Changes

==== Patho-physiology of kushtha ====

==== Patho-physiology of kushtha ====

1. Kapāla Kuṣṭha:

===== 1. Kapāla Kuṣṭha =====

 

It is rūkṣa, paruṣa, khara in nature which signifies the increase of rūkṣa, khara guna at the level of skin. Roughness, dryness increases when there is destruction of sweat glands (dusti of ambu dhatu), decrease in essential fatty acids (reduce snigdhata of meda inturn kapha), proliferation of keratinocytes. Primary lesion manifest in the form of dry, rough and blackish brownish colour. Secondary lesion includes loss of sensation (due to degeneration of nerve endings or less nutrition to the nerve tissue due to atherosclerosis or reduce blood supply) severe pricking pain (nistōda) itching, burning sensation and pustular presentation. Thus conditions of non erythematous eczema, keratosis, atrophic actinic keratosis, non hypertrophic keratosis, seborrhic conditions can be understood in Kapāla Kuṣṭha.

It is rūkṣa, paruṣa, khara in nature which signifies the increase of rūkṣa, khara guna at the level of skin. Roughness, dryness increases when there is destruction of sweat glands (dusti of ambu dhatu), decrease in essential fatty acids (reduce snigdhata of meda inturn kapha), proliferation of keratinocytes. Primary lesion manifest in the form of dry, rough and blackish brownish colour. Secondary lesion includes loss of sensation (due to degeneration of nerve endings or less nutrition to the nerve tissue due to atherosclerosis or reduce blood supply) severe pricking pain (nistōda) itching, burning sensation and pustular presentation. Thus conditions of non erythematous eczema, keratosis, atrophic actinic keratosis, non hypertrophic keratosis, seborrhic conditions can be understood in Kapāla Kuṣṭha.

2. Udumbara kuṣṭha :

 

===== 2. Udumbara kuṣṭha =====

 

It is pitta dominated kuṣṭha. Hyperpigmentation, increased vasocongestion, burning, pain and pus formation are the symptoms and signs.

It is pitta dominated kuṣṭha. Hyperpigmentation, increased vasocongestion, burning, pain and pus formation are the symptoms and signs.

Primary lesion manifest as red in colour associated with pus, burning sensation caused mainly due to pitta and rakta. Usna and tiksna guna is responsible for the same.

Primary lesion manifest as red in colour associated with pus, burning sensation caused mainly due to pitta and rakta. Usna and tiksna guna is responsible for the same.

Thus infective and inflammatory phase is being explained. Increased flow of inflammatory factors causes rise in temperature, redness and burning sensation. Eczema is inflammation of the skin. It is characterized by erythematous, vesicular, weeping, itchy and crusting patches. The condition is caused by dysfunctional interplay between the immune system and skin.

Thus infective and inflammatory phase is being explained. Increased flow of inflammatory factors causes rise in temperature, redness and burning sensation. Eczema is inflammation of the skin. It is characterized by erythematous, vesicular, weeping, itchy and crusting patches. The condition is caused by dysfunctional interplay between the immune system and skin.

Dyshidrosis, discoid eczema, venous eczema, dermatitis herpetiformis, autoeczematization, eczema overlaid by viral infections can be understood under Udumbara kuṣṭha.

Dyshidrosis, discoid eczema, venous eczema, dermatitis herpetiformis, autoeczematization, eczema overlaid by viral infections can be understood under Udumbara kuṣṭha.

3. Mandala Kuṣṭha:

 

===== 3. Mandala Kuṣṭha =====

 

Itis predominated by kapha dōṣa. The sthira, snigdha guna brings about sthirata and snigdhata to the Kuṣṭha. Therefore the lesion is granulomatous in presentation. The early and indeterminate leprosy especially Lepromatous leprosy is a skin condition consisting of pale macules. It results from failure of Th1 cell activation which is necessary to eradicate the mycobacteria. In Lepromatous Leprosy Th2 response is turned on and because of reciprocal inhibition the cell mediated response is depressed.  

