Abstract

AYURVEDIC MANAGEMENT OF BULLOUS PEMPHIGOID (VISPHOTA): A CASE REPORT

Dr. B. Sanjuktha Shree*, Dr. Mahesh Sharma M., Dr. Srinivasa S. and Dr. Gopika S. V. Gokul

Abstract

Introduction: Bullous pemphigoid is a chronic autoimmune disorder characterized by sub-epidermal blisters that persist from months to years, with unpredictable exacerbations or remissions. It is usually seen in elderly patients between the age of 60 to 80 years. This disease consists of both immunological and inflammatory components, in which the immune system produces auto-antibodies against basal membrane antigens of the skin. This triggers an inflammatory response that produces the blisters. Materials And Methods: The present study is a case of a 79-year-old male patient, admitted to the Kayachikitsa department of SDMIAH, Bengaluru, who is a known case of Type 2 Diabetes mellitus, with the chief complaints of widespread pruritic bullous eruptions distributed over bilateral upper, lower extremities and trunk associated with itching and discharge, for a duration of 3 months. Dermatological examination revealed numerous intact tense bullae and scattered erosions on the trunk and the extremities. Based on the clinical features, this chronic vesiculobullous skin condition can be clinically correlated to Visphota according to Ayurveda. This case was managed through an ayurvedic treatment approach on the lines of Kaphaja Visphota which majorly concentrated on Shamana chikitsa planned after assessing the dosha, avastha, bala, and agni of the patient. Result: The lesions changed from erosive, and exudative to erosive, dry, and reepithelialised lesions. The improvement observed was graded using Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) which improved from 58.5 to 27 points which is a significant regression in a short period in an elderly patient with Type 2 Diabetes mellitus. Discussion: This case study documents the challenges in managing cutaneous manifested autoimmune condition in elderly patients, through understanding its link with Type 2 Diabetes mellitus. Photographs were taken during and after treatment for records with consent.

Keywords: Bullous Pemphigoid, Chronic, Autoimmune, Visphota, Shamana Chikitsa.