Vatabalasajit, Bhagnasandhanakrit, Medohara, Shothahara Chitrak Katu Katu Ushna Laghu, Ruksha, Teekshna Kapha Vata Shamak Deepan, Pachana, Kleda Shoshana, Pittasarak, Krumighna, Kushthaghna, Lekhana, Shothahara, Rasayan Nimba Tikta Kashaya Katu Sheeta  Laghu, Ruksha Kapha Pitta Shamak Kandughna, Kushthaghna, Shothaghna, Krumighna, Dr. Vivek Murlidhar Chaudhari et al. Management of Dadru Kushtha with Ayurveda Intervention - A Case Study ISSN: 2456-3110                                                             CASE REPORT May-June 2020  Journal of Ayurveda and Integrated Medical Sciences | May - June  2020 | Vol. 5 | Issue 3 167  Vranashodhak-ropak, Yakrut Srava Vardhak Haritaki Kashaya Pradhan Lavan Varjit Pancharasa Madhur Ushna Laghu, Ruksha Tridosha Shamak Saraka, Kushthaghna, Deepan, Rasayan, Bruhan, Shothahara, Kushthaghna, Krumighna Amalaki Amla Pradhan Lavan Varjit Pancharasa Madhur Sheeta Guru, Sheeta Tridosha Shamak Rasayan, Dahahara, Medohara, Saraka Bhibhitaki Kashaya Madhur Ushna Laghu, Ruksha Kapha, Pitta Shamak Krumighna, Kandughna  Gandhak Katu, Tikta Katu Ushna Laghu Kapha Vata  Shamak Kandughna, Kushthaghna, Visarpahara, Adhmanahara, Krumighna Parad Shadrasa Madhur Ushna Snigdha, Sara, Laghu Tridosha Shamak Rasayan, Vrana Shodhan-ropan, Krumighna Abhrak Madhur, Kashay Madhur Sheeta Snigdha, Laghu Tridosha Shamak Deepan, Pachana, Balya, Varnya Tamra  Kashay, Tikta, Amla, Madhur Katu Sheeta Sara, Laghu Kapha Pitta Shamak Rasayan, Lekhana, Ropan Gandhak Rasayan (Bhaishajya Ratnavali) Dravya Rasa Vipaka Veerya Guna Doshghnata Karma  Gandhak Katu, Tikta Katu Ushna Laghu Kapha Vata  Shamak Kandughna, Kushthaghna, Visarpahara, Adhmanahara, Krumighna Dalchini Katu, Tikta, Madhur Katu Ushna Laghu, Ruksha, Teekshna Kapha, Vata Shamak Kandughna, Vishaghna, Krumighna, Deepan, Pachana Ela Katu,  Madhur Katu Sheeta Laghu, Ruksha Kapha, Vata Shamak Deepana Tamalapatra Katu, Tikta,  Katu Ushna Laghu, Ruksha, Teekshna Kapha, Pitta Shamak Kandughna, Vishaghna, Krumighna, Deepan, Pachana Dr. Vivek Murlidhar Chaudhari et al. Management of Dadru Kushtha with Ayurveda Intervention - A Case Study ISSN: 2456-3110                                                             CASE REPORT May-June 2020  Journal of Ayurveda and Integrated Medical Sciences | May - June  2020 | Vol. 5 | Issue 3 168  Nagkeshar Kashay, Tikta, Madhur Katu Ushna Laghu, Ruksha, Teekshna Kapha, Vata Shamak Kandughna, Vishaghna, Krumighna, Deepan, Pachana, Shothahara Haritaki Kashaya Pradhan Lavan Varjit Pancharasa Madhur Ushna Laghu, Ruksha Tridosha Shamak Saraka, Kushthaghna, Deepan, Rasayan, Bruhan, Shothahara, Kushthaghna, Krumighna Amalaki Amla Pradhan Lavan Varjit Pancharasa Madhur Sheeta Guru, Sheeta Tridosha Shamak Rasayan, Dahahara, Medohara, Saraka Guduchi Katu, Tikta Madhur Ushna Laghu, Ruksha Tridosha Shamak Kandughna, Rasayan, Deepana, Pachana, Krumighna, Vishaghna Bhrungaraj Katu, Tikta Katu Ushna Laghu, Ruksha