Itis predominated by kapha dōṣa. The sthira, snigdha guna brings about sthirata and snigdhata to the Kuṣṭha. Therefore the lesion is granulomatous in presentation. The early and indeterminate leprosy especially Lepromatous leprosy is a skin condition consisting of pale macules. It results from failure of Th1 cell activation which is necessary to eradicate the mycobacteria. In Lepromatous Leprosy Th2 response is turned on and because of reciprocal inhibition the cell mediated response is depressed.  

4. Rushyajivha kushtha:

 

===== 4. Rushyajivha kushtha =====

 

It is dominated by vāta and pitta dōṣa. Vāta dōṣa brings roughness, pain whereas pitta is responsible for the discolouration, burning sensation whereas both the dōṣa are responsible for ashugati and samuthan.

It is dominated by vāta and pitta dōṣa. Vāta dōṣa brings roughness, pain whereas pitta is responsible for the discolouration, burning sensation whereas both the dōṣa are responsible for ashugati and samuthan.

Thus inflammatory and degenerative changes dominate the condition. Pathogenesis involving infective origin or allergic origin may be included. Diseases such as Lyme disease may be included. Expanding redness known as erythema migrans begins at the site of bite after a period of one week. There is no much itching i.e. alpa kandu but the rash is red and warm but generally painless. Classically the innermost portion remain darker red and becomes indurated (is thicker and firmer).

Thus inflammatory and degenerative changes dominate the condition. Pathogenesis involving infective origin or allergic origin may be included. Diseases such as Lyme disease may be included. Expanding redness known as erythema migrans begins at the site of bite after a period of one week. There is no much itching i.e. alpa kandu but the rash is red and warm but generally painless. Classically the innermost portion remain darker red and becomes indurated (is thicker and firmer).

5. Pundarika kushtha:

 

===== 5. Pundarika kushtha =====

 

It is dominated by pitta and kapha. Pitta is responsible for redness, burning sensation, pāka, pus formation whereas kapha is responsible for whitish nature, itching and kr̥mi.

It is dominated by pitta and kapha. Pitta is responsible for redness, burning sensation, pāka, pus formation whereas kapha is responsible for whitish nature, itching and kr̥mi.

Primary lesion manifest as “rakta rāji sirā santata utsedavanti” i.e. vessel are inflamed and are palpable. Systemic vasculitis may affect the skin and vascular damage may be the main feature in several skin diseases. The histological features that are common are:- Vessel wall damage , red cell extravasation , invasion of inflammatory cells into vessel walls.  

Primary lesion manifest as “rakta rāji sirā santata utsedavanti” i.e. vessel are inflamed and are palpable. Systemic vasculitis may affect the skin and vascular damage may be the main feature in several skin diseases. The histological features that are common are:- Vessel wall damage , red cell extravasation , invasion of inflammatory cells into vessel walls.  

6. Sidhma kushtha:

 

===== 6. Sidhma kushtha =====

 

It is dominated by vāta kapha dōṣa, fine powder falls after scratching and resembles colour similar to flower of alābū. The specialty of disease is that it is mainly seen in urabhāga i.e. trunk. Tinea versicolar is a condition characterized by a skin eruption on the trunk and proximal extremity. The symptoms of this condition include; fine scaling of the skin producing a very superficial ash like scale. Pale (sveta), dark tan (arun), pink in colour (shukla rakta avabhasani) with a reddish undertone (tamra) that can darken when the patient is overheated, such as in a hot shower or during/ after exercise, tanning typically makes the affected areas contrast more starkly with the surrounding skin leading to sharp borders. In people with dark skin tones, pigmentary changes such as hypopigmentation (loss of colour) are common while in those with lighter skin colour hyperpigmentattion (increase in skin colour) is more common. The yeast is thought to feed on skin oils (lipids) as well as dead skin cells.

