Issue : 02 DOI :

INTERNATIONAL

JOURNAL

OF

DIAGNOSTICS

AND

RESEARCH

Volume : 02

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1

Abstract

Background: In Ayurveda, all types of Kustha are believed to have a Tridoshaja origin, and they are

classified into two categories: Mahakustha and Kshudra Kustha. Vicharchika is a type of Kshudra Kustha,

characterized by symptoms such as Kandu (itching), Srava (discharge), Pidaka (vesicles), and Shyava

Varnata (skin discoloration). In modern medical terms, Vicharchika closely resembles eczema and is

considered a form of dermatitis, where the dermis becomes inflamed, often referred to as Atopic

Dermatitis, characterized by pruritis, burning, oozing, papules, vesicles, dryness, scaling, discoloration and

skin lichenification. Vicharchika affects psychological health causes anxiety, depression, disturbs the

person’s routine thus interrupts the ability to function normally and lead to social isolation. In classical text

of Ayurveda Shodhana and Shamana therapy is explained best line of treatment for Kushta. Among

Shodhana therapy Virechana karma is best purificatory therapy in Vicharchika.

Material & Methods: A case of 51 year old female patient, presented with excessive Kandu (itching),

Rukshata (dryness), small eruptions, Vedana (pain), Raji (thick skin), Vaivarnya (discoloration) on her

Hasta Pradesh (hands), Ubhaya Pad Pradesh (toes) and thigh region since 7 years. She had been taking

oral anti-allergic medications for pruritus on and off but became frustrated with the frequent relapses. The

condition was successfully managed through an Ayurvedic approach.

Results: The significant changes were observed after Virechana karma which was followed by Shamana

Aushadhi for 3 months. So the patient showed much improvement in characteristics features of

Vicharchika, hence it’s proved Shodhana Karma followed by Shamana Aushadi is an effective treatment in

Vicharchika.

Discussion: Favorable outcome was observed due to the Kapha-Pitta balancing, Tridosha-modulating,

Kusthaghana, Shothahara, and Kandughana properties of the medications used in Shodhana and Shamana

therapies.

Conclusion: Significant results were observed following Virechana Karma and Shamana Chikitsa, with no

adverse side effects. This case study highlights that both Shodhana (Virechana Karma) and Shamana

Chikitsa are safe and effective in treating Vicharchika.

Keywords- Kushta, Vicharchika, Eczema, Shodhana, Shamana, Virechana.

Keywords :

Corresponding author: Dr. Neha

Article Info: Published on : 15/01/2025

P

ISSN No. : 2584-2757

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Issue : 02

Publisher

ROGANIDAN VIKRUTIVIGYAN PG ASSOCIATION

FOR PATHOLOGY AND RADIODIGNOSIS

DOI

: 1 0 . 5 2 8 1 / z e n o d o . 1 4 6 4 9 8 5 9

Reg. No. : MAHA-703/16(NAG)

Year of Establishment – 2016

INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH

Management of Vicharchika (Eczema) an Ayurvedic Approach-A Case Report

Dr.Neha

1

, Dr.Chander Shekhar Sharma

2

1

Assistant Professor, Panchakarma,Dayanand Ayurvedic College, Jalandhar, Punjab.

2

Professor and Head of Kayachikitsa Department, Dayanand Ayurvedic College, Jalandhar, Punjab.

Cite this article as: - Dr.Neha

(2025) ; Management of Vicharchika (Eczema) an Ayurvedic Approach-A Case Report;

Inter.J.Dignostics and Research 2 (2) 1-9, DOI: 1 0 . 5 2 8 1 / z e n o d o . 1 4 6 4 9 8 5 9

G

A

R

V

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2

Introduction:

The skin, as the largest organ and protective covering

of the body, is an extraordinary structure.

[1]

It reflects

an individual’s overall health and well-being, and is

one of the five sense organs.

[2]

Humans rely on this

1.7m² barrier to separate the body’s vulnerable interior

from the potentially harmful external environment.

[3]

Skin diseases are becoming more prevalent, impacting

individuals of all ages, from children to the elderly.

These conditions can lead to discomfort,

disfigurement, disability, and, in rare instances, even

death.

[4]

and their incidence is 2-3 percent of all

medical problems seen in practice.

[5]

In Ayurveda, skin

diseases are classified under the category of Kustha

and are considered as a Rakata Pradoshaj Vikar.

[6]

and

Virechana Karma is described in the Ayurvedic

Samhitas under Kustha Chikitsa.

