Comparative clinical study to evaluate the effect of Jalaukavacharana and Khadira Kwatha Parisheka with Jalaukavacharana in Vicharchika w.s.r to Eczema

Skin is the chief wrap of the body, plays a chief role in maintaining barrier between internal and external  environment.

Ayurveda has described skin diseases under Kushtha. “Kushtha” literally means disfigurement of skin.  Vicharchika is one of the Kshudra Kustha [1]. Clinical features of Vicharchika as explained in Charaka Samhita  like itching, eruptions with excessive oozing matches the main clinical features of Eczema. Eczema apart from  causing physical discomfort and disfigurement; disturbs the social and personal life of the patient and affects him  psychologically. Management of Eczema is also quiet challenging for the physician due to its chronic protracted  course.

The prevalence of Eczema (also known as atopic eczema/dermatitis) is high, affecting up to 20% of children and  up to 10% of adults. The burden of disease ranks 15th worldwide for non-fatal diseases, and number one for skin  diseases, measured in disability-adjusted lifeyears (DALYs). [2]

In the contemporary science treatment modalities includes corticosteroids, immunosuppressant and light  therapy. [3] The corticosteroids give side effects like liver and kidney failure, bone marrow depletion, etc. The  immunosuppressant gives side effects like hair loss, hypertension, diabetes, mouth sores, etc. While light therapy  is generally considered safe and effective, it may carry potential side effects such as irritability. Additionally, the  cost of treatment is often prohibitive for common people.

The texts of Ayurveda consider Rakta Dusti as one of the prime causes of skin diseases [4]. Acharya Sushruta propounds practical guidelines for bloodletting and claims it as most effective therapy in half of the skin ailments [5]. Among various methods for bloodletting Jalaukavacharana (Leech therapy) is considered as the ideal method  to expel out the vitiated blood safely, quickly, and effectively. According to the literature, Khadira Kwatha is  considered best for skin diseases [6]. Khadira is characterized by its tikta and kashaya rasas, which help in  balancing pitta and kapha doshas [7]. Due to its properties, Khadira is considered suitable for treating Vicharchika,  which is primarily a Kaphaja disorder [8] associated with rakta dushti. It is readily available at an affordable cost.  So, Jalaukavacharana along with Khadira Kwatha is considered to evaluate their efficacy along with oral  medications in cases of Vicharchika (Eczema).