Introduction

Ayurveda uses the general term "Kushta" to describe skin conditions. Dosha preponderance differs in each kushta, considering the reality that they are all tridoshaja. Vicharchika is classified as a kshudra kushta, with kaph dosa being the most common of the 20 kushtas. The symptoms of Vicharchika include Shyava Varna, Pidika, Asrava, and Kandu. Eczema and vicharchika share a similar appearance and are classified under rakta pradoshaja category.(1)Eczema, sometimes referred to as atopic dermatitis, is a chronic inflammatory skin condition that is characterised by regions of poorly defined erythema and scales on top of dry, itchy skin that is prone to infection. The disease's course appears to be significantly influenced by hereditary or environmental causes.(2) Eczema is a skin disorder causing pruritus, erythema, oedema, and itching, affecting the face, neck, wrist, ankle, and cubital regions.(3) According to the WHO, eczema affects people of all ages in India and has an incidence rate of 15% to 20%.(4)

Case Report: A 37-year-old female patient came to the OPD section of the Kayachikitsa department in SMBT Ayurved Hospital, Dhamangaon, Nashik. Patient name: ABCD OPD/IPD No.: 1-100924with complaints of section of the with recurrent skin rashes over bilateral palms characterised by redness, itching, flaking, burning sensation, Discolouration of skin The patient was suffering from these symptoms for 6-8 months. The patient not taken any other treatment. The symptoms got worse with the time and started affecting his personal life. So, the patient decided to take Ayurvedic treatment. The Ayurvedic diagnosis is considered as Vicharchika. The involvement of Vata results in dry, blackish lesion of Vicharchika, itching in the affected area is due to Kapha.

Name: ABCD

Age: 37 years

Sex: Female

Occupation: Farmer

Religion: Hindu

Diet: Vegetarian

Drug History: No

Personal History:

1. Bowel movement –Samyaka

2. Appetite – Excessive Hunger,Irregular meal time

3. Sleep- Sleep disturbed

4. No history of any type of addiction like smoking, alcohol, tobacco.

5. Oedema: Not present

6. Blood Pressure: 120/80 mmHg

7. Icterus: Not present

8. Clubbing: Not present

History of past illness:

 1-Medical history- No Past History of Hypertension,Asthma,Dibetic Milletus or any other major illness.

 2-History of Blood Transfusion – No history of blood transfusion.

 3-Drug History- He was not taking any other treatment.

 4-Family History –No significant history.

5-Surgical History- No significant history.

Samanya Pariksha

Pulse rate -84/min

B.P.-120/70 mm hg

R.R.- 19/min

Spo2 -99%

Temperature –Afebrile

 Systemic Examination:

CNS: Conscious and well oriented to person, place, and time.

CVS: S1, S2 is audible, No murmur sound.

Respiratory System: B/L Symmetrical,Normal vesicular Breathing heard ,No added Sounds heard.

P/A: -Umbilicus Centrally placed, Soft, non-tenderness,no-organomegaly.

Digestive System: Normal

Asthavidha Pariksha:

Samprapti of Vicharchika:(6)

Nidana

Jatharagni Mandhya

Tridosha Dusti

Dushta Kapha Cause Kledana

Dhatu Shaithilya (Dhatwagni Mandhya)

Twak,Rakta,Mamsa dusti

Shyava Varna Pidaka,Bahusrava and Kandu

Vicharchika Kustha

Aim & Objective: To explore the Efficacy of Ayurvedic Treatments for Vicharchika w.s.r Eczema

Material and methods:  Study type: Simple Random Single Case Study.

Center of study: OPD section of the Kayachikitsa department in SMBT Ayurved Hospital, Dhamangaon, Nashik. The patient is chosen on the basis of the following criteria: vicharchika signs and symptoms are present in this patient.

Material with daily Treatment and Prognosis Clinical examination of the patient revealed regression of symptoms due to our Ayurvedic Management

Depending upon sign and symptoms, the patient was diagnosed as Vicharchika (Eczema).

Samana oushadhi were given to the patient along with some other Ayurvedic Medication.

Assessment criteria:

Subjective Parameters

Kandu (itching)

Rukshta (dryness)

During treatment, the patient had begun to improve, and by the end of the 22nd day, they had fully recovered. Every subjective parameter is improved by Ayurvedic treatment.