[7]

In modern science

various facilities, new techniques and upgraded

technologies for treatment are available, still many

diseases are in progression state and Vicharchika is

among one of them.Hence the main treatment in

Ayurveda for Vicharchika is Shodhana i.e Virechana

is indicated which eliminated vitiated Dosha, then

followed by administration of Shamana drug.

Case Study

History of Present Illness:

A 51-year-old female patient, working as a staff nurse,

has been suffering from ongoing issues of excessive

itching, dryness (Rukshata), small eruptions, pain

(Vedana), redness (Raji), and discoloration

(Vaivarnya) on her hands (Hasta Pradesh), toes

(Ubhaya Pad Pradesh), and thigh area. Despite using

oral anti-allergic medications intermittently for relief,

she got frustrated and fatigued by the recurrent nature

of the condition and visited ayurvedic hospital for

better solution.

Patient’s other Information:

 Past history- No any major illness/no previous

operation done/no h/o any trauma.

 Family History- No Relevant Family history.

 Drug history- History of using anti- allergic

drugs for pruritis on and off

 Personal history-Diet (Mixed), Dietary Habits-

Three meals/day, Appetite-Normal, Sleep-

Disturbed due to itching, Bowel habits -Regular-

, Addiction-She takes tea 5-6 times a day.

Systemic Examinations

 On an Integumentary examination, distribution

of the skin eruptions was over hands, toes and

thigh area. Type of lesion was vesicles and scaly

lesions. The colour was blackish associated with

rough surface, lichenification and no discharge.

 Respiratory System- Bilateral air entry

equal. No abnormality detected.

 Cardiovascular system- S1, S2 normal.

 Per-Abdomen- soft, non-tender, non-

distended and no organomegaly detected.

Asthavidhapariksha:

 Nadi- Kaphavataj

 Mala- 2times/day, bowel habit was regular.

 Mutra- 5-6 times/day

 Jihva- Sama

 Shabda-Prakrita

 Sparsha- Anushna

 Drika-Prakrita

 Aakriti-Madhyam

Vital Data: Blood pressure- 130/90mm of Hg,

Pulse: 78/min, Temperature-98.6

0

F, Respiratory

rate- 14/min

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Diagnostic Assessment: All routine Laboratory

investigations were within a normal range (CBC,

FBS, LFT and RFT). The patient was not willing

for tissue biopsy due to unaffordable cost and fear.

Therefore, based on clinical presentation

Subjective Criteria:

Table-1 Subjective Parameters :

Blood investigations :

Table-2 Laboratory investigations :

All the blood tests were within normal limits.

Sr.

No

Parameter

Scoring Criteria

Score

1.

Kandu

(Itching)

No itching

0

Mild itching not

disturbing normal

activity

1

Occasional itching

disturbs normal

activity

2

Itching is present

continuously and

even disturbing

sleep.

3

2.

Daha

(Burning)

No burning

sensation

0

Mild type of

burning not

disturbing normal

activity

1

Occasionally

burning disturbing

normal activity

2

Burning present

continuously &

even disturbing

sleep

3

3.

Strava

(oozing)

No discharge

0

Occasional

discharge after

itching.

1

Occasional oozing

without itching.

2

Excessive oozing

making clothes wet

3

Sr.

No

Parameter

Scoring Criteria

Score

4.

Rukshata

(Dryness)

No dryness

0

Dryness with rough

skin (Ruksha)

1

Dryness with

scaling (Khara)

2

Dryness with

cracking (Parusha)

3

5.

Pidikotpatti

(Eruption)

No eruption in the

lesion

0

Scanty eruptions in

few lesions

1

Scanty eruptions in

at least half of the

lesion

2

All the lesions full

of eruption

3

6.

Vaivarnyat

a

(Discoloura

tion)

Nearly normal skin

colour

0

Brownish red

discoloration

1

Blackish red

discoloration

2

Blackish

discoloration

3

7.

Rajii

(Thickenin

g of skin)

No thickening of

skin

0

Thickening of skin

but no criss-cross

marking

1

Thickening with

criss-cross marking

2

Severe

lichenification

3

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Sr.

No

.

