MANAGEMENT OF SUBUNGUAL WART BY AGNIKARMA: A CASE STUDY

Nail abnormalities, or onychodystrophy, can be caused by various pathologies, including fungal and non-fungal infections. A subungual wart is a clinical presentation that might sometimes look like a fungal infection in the nailbed; misdiagnosis may delay the treatment outcome, hampering the quality of the patient’s life. Wart infec-tions are caused by the human papillomavirus (HPV) and are most commonly found on the hands, feet, and el-bows[1]. Less frequently, HPV can infect subungually or beneath the nail plate. These warts can initially mani-fest as small lesions and multiply, leading to more extensive, hyperkeratotic growths called verruca vulgaris [2]. As the size of the periungual wart increases, it can progressively deform the shape of the nail plate, causing pain and discomfort [3]. Warts in Ayurveda can be correlated to ‘Charmakeela’, a Kshudra Roga mentioned by Acharya Sushruta. Charmakeela (warts) is mainly confined to the body surface, and it is bothersome due to its common occurrence in hands, with a higher incidence of 7-10% of the population with a recurrence rate of 48% and poor cosmetic aspects. Warts are more common in children and adolescents. Currently available treatment modalities in contemporary science include Cryosurgery, Laser surgery, Electrosurgery, Bleomycin, Curettage and Topical Keratolytic applications. Despite having different treatment modalities for warts, a promising thera-py to cure and prevent its recurrence is still an essential goal to be accomplished [4]. Charmakeela occurs in twacha due to vitiated vata and kapha dosas. Since Agnikarma, a para-surgical procedure in Ayurveda has ush-na guna, it acts against the qualities of vata and kapha dosha, thereby curing the pathogenesis of warts and pre-venting the recurrence. Hence, Acharya Sushrutha has advocated Agnikarma as one of the treatment modalities for Charmakeela[5]. In this paper, a documented case illustrates the successful management of a chronic sub-ungual wart with the help of Agnikarma treatment.