It is dominated by vāta kapha dōṣa, fine powder falls after scratching and resembles colour similar to flower of alābū. The specialty of disease is that it is mainly seen in urabhāga i.e. trunk. Tinea versicolar is a condition characterized by a skin eruption on the trunk and proximal extremity. The symptoms of this condition include; fine scaling of the skin producing a very superficial ash like scale. Pale (sveta), dark tan (arun), pink in colour (shukla rakta avabhasani) with a reddish undertone (tamra) that can darken when the patient is overheated, such as in a hot shower or during/ after exercise, tanning typically makes the affected areas contrast more starkly with the surrounding skin leading to sharp borders. In people with dark skin tones, pigmentary changes such as hypopigmentation (loss of colour) are common while in those with lighter skin colour hyperpigmentattion (increase in skin colour) is more common. The yeast is thought to feed on skin oils (lipids) as well as dead skin cells.

7.Kakanaka kushtha:

 

===== 7.Kakanaka kushtha =====

 

It is predominated by all the three dōṣa. Thus symptoms of all three dōṣa are observed. The presentation is similar to gunjā i.e bright red with black spot. In nidānsthān Caraka has explained it to be of different colours and it is asadhya.

It is predominated by all the three dōṣa. Thus symptoms of all three dōṣa are observed. The presentation is similar to gunjā i.e bright red with black spot. In nidānsthān Caraka has explained it to be of different colours and it is asadhya.

Squamous cell carcinoma or squamous cell cancer or epidermoid carcinoma or squamous cell epithelioma is a cancer of a kind of epithelial cell, the squamous cell. These cells are the main part of the epidermis of the skin, and this cancer is one of the major forms of the skin cancer. However, squamous cells also occur in the lining of the digestive tract, lungs and other areas of body and squamous cell carcinoma occurs as a form of cancer in diverse tissue such as lips, mouth, oesophagus, urinary bladder, prostrate, lung, vagina and cervix. Despite sharing the name squamous cell carcinoma there may be tremendous differences in presenting symptoms, natural history, prognosis and response to treatment. It arises from the uncontrolled multiplication of cells of epithelium, or cells showing particular cytological or tissue architectural characteristic of squamous cell differentiation, such as the presence of keratin, tonofilament bundles or dermosomes structures involved in cell to cell adhesion. This non melanoma skin cancer may appear as a firm red nodule, a scaly growth that bleeds or develops a crust or a sore that doesn’t heal.

Squamous cell carcinoma or squamous cell cancer or epidermoid carcinoma or squamous cell epithelioma is a cancer of a kind of epithelial cell, the squamous cell. These cells are the main part of the epidermis of the skin, and this cancer is one of the major forms of the skin cancer. However, squamous cells also occur in the lining of the digestive tract, lungs and other areas of body and squamous cell carcinoma occurs as a form of cancer in diverse tissue such as lips, mouth, oesophagus, urinary bladder, prostrate, lung, vagina and cervix. Despite sharing the name squamous cell carcinoma there may be tremendous differences in presenting symptoms, natural history, prognosis and response to treatment. It arises from the uncontrolled multiplication of cells of epithelium, or cells showing particular cytological or tissue architectural characteristic of squamous cell differentiation, such as the presence of keratin, tonofilament bundles or dermosomes structures involved in cell to cell adhesion. This non melanoma skin cancer may appear as a firm red nodule, a scaly growth that bleeds or develops a crust or a sore that doesn’t heal.

Minor kushtha:

 

1.Eka kuṣṭha:

==== Minor kushtha ====

 

===== 1.Eka kuṣṭha =====

 

It is a skin disease caused due to vāta kapha predominancy. As discussed previously vāta dōṣa is responsible for the degenerative or destructive changes where as kapha is responsible for obstructive changes.

It is a skin disease caused due to vāta kapha predominancy. As discussed previously vāta dōṣa is responsible for the degenerative or destructive changes where as kapha is responsible for obstructive changes.

Asvēdana (Anhidrosis) may be caused by destruction of sweat glands and or integumetary system it may be due to autoimmune process or infection or anhidrosis may be due to osbstruction (kapha) in the outlet or blood supply as in microangiopathy.

