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Introduction

Tinea means fungus, the cause of the rash, and corporis means the body. It is a superficial fungal skin infection caused by dermatophytes, which are a type of fungus.The Dermatophyte’s ability to attach to the keratinized tissue of skin forms the basis for the dermatophytoses (superficial fungal skin infections)².Patients commonly present with annular lesions. The lesions advance centrifugally from a core, leaving a central clearing and mild residual scaling; this appears as a “ring” shape giving rise to the term “ringworm.” In Ayurved it can correlated with Dadru.Acharya Sushrut ³and Acharya Vagbhat? explained dadru under Mahakushtha. Dadru is considered as Sankramika Vyadhi?. These Sankramika  Vyadhispreads  from  person  to  person  by Krimi  through  Sweda.Nidana  Parivarjana is  the  main  method  of  keeping  oneself  free  from the  disease.Dadru can  be diagnosed  by  symptoms  like Pidika,Varna with Mandala?.In Ayurveda Shodhan, Shaman and Bahirparimarjan Chikitsa is indicated for Dadru.

Aim: Conceptual study of Dadru Kushtha (Fungal Dermatophytosis).

MATERIAL AND METHOD: Present work is based on a review of classical information, relevant published research Works, and modern literature.

Case report: 15-year-old male patient came to us with chief complaints of

1. Reddish-black circular patch (Raga)
2. Severe itching (Kandu)
3. Mild burning sensation (Daha)

Over the lower abdomen and pubic area since 1 year

History of present illnesses:

18 yr male came to opd with complaints of Reddish-black circular patch (Raga), severe itching (Kandu), mild burning sensation (Daha) Over the lower abdomen and pubic area since 1 year.he consulted an allopathic dermatologist for the same and was diagnosed with tinea corporis. he took the allopathic treatment for 1 month and experienced significant relief. However, soon after stopping the treatment, an exacerbation of circular and red patches with itching and burning sensation was noticed. Then, he consulted our OPD for the possibility of treatment.

Past history: No specific history of any major illness, drug allergy, or previous surgery was given by the patient.

Family history: Positive family history showing the same complaints of the erythematous patch with itching to his sibling was observed.

Ashtavidha pariksha

• Nadi - 78/min, regular with Vata-Pitta dominance
• Mutra- Samyak 5–6 times/day and 0–1 times/night
• Mala-saam, 1-2 times/ day
• Jiwha- saam (undigested food particles)
• Shabda -Spashtha (clear)
• Sparsha - Anushnasheeta (not too hot)
• Drik -Prakruta (normal)
• Akruti (body stature)- Madhyama (average built)

CLINICAL FINDINGS: On dermatological examination, there were circular erythematous plaques with some vesicular eruptions over the lower part of the trunk with a slightly raised reddened demarked edge. These lesions were associated with the symptom of Kandu and Daha. Other physical parameters were normal.

Systemic examination: Blood pressure, respiratory rate, the temperature were within normal limits. Systemic examination did not reveal any abnormality.

Panchkarma chikitsa

AVAGAHA SWEDA?: The word ‘Avagaha’ means to immerse. Avagaha sweda is a type of sudation Therapy which is included in Drava sweda, in which the patient is made to sit/lie in a tub Containing medicated Dravadravya to produce fomentation to the body.

Dravya-khadir, nimb, sariwa, manjishtha, triphala choorna

PROCEDURE: The patient should be seated comfortably in the tub containing medicated Dravadravya in Such a way that his lower part of the body should be submerged above the level of

Umbilicus.  When the temperature of the medicated Dravadravya comes down, some amount Should be replaced by warm Dravadravya, thus keeping the temperature uniform

Between 38?C-42?C.

Assessment Criteria?: Assessment of patient was done on the basis of improvement in subjective parameters like Kandu (Itching), Raaga (Erythema), Utsanna mandala (Elevated circular skin, Lesion) and Pidika (Eruption).

Hetu: In Ayurvedic texts, specific etiology of Dadru Kustha has not been mentioned. Except the General etiology of Kustha. Dadru has been included under Kustha Roga so we can consider Same etiology of Kustha Roga also for Dadru Kustha i.e Adhyashana, Vishamashana, Atyashan,Shitoshna Vyatyasa Sevana and Anupurva Sevana, use of Santarpana and Apatarpana diet without sequenc,Kupathya in Panchkarma, Diwasawapana just after food,Papa Karma and Vipra Guru Tiraskasra.?