Kapha, Vata Shamak Tvachya, Rasayan, Krumighna, Shothahara, Vishaghna, Deepana, Pachana, Yakrut Balya Rakta Pachak Vati (Ashtang Hruday) Dravya Rasa Vipaka Veerya Guna Doshghnata Karma  Patol Katu, Tikta Katu Ushna Laghu, Ruksha Kapha Pitta  Shamak Varnya, Rochana, Deepana, Kandughna, Kushthaghna, Rakta Prasadak Sariva Madhur Tikta,  Madhur Sheeta Guru, Snigdha Tridosha Shamak Kandughna, Kushthaghna, Rakta Prasadak, Aampachan, Varnya Musta Tikta, Katu, Kashay Katu Sheeta Laghu, Ruksha Kapha, Pitta Shamak Deepan, Rasagata & Amashaygata Dosha Pachana, Krumighna, Rakta Prasadak Patha Tikta,  Katu Ushna Laghu, Ruksha, Teekshna Kapha, Pitta Shamak Vishaghna, Kushthaghna, Kandughna, Vrana Shodhan Kutaki Tikta, Katu Katu Sheeta Laghu, Ruksha Kapha, Pitta Shamak Rakta Prasadan, Dahaghna,Deepana, Rechana, Kushthaghna  Dr. Vivek Murlidhar Chaudhari et al. Management of Dadru Kushtha with Ayurveda Intervention - A Case Study ISSN: 2456-3110                                                             CASE REPORT May-June 2020  Journal of Ayurveda and Integrated Medical Sciences | May - June  2020 | Vol. 5 | Issue 3 169  Avipattikar Choorna (Bhaishajya Ratnavali) Dravya Rasa Vipaka Veerya Guna Doshghnata Karma  Shunthi Katu, Tikta, Kashay Katu Ushna Laghu, Ruksha Kapha Vata Shamak Medohara, Chedan, Sendriya Vishaghna, Rasayan, Shothahara Maricha Katu, Tikta, Kashay Katu Ushna Laghu, Ruksha, Teekshna, Vishad, Sukshma, Sara, Sugandhi Kapha Vata Shamak Balya,  Rasayana,  Varnya,  Vatabalasajit, Bhagnasandhanakrit, Medohara, Shothahara Pippali Katu Katu Ushna Laghu, Ruksha, Teekshna Kapha Vata Shamak Deepan, Pachana, Kleda Shoshana, Pittasarak, Krumighna, Kushthaghna, Lekhana, Shothahara, Rasayan Haritaki Kashaya Pradhan Lavan Varjit Pancharasa Madhur Ushna Laghu, Ruksha Tridosha Shamak Saraka, Kushthaghna, Deepan, Rasayan, Bruhan, Shothahara, Krumighna Amalaki Amla Pradhan Lavan Varjit Pancharasa Madhur Sheeta Guru, Sheeta Tridosha Shamak Rasayan, Dahahara, Medohara, Saraka Bhibhitaki Kashay Madhur Ushna Laghu, Ruksha Kapha, Pitta Shamak Krumighna, Kandughna  Musta Tikta, Katu, Kashay Katu Sheeta Laghu, Ruksha Kapha, Pitta Shamak Deepan, Rasagata & Amashaygata Dosha Pachana, Krumighna, Rakta Prasadak Vid Lavana Lavana Madhur Ushna Teekshna, Sukshma, Laghu, Vyavayi Vata, Pitta Shamak Deepana,  Vidanga Katu, Kashay Katu Ushna Laghu, Ruksha Kapha, Vata Shamak Krumighna, Deepan, Saraka Ela Katu,  Madhur Katu Sheeta Laghu, Ruksha Kapha, Vata Shamak Deepana Tamalapatra Katu, Tikta Katu Ushna Laghu, Ruksha, Teekshna Kapha, Pitta Shamak Kandughna, Vishaghna, Krumighna, Deepan, Pachana Lavanga Tikta, Katu Katu Sheeta Snigdha, Laghu,  Kapha, Pitta Shamak Deepan, Pachana Dr. Vivek Murlidhar Chaudhari et al. Management of Dadru Kushtha with Ayurveda Intervention - A Case Study ISSN: 2456-3110                                                             CASE REPORT May-June 2020  Journal of Ayurveda and Integrated Medical Sciences | May - June  2020 | Vol. 5 | Issue 3 170  Trivrut Tikta, Katu Katu Ushna Laghu, Teekshna, Ruksha Kapha, Pitta Shamak Krumighna, Shothaghna, Rakta Prasadak. Sharkara Madhur Madhur Sheeta Snigdha Vata Pitta Shamak Rakta Prasadak, Dahahara Nimba, Karanja by their properties acts as good Kushthaghna Dravya when applied externally.  