Asvēdana (Anhidrosis) may be caused by destruction of sweat glands and or integumetary system it may be due to autoimmune process or infection or anhidrosis may be due to osbstruction (kapha) in the outlet or blood supply as in microangiopathy.

Reduced sweating increases dryness of skin which is presented as rough, scaly or flaky skin. The word ichthyosis comes from ancient Greek where ichthys means fish. All types of ichthyosis have dry, thickened scaly or flaky skin.

Reduced sweating increases dryness of skin which is presented as rough, scaly or flaky skin. The word ichthyosis comes from ancient Greek where ichthys means fish. All types of ichthyosis have dry, thickened scaly or flaky skin.

Ichthyosis vulgaris is a skin condition that causes dry, dead skin cells to accumulate in patches on the surface of skin. It is also known as “fish scale disease” because the dead skin accumulates in a similar pattern to a fish scale.

Ichthyosis vulgaris is a skin condition that causes dry, dead skin cells to accumulate in patches on the surface of skin. It is also known as “fish scale disease” because the dead skin accumulates in a similar pattern to a fish scale.

2. Charmakhya:

 

===== 2. Charmakhya =====

 

Skin is similar to elephant (pachyderms) and thick is nature pachys means thick and derma means skin.

Skin is similar to elephant (pachyderms) and thick is nature pachys means thick and derma means skin.

The main symptom is skin getting thick thus disease like scleroderma, onchocerciasis, harlequin ichthyosis etc can be considered in this group.

The main symptom is skin getting thick thus disease like scleroderma, onchocerciasis, harlequin ichthyosis etc can be considered in this group.

Building up of collagen is associated with thickening of skin. Transport of fats into the space between the skin cells may be another reason for thickening of skin.

Building up of collagen is associated with thickening of skin. Transport of fats into the space between the skin cells may be another reason for thickening of skin.

Research shows that in diabetic patient thickness of skin is observed reason being collagen bundles become large, disorganized and separated by clear spaces. Small amount of acid mucopolysachrides may be present in upper reticular dermis. Presence of active fibroblast and extensive collagen polymerization in the rough endoplasisic reticulam may be the pathogenesis for thick skin.

Research shows that in diabetic patient thickness of skin is observed reason being collagen bundles become large, disorganized and separated by clear spaces. Small amount of acid mucopolysachrides may be present in upper reticular dermis. Presence of active fibroblast and extensive collagen polymerization in the rough endoplasisic reticulam may be the pathogenesis for thick skin.

Calcium deposition may also be cause for tough and thick skin. Rūkṣata, kharata, guna of vāta and shita guna of vāta and kapha alongwith increase of guruta, manda and sthira guna of kapha contribute to thickening of skin. Khara is also property of asthi dhatu which is generated by interplay between prithvi, agni and vāyu. Here calcium is representative of prithvi mahabhut. So prithvi mahabhut bhuyista āhar or increased parthivagni can lead to increase absorption of calcium from gastrointestinal tract.

Calcium deposition may also be cause for tough and thick skin. Rūkṣata, kharata, guna of vāta and shita guna of vāta and kapha alongwith increase of guruta, manda and sthira guna of kapha contribute to thickening of skin. Khara is also property of asthi dhatu which is generated by interplay between prithvi, agni and vāyu. Here calcium is representative of prithvi mahabhut. So prithvi mahabhut bhuyista āhar or increased parthivagni can lead to increase absorption of calcium from gastrointestinal tract.

3. Kitibha kushtha:Skin diseases in which process of tissue granulation takes place is Kiṭibha kuṣṭha. When this process takes abnormally Kiṭibha kuṣṭha is formed. It may take place in psoriasis, lichen planus, lichen sclerosis.

 

===== 3. Kitibha kushtha =====

 

Skin diseases in which process of tissue granulation takes place is Kiṭibha kuṣṭha. When this process takes abnormally Kiṭibha kuṣṭha is formed. It may take place in psoriasis, lichen planus, lichen sclerosis.

