AYURVEDIC MANAGEMENT OF VICHARCHIKA (ECZEMA) - A CASE REPORT

Background: Eczema is a common inflammatory dermatosis characterized by variable clinical manifestations, including erythematous macules, papules, vesicles, scaling, pruritus, and, in more severe cases, exudation and crusting. The clinical presentation of eczema shares several features with Vicharchika, an Ayurvedic dermatological condition described predominantly by Kandu (pruritus), Pidika (popular eruptions), Shyava Varna (dusky or hyper pigmented discoloration), and Bahusrava (excessive exudation). Although Ayurvedic literature describes a multimodal approach to such skin disorders, clinical case documentation using objective outcome measures remains important. Case Presentation: A 41-year-old man presented with an 8 month history of diffuse scaly lesions involving the face, upper and lower extremities, abdomen, and flanks. The lesions were associated with severe pruritus and serous discharge, resulting in considerable discomfort and impairment of daily activities. Based on the clinical presentation and Ayurvedic assessment, the condition was diagnosed as Vicharchika (eczema). Intervention and Outcome: The patient was managed using an individualized Ayurvedic treatment protocol comprising oral Raktha Shodhaka and Kushtahara Shamana Aushadhi, along with Parisheka using Sidharthaka Snana Choorna as part of the management of excessive exudation. Sadyovirechana was subsequently administered for Koshta Shuddhi. From the seventh day onward, Abhyanga was initiated, followed by Siravyadha (therapeutic bloodletting) on the 11th day. Clinical response was assessed by using the Eczema Area and Severity Index (EASI). A clinically significant improvement was observed after 14 days of treatment, with reduction in disease severity and associated symptoms. Conclusion: This case highlights the potential role of an individualized, multimodal Ayurvedic therapeutic approach in the management of Vicharchika presenting with extensive eczematous lesions. The observed improvement in EASI score suggests a favorable clinical response; however, controlled clinical studies with larger sample sizes and longer follow-up are required to establish the efficacy, safety, and sustainability of this treatment approach.