Management of Herpes Zooster (Kaksha) through Ayurveda: A Case Study

Introduction

Lesions of Herpes zoster starts as clusters of closely spaced erythematous papules, which swiftly transform into vesicles on an erythematous and oedematous base. Lesions can appear unilaterally as continuous or broken bands in one, two or more adjacent dermatomes. The three stages of this infection are pre-eruptive, acute eruptive, and chronic infection [1]. This ailment is comparable to Kaksha, one of the Kshudra rogas, which clinically presents as throbbing, blackish vesicles that spreads from the armpit to the extensor area of the arm. Kaksha is the term given to this illness based on the location of the lesion. The commentary by Chakrapani in Charaka Chikitsa Sthana discusses location and uniqueness of this disease [2].

Case Description

A 38 year old women had developed rashes over her left hand which eventually turned into raised fluid filled clustered bluish lesions at the region of axilla, hands and forearm since two days, which was associated with severe pain and pricking sensation. A similar kind of lesion had appeared over the palmar aspect of right middle finger, palm and over wrist. The patient had approached our hospital (Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital) with the above complaints.

Laboratory Findings

• Hemoglobin -12 Gm% (13-16 Gm%)
• Esr - 14 Mm/Hour (0-10 Mm/Hour)
• Total Wbc Count - 4500 Cells/Cmm (4000-11000 Cells / Cmm )
• Rbc Count - 4.56 Millions /Cmm
• Fbs - 97.7 Mg /Dl
• Blood Urea - 14.7 Mg/Dl
• Serum Creatinine - 0.6 Mg /Dl

Discussion

Acharya Sushrutha established vitiation of pitta as the root cause of this illness [8]. Additionally, pittaja visarpa line of therapeutic modalities has been recommended [9]. In this case, patient had indulged in many causative factors like virudha ahara (incompatible foods), avyayama (sedentary life style), and divaswapna (day sleep) frequently over a period of ten days that caused aggravation of pitta dosha, along with agni mandhya, and formation of ama, thereby leading to manifestation of the ailment. Developed lesions were painful, red, sensitive, and had an intense burning sensation. Because of these, pita rechaka (drugs aiding expulsion of pitta) and pita hara (drugs aiding in pacifying pitta) lines of managements were adopted. Formulas patola katu rohinyadhi kashaya, kamaduga rasa, avipathikara choorna, shatadhouta gritha external application, and triphala kashaya sheeta parisheka (showering of cooled decoction) were chosen. Dietary and lifestyle modifications in addition to these treatments, helped to stop the further development of illness and heal the existing lesion. Most of the drugs chosen are even proven to have got strong anti-inflammatory and anti-viral activity which had helped in cessation of the virus. Thereby ceasing the disease progression along with healing of the lesions. Follow up after a week, showed absence of burning, itching, redness, or any discomforts, along with formation of dry crusts over lesions. Peripheral parts of lesions showed signs of healing. Presence of pale yellow discharge was observed at some areas following the breaking off of shrunk and fused lesions. Regions having small lesions had completely healed with appearance of normal healthy skin.

Conclusion

The patient’s recovery through Ayurveda management was clinically significant. Throughout the course of therapy, there were no adverse drug reactions. This case study demonstrates how pitta hara ahara, vihara, and aushadha aid in the efficient treatment of Herpes zoster, which is closely related to the illness kaksha and treated accordingly. And the majority of the ingredients utilised in the formulations listed above have been shown to have antiviral activity and anti-inflammatory activity. This has prevented the disease from progressing and development of severe side-effects such as post-herpetic neuralgia. Exploring the practical use of Ayurvedic formulations in the treatment of different viral symptoms helps in aiding better treatment for other viral diseases.