Granulation tissue appearance is light red or dark pink in colour (śyāva), being perfused with new capillary loops or buds granular in appearance. Formation of extracellular matrix gives it hard touch and abnormal productions of skin cells (especially during wound repair) leading to overabundance of skin cells. Premature maturation of keratinocytes induced by an inflammatory cascade in the dermis also contributes for the same.

Granulation tissue appearance is light red or dark pink in colour (śyāva), being perfused with new capillary loops or buds granular in appearance. Formation of extracellular matrix gives it hard touch and abnormal productions of skin cells (especially during wound repair) leading to overabundance of skin cells. Premature maturation of keratinocytes induced by an inflammatory cascade in the dermis also contributes for the same.

Vāta, rakta, māṁsa, kapha all take part in healing of wound but whenever abnormality at the level of these factors takes place granulation process is hampered which gives the kiṇakharasparśa

Vāta, rakta, māṁsa, kapha all take part in healing of wound but whenever abnormality at the level of these factors takes place granulation process is hampered which gives the kiṇakharasparśa

4. Vaipadika kushtha:Skin fissure is a cutaneous condition in which there is a linear like cleavage of skin, sometimes defined as extending into the dermis. Skin dryness is the cause.  

 

===== 4. Vaipadika kushtha =====

 

Skin fissure is a cutaneous condition in which there is a linear like cleavage of skin, sometimes defined as extending into the dermis. Skin dryness is the cause.  

 

Cracked skin is often kicked off by a vicious cycle of events starting off as a minor, but leading to painful deep cracks. Plain old dry skin can lead to scaling, scaling can cause itchiness leading to scratching and scratching can cause inflammation and tears of skin that can become fissures which leads to more irritation and pain.

Cracked skin is often kicked off by a vicious cycle of events starting off as a minor, but leading to painful deep cracks. Plain old dry skin can lead to scaling, scaling can cause itchiness leading to scratching and scratching can cause inflammation and tears of skin that can become fissures which leads to more irritation and pain.

Healthy skin has slightly acidic pH, exposure to substances with an alkaline pH such as many commercial cleansers and hand soaps also contribute to interruptions of skin integrity. Once the skin integrity is disturbed, a homeostatic repair mechanism is stimulated that causes the rapid repair of barrier function. Continued exposure to alkaline substances will slow down repair by inhibiting normal skin acidity when there is continued exposure to unfavourable environmental factors.

Healthy skin has slightly acidic pH, exposure to substances with an alkaline pH such as many commercial cleansers and hand soaps also contribute to interruptions of skin integrity. Once the skin integrity is disturbed, a homeostatic repair mechanism is stimulated that causes the rapid repair of barrier function. Continued exposure to alkaline substances will slow down repair by inhibiting normal skin acidity when there is continued exposure to unfavourable environmental factors.

Anhidrosis, Dermatitis, Diabetic neuropathy, Eczema, Hypothyroidism, Psoriasis, cold weather, excessive exposure to hot water, detergent chemicals and low humidity can cause cracked skin.

Anhidrosis, Dermatitis, Diabetic neuropathy, Eczema, Hypothyroidism, Psoriasis, cold weather, excessive exposure to hot water, detergent chemicals and low humidity can cause cracked skin.

4.Alasaka kushtha:Ganda here means nodular growth. Chronic and repetitive scratching, picking or rubbing may result in permanent changes to the skin, including nodular lichenification (ganda), hyperkeratosis, hyperpigmentation (rāga) and skin thickening.  

 

===== 4.Alasaka kushtha =====

 

Ganda here means nodular growth. Chronic and repetitive scratching, picking or rubbing may result in permanent changes to the skin, including nodular lichenification (ganda), hyperkeratosis, hyperpigmentation (rāga) and skin thickening.  

