Ayurvedic treatment of Kaksha (Hidradenitis Suppurativa) – A case report
DOI:
https://doi.org/10.70066/jahm.v13i11.2426Keywords:
Apocrine gland, Bhedana, Hidradenitis suppurativa, Kshara (Alkali), Ksharasutra (Medicated thread), Case reportAbstract
Background: Kaksha is a disease described by Acharya Sushruta in Kshudra Rogas (minor disorders) which occurs due to vitiation of Pitta Dosha (regulates body temperature and metabolic activities) in the Bahu (upper limb), Ansapradesha (shoulder), Parshwa (flank) and Kaksha (axilla/armpit). The Kaksha is correlated to chronic inflammatory skin disease known as Hidradenitis Suppurativa (HS), in which formation of subcutaneous nodules or sinus tracts occurs leading to hypertrophic scarring at disease site often causing discomfort to the patient affecting his/her quality of life. The primary areas of HS are the buttocks, genitals, perineal region and axilla due to the presence of apocrine glands. The prevalence rate of HS ranges from 0.00033% to 4.1% globally, but the treatment of HS remains challenging due to the increased recurrence rate and associated postoperative complications.
Clinical Findings: A 37-year-old female patient came with complaints of multiple small pustular swellings associated with severe pain and foul-smelling pus discharge from the right axilla. Local examination revealed four openings with a pus discharge and foul smell.
Intervention: The Ayurvedic diagnosis of Kaksha (ABB-12) was made based on signs and symptoms, whereas, as per modern literature, it was diagnosed as HS. Through an integrated approach based on principles of Ayurveda the case was treated by Shastra Karma (surgical procedures) and Shaman Chikitsa (palliative treatment).
Outcomes: The wound of the patient healed completely in 1 month and no recurrence was seen after 1 year.
Conclusions: In this case, the integrated approach based on principles of Ayurveda helped in complete resolution of the patient complaints and prevented recurrence which is one amongst the major complication seen after the treatment of HS. Hence it is observed that the traditional Ayurveda procedure of Kshara Karma (application of caustics) and Ksharasutra (medicated thread) ligation provided better results in the management of HS.
References
Ambikadutta Shastri (editor). Commentary: Ayurveda Tattva Sandipika on Susruta Samhita of Maharsi Susruta, Nidansthana, chapter 13, verse no. 15, 12th edition, Varanasi; Chaukhambha Sanskrit Sansthan;2001;283
Jastrząb B, Szepietowski JC, Matusiak Ł. Hidradenitis suppurativa and follicular occlusion syndrome: where is the pathogenetic link? Clinics in Dermatology [Internet]. 2023 Sep;41(3):573-586. Available
from: https://doi.org/10.1016/j.clindermatol.2023.08.021
Scuderi N, Monfrecola A, Dessy LA, Fabbrocini G, Megna M, Monfrecola G. Medical and Surgical Treatment of Hidradenitis Suppurativa: A Review. Skin Appendage Disorder [Internet]. 2017 Mar;3(2):95-110. Available
from: https://doi.org/10.1159/000462979
Shukla R, Karagaiah P, Patil A, Farnbach K, Ortega-Loayza AG, Tzellos T, Szepietowski JC, Giulini M, Schepler H, Grabbe S, Goldust M. Surgical Treatment in Hidradenitis Suppurativa. Journal of Clinical Medicine [Internet]. 2022 Apr;11(9):1-15. Available from: https://doi.org/10.3390/jcm11092311
Ambikadutta Shastri (editor). Commentary: Ayurveda Tattva Sandipika on Susruta Samhita of Maharsi Susruta, Sutrasthana, chapter 25, verse no. 7, 12th edition, Varanasi; Chaukhambha Sanskrit Sansthan;2001;103
Ambikadutta Shastri (editor). Commentary: Ayurveda Tattva Sandipika on Susruta Samhita of Maharsi Susruta, Sutrasthana, chapter 11, verse no. 7, 12th edition, Varanasi; Chaukhambha Sanskrit Sansthan;2001;35
Ambikadutta Shastri (editor). Commentary: Ayurveda Tattva Sandipika on Susruta Samhita of Maharsi Susruta, Chikitsasthana, chapter 17, verse no. 30-33, 12th edition, Varanasi; Chaukhambha Sanskrit Sansthan;2001;81
Kouris A, Platsidaki E, Christodoulou C, Efstathiou V, Dessinioti C, Tzanetakou V, Korkoliakou P, Zisimou C, Antoniou C, Kontochristopoulos G. Quality of Life and Psychosocial Implications in Patients with Hidradenitis Suppurativa. Dermatology [Internet]. 2016;232(6):687-91. Available from: https://doi.org/10.1159/000453355
Elliott J, Chui K, Rosa N, Reffell L, Jemec B. Hidradenitis suppurativa: A review of post-operative outcomes. Journal of Plastic Reconstructive & Aesthetic Surgery (JPRAS). 2020 Aug;74(3):644-710. Available from: https://doi.org/10.1016/j.bjps.2020.08.026
Garg A, Geissbühler Y, Houchen E, Choudhary N, Arora D, Vellanki V, Srivastava A, Priyanka, Darcy J, Richardson C, Kimball AB. Disease Burden and Treatment Patterns Among US Patients with Hidradenitis Suppurativa: A Retrospective Cohort Study. American Journal of Clinical Dermatology. 2023 Jun;24:977-990. Available from: https://doi.org/10.1007/s40257-023-00796-2
KT S, V R R. Analysis of efficiency and pain level in the management of Fistula-in-Ano with sliding Ksharasutra technique - A Pilot Study. JAHM [Internet]. 2025 Mar;13(2):1-9. Available from: https://jahm.co.in/index.php/jahm/article/view/1591
Patil P, Shinde J, Khobragade S. Systematic review on efficacy of various Pratisarneeya Kshar application in Ayurveda for the management of hemorrhoids w.s.r. size reduction of pile mass. JAHM [Internet]. 2024 Apr;12(3):44-54. Available from: https://jahm.co.in/index.php/jahm/article/view/1321
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