Test

Result

1

Hematological

Test

Hb% -10.9gm%

TLC-7/cumm

DLC- Gran%- 58.1,

Lymph%- 35,

mid%-4

ESR- 10mm/1

st

2

Fasting Blood

Sugar

77mg/dl

3

Renal Function

Test

Blood Urea-

22mg/dl

S. Creatinine-

1.0mg/dl

4

Liver Function

Test

S. Bilirubin total -

0.5mg/dl

SGOT - 32 U/L

SGPT –25U/L

S. Alkaline

Phosphate – 96U/L

Methodology :

Patient selection :

The patient has been suffering from severe itching

(Kandu), dry skin (Rukshata), discoloration

(Vaivarnaya), cracked skin (Raji), and pain

(Vedana) for the past 7 years. She was registered

for the current study under IPD No- 2100254 at

M.C DAV Hospital, Jalandhar, Punjab, and

diagnosed with Vicharchika (Eczema) based on her

clinical symptoms. The treatment involved a single

session of Virechana Karma, followed by a 30-day

course of Shaman drugs.

Treatment protocol

The need for Shodhana therapy ie Virechan Karam

was first explained to the patient, with a clear

emphasis on the importance of Virechana Karma in

the treatment of Kushta, specifically for

Vicharchika. Various Previous scientific studies

had shown that Virechan Karam plays a crucial role

in the elimination of Pitta Dosha, as well as

balancing Kapha, Vata, and Rakta.

Pathya-Apathaya (wholesome and unwholesome

diet) was strictly instructed to the patient at the time

of Snehapana and advised to use warm water, not

to suppress natural urges and complete abstinence

from sexual activity and avoid day sleep.

Patient was also instructed post procedure activities

(Ashta Pariharya Vishaya) that should be avoided

i.e load speech, chariot travelling, excess walking,

sedentary lifestyle and day sleep, wrong intake of

food andfood intake during digestion etc

Management :

First, the patient's consent was obtained, and she

was advised to avoid contact with gloves,

detergents, soaps, and similar materials.

 Virechana Karma : Preparation of patient

includes Deepana Pachana, Snehapana,

Sarvanga Abhyanga and Sarvanga Svedana

then administration of Virechana drug.

 Deepana Pachana: with Panchakola Churna in

a dose of 3gms three times a day with lukewarm

water for 4 days, till Nirama Lakshana occurs.

 Snehapana: Panchatikta Ghrita was given in

increasing doses (Table-3) each morning on an

empty stomach for a period of 6 days. The

dosage was adjusted based on the patient's Agni

and Koshtha, continuing until the appearance of

Samayak Snigdha Lakshana.

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Table 3- Snehapana chart

During Snehapana patient was advised to take hot

water for drinking whole day and to avoid day

sleep, exposure to direct wind, sunlight, excessive

work and stress etc.

Sarvanga Abhyanga and Svedana- Three days gap

was given. During these days Sarvanga Abhyanga

and Sarvanga Svedana was carried out, then

Virechana Yoga was given.

Diet during VishramKala (After gap of 3 days) –

Diet includes Jangala Mamsa Rasa, Yusha with

Snigdha, Laghu, Ushna quality and Kapha

Avridhikara Aahar. Acharya Sushruta mentioned

that on the previous day of Virechana Laghu

Aahar, Phalamla and Ushnodaka should be

administered.

Virechana Yoga- Triphala Kwath 100ml was given

along with 3gms Trivrit and 3gms DantiChooran.

Total 15 Vega after administration of Virechana

Yoga, it was Kaphanta Virechana and she felt

lightness in whole body.

Paschat karma- Specified diet was followed for 5

days and that depends according to the Shudhi and

known as Samsarjana Karma, which includes

intake of Peya, Vilepa, Mamsarasa and Yusha

preparations.

Shamana Aushadhi :

Table-4 - Shamana Aushadhi and follow-up chart

AfterVirechana - 1. Navakashaya 20ml twice a

day was given for 1month.

First Follow Up

Second Follow Up

1. Mahamanjishtadi

kwath 20 ml three times

a day.

1. Navakashaya 20 ml

twice a day.

2. Arogyavardhini vati 1

tab three times a day.

2. Haridra khand 1tsf

twice a day.

3.Gandhak rasayan 1tab

twice a day.

3. Nimbadi churan 5

gms twice a day.

4. Navakashaya 20ml

twice a day.

4. Panchatikta guggulu

ghrita10 ml at night.

5. Khadirarista 15ml

three times a day.

5. Khadirashtak kwath

20 ml twice a day.

After Virechana Karma Navakashaya was given

twice a day orally, patient showed marked

improvement within one month. Then patient was

followed up for two months and above Shaman

Aushadhi was prescribed, she showed significant

relief in the subjective parameters.