Nodular prurigo cause is unknown. It is uncertain whether scratching leads to lumps, or if the lumps appear before they are scratched. The reason for the lumps, the inflamation and the increased activity and size of nerves in the skin is under investigation but remains unknown

Nodular prurigo cause is unknown. It is uncertain whether scratching leads to lumps, or if the lumps appear before they are scratched. The reason for the lumps, the inflamation and the increased activity and size of nerves in the skin is under investigation but remains unknown

Prurigo nodularis, Hyde’s diseases, picker nodules, lichen corneus obtusus, nodular lichen simplex chronicus, nodular neurodematitis circumscripta are various synonyms. The constant scratching leads to development of discrete, excoriated nodular hyperpigmented / purpuric lesion with crusted or scaly surfaces.

Prurigo nodularis, Hyde’s diseases, picker nodules, lichen corneus obtusus, nodular lichen simplex chronicus, nodular neurodematitis circumscripta are various synonyms. The constant scratching leads to development of discrete, excoriated nodular hyperpigmented / purpuric lesion with crusted or scaly surfaces.

The wart like plaque may be observed in Dermatosis neglecta; an skin condition in which accumulation of sebum, keratin, sweat, dirt and debris lead to localized patch of skin. Dryness is the main cause for the above pathogenesis and role of vāta and kapha in causing dryness is already been discussed.

The wart like plaque may be observed in Dermatosis neglecta; an skin condition in which accumulation of sebum, keratin, sweat, dirt and debris lead to localized patch of skin. Dryness is the main cause for the above pathogenesis and role of vāta and kapha in causing dryness is already been discussed.

Vichārchikā:

 

===== Vichārchikā =====

 

It is cause by kapha dominated condition. Kapha by its snigdha, guru, mridu and sita guna when increased above normal condition it leads to obstructive changes at the integumentary system. Reduced blood supply causes blackish brown discolouration. Further obstructive changes reduce the local immunity and give a chance for dermatophytes to penetrate the skin barrier. It results in eruptions and thereby causing excessive exudation. Secondary infection and reduced blood supply is cause for pruritus. It can be compared with wet eczema.

It is cause by kapha dominated condition. Kapha by its snigdha, guru, mridu and sita guna when increased above normal condition it leads to obstructive changes at the integumentary system. Reduced blood supply causes blackish brown discolouration. Further obstructive changes reduce the local immunity and give a chance for dermatophytes to penetrate the skin barrier. It results in eruptions and thereby causing excessive exudation. Secondary infection and reduced blood supply is cause for pruritus. It can be compared with wet eczema.

Table 2. Comparison of Ksudhra kustha with its Modern resembelance

Table 2. Comparison of Ksudhra kustha with its Modern resembelance

2. Carmākhya Kuṣṭha scleroderma, onchocerciasis, harlequin ichthyosis

2. Carmākhya Kuṣṭha scleroderma, onchocerciasis, harlequin ichthyosis

3. Kitibha Kuṣṭha psoriasis, lichen planus, lichen sclerosis.

3. Kitibha Kuṣṭha psoriasis, lichen planus, lichen sclerosis.

4. Vaipādika kuṣṭha Anhidrosis, Dermatitis, Diabetic neuropathy, Eczema, Hypothyroidism, Psoriasis, cold weather, excessive exposure to hot water, detergent chemicals and low humidity can cause skin fissure, palm and sole psoriasis

4. Vaipādika kuṣṭha Anhidrosis, Dermatitis, Diabetic neuropathy, Eczema, Hypothyroidism, Psoriasis, cold weather, excessive exposure to hot water, detergent chemicals and low humidity can cause skin fissure, palm and sole psoriasis

5. Alasaka Kuṣṭha Nodular prurigo, Dermatosis neglecta

5. Alasaka Kuṣṭha Nodular prurigo, Dermatosis neglecta

6. Dadru kuṣṭha Tinea corpora or ringworm of the body, Tinea faciei or Facial Ringworm, Tinea Capitis Or Blackdot Ringworm, Tinea Capitis or Scalp Ringworm, Tinea Manuum or Ringworm of the Hands, Onychomycosis, Tines Unguium or Ringworm of the nail, Impetigo, Moccasin type of Tinea Pedis

