Ayurvedic Management of Acute Exacerbation of Chronic Eczema: A Case Report

Background: Eczema is a form of dermatitis characterized by inflammation of the epidermis.The exact cause of eczema is unknown.Although it is activated by the immune system and is related to allergic reactions, it is not the same as other allergic reactions.In Ayurveda, the disease is described as "Vicharchika." Case description: A 62-year-old female presented with diffuse rashes, pedal edema, severe pruritus, and chronic lichenification on the bilateral lower and upper limbs and neck region.She had lichenification on the extensor surface of the left foot for 1 year.Blood investigation suggested acute exacerbation of eczema due to elevated immunoglobulin E (IgE) and eosinophil counts.Intervention: Sadhyo Virechana (mild purgation) was administered for Koshta Shuddhi, followed by Shamana Chikitsa (pacifying treatment) comprising Dushivishnashak (latent toxins eliminator) and Raktaprasadana Aushadhi (blood purifying drugs) along with external applications.Outcome: Significant symptomatic relief was achieved within 7 days.Complete clinical remission was recorded within 2 months, evidenced by a reduction in the Eczema Area and Severity Index (EASI) score from 26.6 to 0.4.The study was conducted in accordance with the International Council for Harmonisation -Good Clinical Practice (ICH-GCP) and the Declaration of Helsinki guidelines.No recurrence was noted during a 1-year follow-up period.Conclusion: This case report demonstrates the efficacy and safety, which suggests the potential benefit of structured Ayurvedic interventions in managing acute eczema flares, enhancing quality of life without adverse effects managing exacerbations of chronic eczema, offering sustained clinical remission and improving quality of life without observed adverse effects.