Figure - 1 Day 1  Figure - 2 Day 15  Figure - 3 Day 30  Figure - 4 Day 45 Dr. Vivek Murlidhar Chaudhari et al. Management of Dadru Kushtha with Ayurveda Intervention - A Case Study ISSN: 2456-3110                                                             CASE REPORT May-June 2020  Journal of Ayurveda and Integrated Medical Sciences | May - June  2020 | Vol. 5 | Issue 3 171  CONCLUSION In this case study marked improvement was seen in patient of Dadru Kushtha. The treatment given was found effective in relieving the symptoms and induce remission by way of Aampachana, removal of vitiated Dosha from body and bringing Samyavastha (balanced condition) of Doshas. REFERENCES 1. Shastri Ambikadutta, Susruta Samhita, Chaukhambha Sanskrit Sansthan Varanasi, fourth edition 1976,Nidana Sthana 5/5,page no-247 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, Ashtanga Sangraha of Sarvanga Sundari Vyakhyaya Samhita Sutrasthana- Prathama Bhaga, Shri. Baidyanath Ayurveda Bhavana, pvt. Ltd Nagpur, 3rd edition; 1986:137 5. Shukla Vidyadhar and Ravi Dutta Tripathi Charak Samhita of Agnivesha revised by Charaka redacted By Drudbala with Vaidya Manorama’ Hindi commentary, Chaukambha Sanskrit Pratishthan, Delhi reprint-2011 chapter-7 Chikitsasthan shloka- 29-30 pp.185 6. Burns, Breathnach, Cox, Griffiths, Rook’s textbook of  dermatology, Blackwell  Publishers,  7th  edition- 2004, vol- 2, chapter-31.19 7. Tripathi Ravidatta and Shukla Vidyadhar, Charak Samhita Vol.2 - Chikitsasthana Kushtha Chikitsitam Adhyaya 7/4-8 - Edition, Chaukhamba Sanskrit Pratisthan, Delhi, 2013; 181 8. Jadavaji Trikamji Agnivesha, Charaka, Dridhabala, Charaka Samhita, Sutra Sthana, 1st ed.16/20. Varanasi: Krishnadas Acadamy; 2000. p. 97.  9. Kushwaha Harish Chandra Singh, Charaka Samhita, Ayurveda Dipika Ayushi, Hindi commentary edited by Vd. vol-2 7/41, Varanasi: Chaukhamba Orientalia; 2009. p.209     *******************************  How to cite this article: Dr. Vivek Murlidhar Chaudhari, Dr. Krishna Kiran Kokate. Management of Dadru Kushtha with Ayurveda Intervention - A Case Study. J Ayurveda Integr Med Sci 2020;3:164-171.  Source of Support: Nil, Conflict of Interest: None declared. Copyright © 2020 The Author(s); Published by Maharshi Charaka Ayurveda Organization, Vijayapur (Regd). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  

Management of Dadru Kushtha with Ayurveda Intervention - A Case Study

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Management of Dadru Kushtha with Ayurveda Intervention - A Case Study

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