Effect of Ayurveda interventions in the management of venous stasis dermatitis in a patient with type 2 diabetes: A case report

Abstract

BACKGROUND: Venous insufficiency disorder associated with diabetes is a concerning condition. It can result in venous stasis dermatitis, also known as stasis eczema, characterized by inflammatory changes in the lower extremities. A similar condition is described in Ayurveda as Vatarakta, which can present as Kushtasamalakshanas (early symptoms resembling skin disorders) in the lower limbs due to vitiated Vata (bodily humor) and Rakta Dhatu (blood tissue). Ayurvedic intervention promises successful results through both Shodhana (detoxification) and Shamana (pacifying/palliative) treatment along the line of management in Vatarakta disease. Managing such problems in diabetes patients must be well-planned to prevent rising blood sugar levels. Therefore, venous stasis dermatitis in diabetic individuals can be effectively treated with Shamana (pacifying therapy) combined with Sadyovirechana (therapeutic purgation without prior administration of medicinal oil/ghee). PATIENT INFORMATION: A 54-year-old woman with type 2 diabetes mellitus approached for the Ayurvedic management of inflammatory changes on her right lower leg. She complained of hyperpigmentation, swelling, aching pain, dryness, and severe itching of the right lower leg along the medial aspect of the ankle and foot for 6 months. DIAGNOSIS: According to CEAP (clinical, etiological, anatomical, and pathophysiological) classification, this clinical condition was identified as venous stasis dermatitis with C4a Ep AP PO (changes in skin and subcutaneous tissues in the form of pigmentation/eczema, primary, perforating veins, obstruction, respectively). Before beginning Ayurvedic treatment, an assessment using the revised venous clinical severity score (RVCSS) revealed a score of 7. INTERVENTIONS: Vatashaamaka-Raktadushtihara treatment (therapy that pacifies vitiated bodily humor and purifies vitiated blood tissue) was provided to the patient for 60 days which included Deepana-Pachana (digestive and metabolism-enhancing therapy) followed by Sadyovirechana (therapeutic purgation without prior administration of medicated oil/ghee) using Nimbamritadi Eranda Tailam and Samana Treatment (pacifying therapy) including local application of Nalpamaradi Kera Tailam. OUTCOME: After 60 days of treatment, there was a noticeable improvement in all symptoms except varicosity, and the RVCSS dropped from 7 to 3. CONCLUSION: Even though treating venous insufficiency issues in diabetic individuals may be challenging, a well-planned Ayurvedic therapy regimen that includes Sadyosodhana (therapeutic purgation without prior administration of medicinal oil/ghee) and Shamanatreatment (pacifying therapy) can have excellent results and offer hope for the treatment of several disorders associated with diabetes.