Srava (oozing)

Pidika (vesicles)

Shyava Varn (skin discoloration)

Discussion

Vicharchika is a kushta that is primarily kapha and a rakth pradoshaj vikar. Dooshivish and Virudh ahar are the key hetus that cause a variety of skin conditions. Therefore, changing eating habits and embracing a healthy lifestyle are part of the Nidan Parivarjan. The goals of the saman oushadhi were to increase jadharagni, rectify ama, and eliminate toxins from the body.Haridrakhand is a fantastic medication that improves skin quality and has anti-oxidant, anti-allergic, and anti-histaminic qualities. In addition to serving as Kaphahar and Kandughna, it also lowers inflammation and helps remove toxic compounds like cytokines from the blood.(7)Gandhak Rasayan is an herbomineral formulation with antibacterial, antiviral, and antimicrobial properties. It contains Agnimandya, Tridoshaj, and Rakta dushti, purifying blood with Bhavana dravyas like Guduchi, Nagkeshar, Haritaki, Sunthi, and others having Katukashay rasa and Ushnavirya. It therefore executes Kledhar, Kaphghna, Pachana, and Dipana. In this process, it also acts as Kandughna, Kushtaghna, dahanashak, raktaprasadan, and ugra visha doshaghna properties, promoting the recovery from the ailment.
It also promotes recovery from ailment and cures all 13 types of kshudra kushtha. Gandhak is a good Rasayan. (8)

Arogyawardhini Vati, which balances our body's tridosha and is helpful for indigestion and irregular bowel movements, is part of the ayurvedic treatment in this case study. It increases the body's capacity for digestion and acts as a tonic for the respiratory, excretory, skeletal, liver, heart, kidney, uterine, rectum, and intestine. In vicharchika, it functions as bhedan, Twachya, agni deepana, and pachana karma.(9)

Mechanism of action: Panchatikta ghrita guggulu is a powerful medication that can be used to cure any kind of kushtha. Additionally, Bhaishajaya Ratnavali kushtharogadhikar explains it. The tikta rasa, laghu, and ruksha gunas in all the contents serve to boost the immune system and reduce kandu.(9) Mahamajisthadi kwath includes medications like Arishta, Patolamula, Katuka, Bhringa, Magadha Piper, Trayanti, and Patha. These medications have qualities similar to Varnya, Kapha Pittashamak, Shothahar, Kushtaghna, and Vranropak. They have Kapha Pittahara or Tridoshaghna properties, such as Katu Vipaka. Blood purification remedies include Manjistha, Nimba, Haridra, and Vacha. These medications follow the Samprapti Vighatana Chikitsa Siddhanta.Mahatiktak ghrita's Guggule mode of action: Mahatikta ghrita Guggule is recommended for a number of illnesses. When used, it relieves boils, rashes, pus discharge, and other skin conditions. Mahatikta ghrita Guggule is also used to treat chronic fever, vat-rakta, or gout, jaundice, and hyperacidity and mounds of blood.(9)

Mode of action of Triphala dhawan and Siraveda: When Triphala Kwatha Dhawana removes pollutants from the area, healthy granulation tissue forms and has a greater capacity to heal. The following three astringent plants make up this herbal mixture: 1. The Haritaki 2. The Bibhitaki 3. The Amalaki. Beneficial skin revitalisation with triphala kwatha: exfoliates dead skin cells, reviving the skin for a more radiant and clear appearance. According to Siraveda, pain is instantly relieved by the removal of morbid humour (vitiated Doshas) that has collected as a result of an inflammatory response. Due to Siravedha's enhanced blood circulation, the Ushna Guna of the Rakta masks the Sheet Guna of the Vata. (10)This may have an analgesic effect by lowering intravascular volume and pressure.(11)

Conclusion

Vicharchika is a chronic disease that can be easily treated with ayurvedic samanaoushadhis along with nidan parivarjan and correcting lifestyle and food habits. Localised skin lesions can be effectively treated with herbal medicines after proper evaluation of dosha predominance at OPD level. The case report demonstrates the treatment of eczema with only Ayurvedic medicinal intervention. No surgical intervention was given. Pathyasevan plays a major role in the treatment of vicharchika. Apathya ahar should be avoided. The present case study concludes that use of Ayurvedic medicines like Aarogyavardhini vati, Gandhak rasayan, Mahamajishtadi kwatha, Mahatiktak Ghrit Guggule, Pachatilta Ghrit Guggule, Arogywardhini vati, Tiphala kwatha dhavan, and Siraveda  Vicharchika vyadhi, with some dietary and lifestyle changes, is very effective management.The case report showcases the effectiveness of traditional Ayurvedic practices in managing Vicharchika, recommending further larger-scale studies for validation and promotion of integrative dermatological care.