6. Dadru kuṣṭha Tinea corpora or ringworm of the body, Tinea faciei or Facial Ringworm, Tinea Capitis Or Blackdot Ringworm, Tinea Capitis or Scalp Ringworm, Tinea Manuum or Ringworm of the Hands, Onychomycosis, Tines Unguium or Ringworm of the nail, Impetigo, Moccasin type of Tinea Pedis

7. Carmadala Kuṣṭha

7. Carmadala Kuṣṭha

Pre ulcerative phase of Ecthyma, Interdigital type of tinea pedis (athlete’s foot)

Pre ulcerative phase of Ecthyma, Interdigital type of tinea pedis (athlete’s foot)

Wet Eczema

Wet Eczema

Current clinical management of skin diseases:

==== Current clinical management of skin diseases ====

 

Principal treatment modalities: 1. Internal and external application of sneha (medicated ghee or oil) 2. Shodhana (purification therapies) 3. Raktamokshana ( blood letting)  

Principal treatment modalities: 1. Internal and external application of sneha (medicated ghee or oil) 2. Shodhana (purification therapies) 3. Raktamokshana ( blood letting)  

Principal drugs: 1. Gandhaka (sulphur) 2. Nimba 3. Bakuchi 4. Hartal 5. Haridra 6. Manjishtha 7. Khadira 8. Sariva 9.Patol 10. Lodhra  

Principal drugs: 1. Gandhaka (sulphur) 2. Nimba 3. Bakuchi 4. Hartal 5. Haridra 6. Manjishtha 7. Khadira 8. Sariva 9.Patol 10. Lodhra  

Bakuchi seed powder 750-1500 mg After meals Khadira + Aamalaki kashaya  

Bakuchi seed powder 750-1500 mg After meals Khadira + Aamalaki kashaya  

Sarvanga sundari vati 500 -1000 mg After meals Ghee

Sarvanga sundari vati 500 -1000 mg After meals Ghee

Further reading:

 

=== Further reading ===

1. Adrienne Santos-Longhurst Type 2 Diabetes and Skin Health published Published on September 8, 2014, http://www.healthline.com/health/type-2-diabetes/skin-problems  

1. Adrienne Santos-Longhurst Type 2 Diabetes and Skin Health published Published on September 8, 2014, http://www.healthline.com/health/type-2-diabetes/skin-problems  

2. Ca.Sa.7/4, Charak Samhita By Agnivesha edited by Yadavji Trikamji Acharya-Munshiram Manoharlal Publishers Pvt. Ltd. 4th Edition.

2. Ca.Sa.7/4, Charak Samhita By Agnivesha edited by Yadavji Trikamji Acharya-Munshiram Manoharlal Publishers Pvt. Ltd. 4th Edition.

41. Loren Pickart et al; The Essentials Of Copper Your Body’s Protective and Anti-Aging Metal: Published by skin biology forum, 2014.

41. Loren Pickart et al; The Essentials Of Copper Your Body’s Protective and Anti-Aging Metal: Published by skin biology forum, 2014.

References related to photographs

=== References related to photographs ===

1. link: https://www.skincheck.com.au/skinclinic/solar-keratosis/

1. link: https://www.skincheck.com.au/skinclinic/solar-keratosis/

20. link: http://skinbiology.com/images/Copper_chaptergraphic1_copperdeficiency.jpg

20. link: http://skinbiology.com/images/Copper_chaptergraphic1_copperdeficiency.jpg

Glossary:

=== Glossary ===

 

1. virōdhīnyannapānāni  (विरोधीन्यन्नपानानि- virodhInyannapAnAni) - The food, drinks, & medicine, which does the dislodgement of Dosa from its site i.e. Dosatlkesa, but does not expel it out and which acts contradictory to the body tissues. They do not help in the nourishment of Dhatu and in due course produce many diseases /incompatible food. Foods which are antagonist to body and Dhatu are called as Virudha.  

