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Introduction

Disease of the skin are common occurrence There are not many statistics to prove the exact frequency of skin diseases in this country, but general impression 10-20% of patient seeking medical advice suffere from skin diseases. Disease of skin account for a great deal of misery, suffering, incapacity and economic loss. Besides this, they are a great handicap in the society, because they are visible. Kustha is a condition in which different body organs, dhatus, upadhatus are destroyed and contempted. In Ayurveda Kustha encompasses a broad spectrum of skin diseases. Ekakustha can be corelated with Ecthyosis vulgaris based on similarities in etiopathogenesis and symptomatology. Vitiation of Kapha and Vata in particular along with vitiated rakta in general plays the major role in the manifestation of Ekakustha. Ichthyosis vulgaris is a disorder of the skin that causes excessively dry, thick, scaly skin. Ichthyosis means fish scales and vulgaris means “common”. It is the commonest form of ecthyosis where the skin looks like that of fish scale. Ecthyosis vulgaris is usually caused by a genetic variation, which can be inherited or happen spontaneously during fetal development. But the same can also occur with medical illneses like cancer, sarcoidosis, lupus and so on. Rarely medicines like cimetidine, clofazimine and nicotinic acid may result this condition. The principle of treatment is three fold in Ayurveda, Sodhana treatment is considered as best among these as it can remove all vitiated doshas from the body responsible for manifestation of disease. In the pathogenesis of Eka kustha the doshas are vitiated extremely and the nature of the disease is chronic in nature. Hence, all the acharyas have advocated sodhana as the first line of management for this condition. In this study purificatory(sodhan) measure was administerd considering the age of the patient as well as considering the excessive dryness of the skin external application and orally ghrita pan was advised.

CASE REPORT

A 18 years old male boy accompanied with his father visited the OPD of Agada Tantra of Government Ayurvedic College and Hospital, Guwahati, Assam, India on 06-01-2025(Registration No-0703/25) presenting with dry, thick and scaly lesion on the various parts of the body since 7 years with on and off pattern. No any history of other diseases was there. The patient has consumed allopathic and homeopathic medicine but there was no satisfactory improvement. Besides he complained that new lesions were manifested after stopping the taking of medicine. No any significant laboratory findings were detected.[Figure-1]

Treatment

This Patient was treated in the OPD of Agada Tantra of Government Ayurvedic College and Hospital, Guwahati, Assam, India. The patient was treated in line with the management of Eka kustha. The patient was administerd with nitya virechana(purgation therapy),internal medication and external application.

The Detail of the medicine are described below

1.Arogyavardhani Vati : 500 mg twice daily along with meal.

2.Dooshivishari Gutika : 500 mg twice daily after food along with honey to be leacked.

3.Kaishore Guggulu :250 mg with Guduchyadi Lauha :250 mg twice daily after breakfast and evening

4.Avipattikar Churna : 5 gm with luke warm water at bed time.

5.Aloevera thick Gel : For local application

The patient was advised to revisit after 2 months and also advised to stop Arogyavardhani Vati after one month. The patient again visited the OPD of Agada Tantra of Government Ayurvedic College and Hospital, Guwahati, Assam, India on 10-03-2025.Marked improvement was observed with regard to subjective criteria like thickness, dryness and scaly lesion.[Figure :2] The patient was advised with the following medication

1.Arogyavardhani Vati : 250 mg twice daily along with meal.

2.Dooshivishari Gutika : 250 mg twice daily after food along with honey to be licked.

3.Kaishore Guggulu :250 mg twice daily after breakfast and evening

4.Avipattikar Churna : 5 gm with luke warm water at bed time.