Table-5 Subjective parameters :

Sr

No

Parameter

Before

treatment

After

treatment

1.

Kandu (Itching)

2

0

2.

Daha (Burning)

0

3.

Strava (oozing)

0

4.

Rukshata

(Dryness)

3

0

5.

Pidikotpatti

(Eruption)

2

1

6.

Vaivarnyata(Disco

louration)

3

1

7.

Rajii(Thickening

of skin)

1

0

Days

Dose

1

st

30ml

2

nd

70ml

3

rd

90ml

4

th

120ml

5

th

160ml

6

th

180ml

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Figure 1: Showing progress before and after Treatment

Discussion :

Kushta is a Vyadhi (Disease) that originates due to

vitiation of all the three Doshas and involvement of

Dushit Twaka, Rakta, Mamsa Dhatu and Jaliya

Ansha present in the body. Kushta Roga has

specific Nidana so the first step of Chikitsa is

Nidana Parivarjan, the patient is Staff nurse, had

regular contact with gloves, sanitizer and other

materials etc that’s the one cause of hands eczema,

during treatment patient strictly avoid contact with

gloves. On the basis of symptoms the present case

study is taken and considered as Kshudra Kushta i.e

Vicharchika with Pitta Dosha Pradhanya and

Kapha Dosha Anubandha. A specific procedure for

Pitta Dosha is Virechana Karma which moves

vitiated Dosha towards Adhobhaga

[8]

and expels

from Guda and also acts on vitiated Kapha Dosha.

In this case study Virechana Karma was given and

drugs Trivrit Churan, Danti Churan and Triphala

Kwath was selected

[9]

.Trivrit Churan has Madhura,

Kashaya, Tikta Rasa, Katu Vipaka and Ushna Virya

so helps to pacify Pitta Dosha with Kushtaghan,

Krimighan and Rakta Shodhana properties. Danti

Churan has Katu Rasa, Tiksan Guna, Laghu Virya,

Usna Vipaka and has Kaphahara, Vidahara and

Shodhan properties. Triphala Churan acts as

Dipana, Anulomana, Rasayana, Tridoshahara,

Bhedaka and enriched with, Katu Madhura,

Ruksha, Ushna, Amla etc properties. Thus through

Virechana Karma pacified Pitta and Kapha Dosha

and itching, dryness, eruption and discoloration also

reduced. After Shodhan therapy, orally Shaman

Aushadhi was given as follows: Navakashya

[10]

is

composed of Triphla, Kutaki, Neem ,Manjishta,

Haldi etc and has Tikta, Ruksa, Laghu, Sita, Katu

Dravayas and Tridoshara, Kapha-Pittahara,

Krimihara and Rakta Shodhak, antifungal

properties. Mahamanjishtadi Kwath

[11]

contents are

Manjishtha, Triphla, Mustak, Gudhuchi, Kutha,

Nimbi, Khadira, Chandana etc and has Guru,

Ruksha Guna, Tikta, Kashaya Rasa, Madhura

Vipaka and Usna Virya Dravya. It has effect on

Tridosha, balances Kapha-Pitta and recommended

for all skin diseases. Arogyavardhini Vati is

composed of Shudha Parad, Gandhaka, Shilajit,

Lauha, Tamra Bhasam, Triphala Churan, Kutaki,

Chitrak Moola and Bhavita with Nimba Patra

Swaras and in Kustha Rogadhikara it’s written.

Tikta Rasa is recommended in Kushta disorders

[12]

.

Hence it works as Kaphahar, Kledhara, Lekhana,

Bhedana and Yakrituttajak and has capacity to

normalize Bhootagni and Dhatvagni. It acts on

diseases like skin problems, Kandu, psoriasis and

eczema.Gandhak Rasayan

[13]

contains Shudha

Gandhak and Bhavana of different Kashaya,

Swaras like Go-Dhugadh, Guduchi Swaras, Adarak

Swaras etc and it’s highly recommended in

Kushtha Vikar. It contains Tikta, Kashaya Rasa,

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Usna Virya and Katu Vipaka Dravyas. It has effect

on Tridosha Kushtahara, Kanduhara anti-bacterial,

anti-pruritis and anti- inflammatory, anti- fungal

properties and a blood purifier. Khadirarista

[14]

has

ingredients i.eKhadira, Devdaru, Bakuchi,

Daruharidra, Triphala and enriched with Tikta,

Kashaya Rasa, Laghu, Shita, Ruksha Katu

Dravays. Its properties are Kapha Pitta Shamaka,

Tridoshara, Kushtaghana, Shothahara, Krimihara,

anti-bacterial, anti-oxidant and antimicrobial.