Samprapti¹?

Nidan sewan

Pitta kapha pradhan tridosh prakop

Tiryak gaman of dosha

Twacha, rakta, mans, ambu shithilta

Twacha sthan sanshray and twacha dushti

Dadru utpati

Samprapti ghataka

Dosha- Pitta & Kapha Paradan Tridosha

Dushya-Twacha, Rakta,Mansa & lasika

Strotas- Raktavaha

Strotadushti- Sanga

Adhishtana-Twacha

Rogamarga- Bhaya

Acharya Charaka described Dadru in the fourth layer of Tvak¹¹.Acharya Sushruta described Kushtha in fourth and fifth layer of Tvak.¹²

Discussion

Kusht Kalanal Ras: It is useful in the treatment of all types of skin diseases.It contains Shudda Gandhaka which purifies the blood,Loha Bhasma which is used in Ayurvedic treatment of anemia, eye disorders, skin diseases etc.,Pippali which has anti-aging property,Neem decoction act as anti- inflammatory, anti-bacterial, wound healing and anti-fungal activities,Triphala Kwatha which is an Ayurvedic medicine used in the treatment of skin diseases, oral ulcers, liver diseases. Aragvadha which has anti-bacterial and anti- fungal activities.¹³

Gandhak rasayan: Gandhak rasayan is polyherbal drug which is Rakta shodhak, kandughana and Rasayan mainly indicated in kushtha rog. It is prepared from chaturjata, triphala, Shunthi, and  swaras of guduchi, bhringraja,adraka , pure gandhak. It has antifungal and Antibacterial properties. Thus, it reduces the infection. It Reduces features of raag, pidika with raktashodhak and Kushthaghana properties.¹?

Khadirarishta: Khadira has immunomodulatory, anti-inflammatory, and antioxidant properties that can play a beneficial role in autoimmune and chronic inflammatory conditions. Bakuchi is also known as Kushtanashini, has immunomodulatory, anti-inflammatory, antioxidant, anti-psoriatic, anti-leprotic, and antibacterial properties. It acts through regulating multiple pathways to correct the pathophysiology of chronic skin ailments.¹?

Gandhrvaharitaki vati : This Kalpa helps to digest and excrete the Apakva Mala out of body by its Anulomak action. It is Snigdha Rechak Kalpa thus, it helps to relieve constipation and restore niramta.¹?

Somraji tailam : Dadru is a Kapha Dosha dominant Tridoshaja skin disorder. Local application of SomrajiTaila reduces symptoms of Dadru or Dermatophytosis Due to its Katu , Tikta test,Ushna Veerya Laghu, Ruksha Guna, and Katu Vipaka.Some contents of Somraji Taila also have Rakta Shodhaka property help to get Rid of the growth of fungus on the skin.Various researches on the contents of Somraji Taila have Proved its antifungal, antimicrobial, and anti?inflammatory activities .The other contents of Somraji Taila such as Haridra, Sarshapa, and Amalatasa have anti?inflammatory,anti?microbial activities antifungal activity. Somraji oil having the property of deep penetration helps to remove inflammatory substances and promote the regeneration of new tissue.The local application of Somraji oil acts quicker due to the physiological effect of heat on the skin.¹?

Avagaha Sweda: Avagaha Sweda is a type of sudation therapy, which involves sweat glands of a skin secreting salty fluids.Avagaha Sweda gives relief from pain and inflammation.drugs used in avagaha sweda such as khadir, nimb, sariwa, manjishtha, triphala are having kaphaghana and kushtaghna properties.¹?

Probable mode of action: The given drugs were having Rakta Shodhaka (Blood purifying), Krimighna(Antimicrobial and antifungal), Kushthaghna(Beneficial in skin diseases), Kandughna (Reduces itching), Dahaprashamana (Reduces burning sensation) Properties as well as antimicrobial, antifungal, Anti?inflammatory, antiproliferative actions, expected to Exert significant impact on the pathogenesis of Dadru Kushtha or fungal dermatophytosis.

Conclusion

The skin of a person is the index of psychosomatic health. Nowadays various types of fungal diseases are on the rampage, Dadru is one of them.Adverse consequences with contemporary treatment for Fungal dermatophytosis and recurrences demanded for Solution from Ayurvedic medicine.

Considering these Facts and the limitations of contemporary treatment, this case study was done to evaluate efficacy of ayurvedic treatment in dadru kushta.