5.Aloevera thick Gel : For local application

The patient was advised to revisit after 2 months and also advised to stop Arogyavardhani Vati after one month. But due to examination and other works the patient had visited the OPD of Agada Tantra of Government Ayurvedic College and Hospital, Guwahati, Assam, India on 11-07-2025.Highly significant improvement was observed with regard to subjective criteria like thickness, dryness and and scaly lesion. Other important observation was that though patient was without any medication except external application there were no lesion and relapse.[Figure :3]

The patient was advised with the following medication

1.Haridra Khanda: 5 gm twice daily after meal with a cup of milk.

2.Satadhauta Ghrita: For local application.

The patient was advised with the following regimen

1. Avoid sleeping in the late night.
2. Avoid non-vegetarian diet.
3. Avoid heavy dinner.
4. Avoid sour substances and curd

Discussion

The dryness, thickening and scaly lesions in ichthyosis vulgaris are caused by a genetic mutation in the filaggrin(FLG) gene. The filaggrin protein is crucial for maintaining a healthy and functional skin barrier. A deficiency in this protein leads to the characteristic symptoms of this disease through several mechanisms. Arogyavardhani Vati is having the pharmacological properties like deepan, pachan, anuloman and kusthaghna.In Ayurveda it is considered that imbalanced digestive power i.e.mandagni is the prime cause all types of ailments. This mandagni is responsible for formation of undigested food materials inside the body i.e. ama.This can be corelated with oxidative stress which is aetiology of numerous diseases of the human body.All the ayurvedic scholars clearly mentioned that medicine having properties like deepan, pachan and anuloman plays a vital role in the management of a disease.That is why Arogyavardhani Vati plays an important role in the treatment of Eka Kustha .Again this medicine possesses the kusthaghna property and capable of subside the Eka Kustha. Kustha is described as one of the manifestation of dushivisha i.e.cumulative poison by all the acharyas. Dooshivishari gutika is one of the well-known ayurvedic  medicine used against all types of manifestation resulting from dushivisa as it possesses vishaghna (anti-poisonous) property. So, dushivishari gutika plays a major role in the treatment of Eka Kustha. In the pathogenesis of Eka Kustha vitiated vata and rakta dosha plays an important role. Kaishore guggulu is the drug of choice for kustha as well as disorders of vitiated rakta. Keeping these facts in mind Kaishore guggulu is administered in this case. Sodhan is considered as the best treatment module in ayurvedic system of medicine. In this process aggravated doshas are expelled out from the body. Virechan is one of the such process and Avipattiakar churna is advocated for this. In Eka kustha there are severe aggravation of doshas. So, without expelling them we cann’t expect desire result and Avipattikar churna is the drug of choice in this case. Dryness is one of the important issue in ichthyosis vulgaris.In Ayurveda it is described that vitiation of Vata dosha is responsible for manifestation of dryness in the body.In the pathogenesis of Eka Kustha aggravated or vitiated vata dosha plays a major role leading to dryness. Aloe vera gel and Satadhauta ghrita are the solution in this case. Haridra Khanda is the drug of choice for various skin disorders as well as it is used to prevent recurrence. In this case this medicine is prescribed to prevent recurrence as well as for its property of sodhana. Because it expel out the doshas from the body by virtue of its mridu virechak(mild purgative) property preventing the doshas to get accumulated inside the body and relapse. Proper diet and regimen are an integral part of management and prevention of diseases in ayurvedic system of medicine. In Ayurveda along with medicine do’s and don’ts are described and accordingly these were advised to the patient. This diet and regimen are very important because they play a vital role in recurring or aggravation of clinical feature. For example, late night sleeping causes aggravation of vata dosha which is the root cause of this disease. Again heavy dinner is the cause of oxidative stress leading to diseases. So, these factors were considered and accordingly the patient was advised.

Conclusion

Sodhana chikitsa is considered as best treatment of Eka Kustha accompanied by saman ausadhi and pathya. In the present study these aspects were strictly followed. In conclusion we can say that Ayurvedic approach of management of ichthyosis vulgaris i.e. Eka Kustha is an excellent one and can be administered to prevent or relapse as well as to treat without any hesitation.