Haridra Khand

[15]

is a combination of Haridra,

Triphala, Trikatu, Kutaki, Nagarmotha, Nishotha,

Chitrak, Ela, Dalchini, Jeera, Dhaniya, Lauha

Abharak Bhasam etc, which are enriched with

Tikta, Katu, Ruksa, Laghu,Usna, Katu Dravays and

has Kapha-Pitta Shamaka, Tridosahara, Dipana,

Chedana, Bhedan, Anulomana properties. Nimbadi

Churan

[16]

contains Tikta, Kasaya Rasa, Laghu,

Ruksa Guna, Sita Virya, Katu Vipaka Dravya and

Kapha-Pittanasaka, Dipana, Shothara,

Raktapittanasak properties. Panchatikta Guggulu

Ghrita

[17]

is the potent drug for the treatment of

Kushta Roga. The contents are Nimba, Guduchi,

Patola, Kantakari, Vasa. It has Tikta, Kasaya,

Laghu, Ruksa, Sita, Katu Dravayas and Pitta-

Shamaka, Kapha-Vata samaka, Dipana-Pacana

properties. It’s beneficial in skin disorders, acne,

anti- bacterial and also an immunomodulator.

Khadirashtak Kwath

[18]

– its composed of Khadira,

Amla, Triphala, Neem, Patola, Vasa, Guduchi and

has Tikta, Kashaya Rasa, Laghu, Ruksha Guna,

Anushna Virya and Madhura Vipaka Dravyas. It

has Kandughana and Kushtaghan, anti-microbial,

anti-bacterial properties. As Viruddha Aahar is

important factor for etiopathogenesis of skin

ailments, so patient should avoid Viruddha Aahar

for better relief and speedy recovery and further

recurrence of skin ailments, as first line of

treatment that is said to be Nidana Parivarjana.

Hence the promising results in this case study are

combined effect of Shodhana, Shamana and Pathya

Sevan and patient folloups.

Conclusion :

Skin diseases have become increasingly common

and significantly impact an individual's daily

activities. The skin serves as an important reflection

of our overall health, and to maintain its well-being,

it is essential to avoid irritants and harmful

chemicals. The first step in treatment is Nidana

Parivarjana (elimination of causative factors),

which trigger conditions like Vicharchika (skin

disorders). In many cases, simply avoiding these

triggers can alleviate half of the problem.

The next step is Virechana Karma, a Shodhana

therapy that helps eliminate the vitiated Doshas.

After Shodhana, Shaman Chikitsa is administered,

which provides considerable relief from the signs

and symptoms. This approach demonstrates that

skin diseases can be effectively treated with

Shodhana Chikitsa followed by Shaman Aushadhi.

Moreover, with proper awareness, education,

evidence-based studies, and the avoidance of

trigger factors, skin problems can be effectively

managed.

Informed Consent

Patient consent was obtained for the photographs

and before submitting this case study for

publication.

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diseases, 17

th

edition, 2003 Arnold, ch-1,

pg- 1.

2. Vaidya Jadavaji Trikamji Acharya, Charka

Samhita with Ayurveda Dipika commentary

by Chakrapanidutta, Chaukhamba Surbharti

Prakashan Varanasi, 2005, Sutrasthan ch-

8/10-11, pg-56.

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th

edition, 2003 Arnold, ch-1,

page- 1.

4. Davidsons Principles & Practice of

Medicine, 19

th

Edition, pg no. -1052

5. P.N Behl, Practice of Dermatology. Ninth

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Ratnawali edited with Siddhipradi hindi

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Mishra. Chaukambha Bharti

Prakashan,Varanasi first edition 2005 chp-

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th

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Hindi Commentary, Chaukhambha

Orientalia, Varanasi. Reprint Edition - 2013.

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Ratnawali edited with Siddhipradi hindi

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Vidyotani hindi commentary, edited by

Brahma Shankar shastry.Chakhambha

Sanskrit Santhan Edition -2004, Rasayana

adhikara shloka-1-4

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14. Kaviraj Govind Das Sen, Bhaisajya

Ratnawali edited with Siddhipradi hindi

commentary by Prof. Siddhi Nandan

Mishra,Chaukambha Bharti

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Dr. Neha Inter. J.Digno. and Research

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