Evaluation of add on-effect of Virechana in the management of Shvitra (vitiligo in children) along with Manjishtadi Kashaya, Siva Gutika and Gandhakadi lepa -An open label randomized comparative clinical study.

INTRODUCTION:

 Vitiligo is a common dermatological disorder of chronic depigmentation which is phenotypically characterized by white macules on the skin caused as a result of the systematic destruction of functional melanocytes. It is reported to have a global prevalence of 1% and an Indian incidence of 0.2 to 8.8%. Its common age of onset is 10 to 30 years. It affects both the genders almost equally, but females show earlier ages of onset, hence their predominance being marked in the childhood vitiligo.The exact etiology of vitiligo is poorly understood and is often considered as a multifactorial disease with a complex pathogenesis encompassing several postulations implicating autoimmune, cytotoxic, biochemical, oxidant–antioxidant, viral, and neural mechanisms for destruction of the melanocyte function in genetically predisposed. It is classified into two classes segmental and non-segmental. There is a probable symmetry in the location of patches in non-segmental type of Vitiligo. This class includes generalized, Universal, Focal, Acrofacial and Mucosal Vitiligo. Latter is static and mostly affects the area of skin attached with dorsal root of spinal cord unilaterally.

 OBJECTIVES: PRIMARY:Reduction in subjective symptoms, Vitiligo Extensive Tensity Index (VETI) score and increase in repigmentation among pediatric patients of 10-16 years age group of Shvitra(vitiligo) on giving virechana along with Manjishtadi Kashaya, Siva Gutika and Gandhakadi Lepa and only shamana chikitsa for the duration of 60 days.

         SECONDARY: Improvement in Children’s Dermatological Life Quality Index (CDLQI) among pediatric patients of 10-16 years age group of Shvitra (vitiligo) on giving virechana along with Manjishtadi Kashaya, Siva Gutika and Gandhakadi Lepa and only shamana chikitsa for the duration of 60 days.