Management of Hidradenitis Suppurativa by Guggulu based Apamarga Ksharasutra - A Case Study

Abstract

Hydradenitis Suppurativa (HS) is a chronic infective and fibrous disease of the skin bearing apocrine sweat glands characterised by recurrent painful deep seated rounded nodules and abscesses. Axilla, groin, perianal and perineal regions are the common sites. Onset is usually after puberty between 20 and 40 years of age. This recurrent inflammatory skin condition with an estimated prevalence of 1-4 % is more frequent in women. The disease tend to become chronic with subcutaneous extension leading to indurations, sinus and fistula having a profound impact on the quality of life. The clinical features of HS can be compared with Naadivrana mentioned in classics. The treatment modalities of Naadivrana ^[4,5] includes mainly Shodhana and Ksara Sutra application are adopted in the present case. In modern system of medicine there are no curative (medical) therapies for HS, only symptomatic treatment can be done. This includes adjuvant therapy (e.g., pain management, smoking cessation, weight loss, treatment of super infections, hygiene practises, topical wound dressings) to topical and systemic agents (e.g., antibiotics, anti-inflammatory agents, anti-androgen drugs) and surgical interventions such as excisional surgery and laser surgery. Shodhana Chikitsa is not only effective in eliminating toxins. It has a wide range of therapeutic uses such as improving circulation immunity and eradicating diseases etc, Guggulu based Apamarga Kshara Sutra has the combined effect of Apamarga Kshara, Guggulu and Turmeric and said to be unique drug formulation for cutting and healing of sinus tract.