Dermatoscopic and Cadaveric Correlation of Twak Sharir With Special Reference to Eka-Kushtha (Psoriasis) and Vicharchika (Eczema): An Integrative Anatomical and Clinical Study

Twak (skin) is considered one of the most significant structures in Ayurveda, serving protective, sensory, metabolic, and aesthetic functions. Classical Ayurvedic literature, particularly the Samhitas of Sushruta, describes Twacha as consisting of seven distinct layers with functional and pathological relevance. Modern dermatology recognises skin as a multilayered organ composed of epidermis, dermis, and subcutaneous tissue. The present study was undertaken to correlate Ayurvedic concepts of Twak Sharir with modern anatomical and dermatoscopic findings, with special reference to Eka-Kushtha (Psoriasis) and Vicharchika (Eczema). The study was conducted in two phases: a cadaveric anatomical study and a dermatoscopic clinical study. Cadaveric observations included regional variations in skin thickness, dermal density, vascularity, adnexal structures, and subcutaneous attachments. Dermatoscopic evaluation was performed in clinically diagnosed cases of psoriasis and eczema to identify characteristic vascular and scaling patterns and correlate them with histopathological changes. The cadaveric study demonstrated that the seven layers described in Ayurveda can be functionally correlated with modern epidermal and dermal subdivisions. Dermatoscopy revealed regular dotted vessels, diffuse micaceous scales, and uniform erythema in psoriasis, while eczema demonstrated yellow serocrusts, irregular vascular patterns, excoriations, and patchy scaling. These findings support the Ayurvedic concept that disease severity and prognosis depend upon the depth of tissue involvement. The study establishes an integrative bridge between Ayurvedic Twak Sharir and contemporary dermatological science and highlights the diagnostic value of dermatoscopy in differentiating chronic inflammatory dermatoses.