1. virōdhīnyannapānāni  (विरोधीन्यन्नपानानि- virodhInyannapAnAni) - The food, drinks, & medicine, which does the dislodgement of Dosa from its site i.e. Dosatlkesa, but does not expel it out and which acts contradictory to the body tissues. They do not help in the nourishment of Dhatu and in due course produce many diseases /incompatible food. Foods which are antagonist to body and Dhatu are called as Virudha.  

13. puṇḍarīka - (पुण्डरीक – puNDarIka)- Like colour of white lotus

13. puṇḍarīka - (पुण्डरीक – puNDarIka)- Like colour of white lotus

14. sidhma (सिध्म – sidhma) - A subtype of kustha characterized by formation of eruption that are rough, brownish in color, fissured and thin at the margins, oily in the centre, have a tinge of the white and red, and are sluggish in growth and ulceration.  

14. sidhma (सिध्म – sidhma) - A subtype of kustha characterized by formation of eruption that are rough, brownish in color, fissured and thin at the margins, oily in the centre, have a tinge of the white and red, and are sluggish in growth and ulceration.  

15. kākaṇak  (काकणकै – kAkaNak) – like fruits of red gunja

15. kākaṇak  (काकणकै – kAkaNak) – like fruits of red gunja

16. kiṭima (किटिम – kiTima) - A subtype of kustha characterized by formation of eruptions that are rounded, thick, oily, blackish in color, and are attended by oozing and severe itching.

16. kiṭima (किटिम – kiTima) - A subtype of kustha characterized by formation of eruptions that are rounded, thick, oily, blackish in color, and are attended by oozing and severe itching.

17. yadrajō ghr̥ṣṭaṁ vimuñcati (यद्रजो घृष्टं विमुञ्चति - yadrajo ghRuShTaM vimu~jcati) – on scratching fine particle of epidermal layer fall.

17. yadrajō ghr̥ṣṭaṁ vimuñcati (यद्रजो घृष्टं विमुञ्चति - yadrajo ghRuShTaM vimu~jcati) – on scratching fine particle of epidermal layer fall.

18. matsyaśakalōpamam (न्मत्स्यशकलोपमम् – matsyashakalopamam - Resembles the scale of fish.  

18. matsyaśakalōpamam (न्मत्स्यशकलोपमम् – matsyashakalopamam - Resembles the scale of fish.  

19. hasticarmavat  (हस्तिचर्मवत् – hasticarmavat) – like skin of elephant

19. hasticarmavat  (हस्तिचर्मवत् – hasticarmavat) – like skin of elephant

20. kiṇakharasparśaṁ  (किणखरस्पर्शं – kiNakharasparshaM) – like the feeling of wound scar

20. kiṇakharasparśaṁ  (किणखरस्पर्शं – kiNakharasparshaM) – like the feeling of wound scar

22. Pracchanam  (प्रच्छन – pracchanam)- debridement

22. Pracchanam  (प्रच्छन – pracchanam)- debridement

23. śītarasaḥ - (शीतरसः – shItarasaH) - type of sīdhu kalpana wherein apakva iksurasa etc.are used for preparation.  

23. śītarasaḥ - (शीतरसः – shItarasaH) - type of sīdhu kalpana wherein apakva iksurasa etc.are used for preparation.  

24. pakvarasō - (पक्वरसो pakvaraso)- type of sīdhu kalpana wherein drava dravya are used for preparation

24. pakvarasō - (पक्वरसो pakvaraso)- type of sīdhu kalpana wherein drava dravya are used for preparation

25. suptasuptāny  (सुप्तसुप्तान्य – suptasuptAny) – numbness / loss of sensation

25. suptasuptāny  (सुप्तसुप्तान्य – suptasuptAny) – numbness / loss of sensation

26. lēlītaka – (लेलीतक lelItaka) gandhaka / sulphur

26. lēlītaka – (लेलीतक lelItaka) gandhaka / sulphur