Efficacy of Joshanda Haleela Kabuli Orally with Tila Ushaq and Sirka vs Luaab e Hulba and Muqil topically in Fasad al Lawn ( Acanthosis Nigricans )-A Comparative Clinical Trial

Acanthosis Nigricans Fasad al-Lawn is a skin disorder characterized by hyper- pigmentation and hyper keratosis of the skin. It is a cutaneous manifestation of underlying conditions which appears as a thick, velvety texture. It is  characterized by poorly defined borders with velvety hyper- pigmented patch on the skin folds such as axilla,back of the neck, elbow, face, lips, soles of feet, and groin. The prevalence of Acanthosis Nigricans varies significantly, depending on age, ethnicity, skin type, degree of obesity, and concomitant diseases especially endocrinopathy, which can reach up to 25% in general surveys and above 60% in studies of overweight or obese children. Different epidemiological studies have reported its incidence of approximately 7% in general population and can be present up to 74% in obese people. Individuals with dark skin display this sign more commonly, with native Americans and African Americans being most commonly affected, followed by Hispanics, Asians, and much less Caucasians. In overweight or obese children, the ethnic influence on the prevalence rates appears less obvious. Occurrence of Acanthosis Nigricans increases with age and shows no gender difference. Although, the actual cause is unknown and it is most likely caused by factors that stimulate epidermal keratinocyte and dermal fibroblast proliferation. Acanthosis nigricans is a dermatological condition that primarily affects the skins appearance. It manifests in various forms, each associated with different underlying factors. This condition can serve as an important indicator of broader health issues. By identifying and addressing the root causes, individuals can take steps to enhance their overall well-being and quality of life.Currently, there is no optimal treatment for Acanthosis Nigricans available. The treatments we do have often come with side effects like redness, itching and burning sensations. As a result, there is a need to find more effective treatment option that minimizes these side effects, improving the overall experience and outcomes for individuals with this condition.

 In Unani classical literature Acanthosis Nigricans is termed as Fasad al- Lawn or Jild ka Mailapan which is caused by *Sawdawi Madda.*Unani system of medicine has extensive variety of arrangements asserting narratives adequacy in pigmentory issues of skin. The unani physicians recommended both single and compound formulations for the management of *Fasad al -Lawn.*Single drugs like Masoor, Baqla,  Jau , Gond Babool, Neem pukhta chuwara,  Unnab,  Haleela siyah, kabuli etc.. and compound drugs like Itrifal Saghir, Matbookh e Aftimoon, Anar sheerein, Badam Sheerien Muqashar etc.. These drugs possess properties like Jali (detergent), Muhalil (resolvent), Muhammir (rubeficient), and Murattib (humidifying agent), Munzij (concoctive), Mushil (purgative),. However these drugs have not been scientifically explored so far.  Hence, to evaluate the efficacy of one of the unani formulation Joshanda- e- Haleela Kabuli orally with Tila Ushaq and Sirka vs Luaab- e -Hulba and Muqil topically is designed to provide safe, more effective and economical treatment for Fasad al- Lawn.