Abstract

AN OBSERVATIONAL STUDY OF HISTOPATHOLOGICAL CHANGES IN TAMRA TWACHA WITH SPECIAL REFERENCE TO SHWITRA (VITILIGO)

Dr. Abhilash Pardhekar*, Dr. Shilpa Varade, Dr. Vinod Choudhari,  Dr. Ashvini D. Pardhekar, Dr. Manisha Davkare

Abstract

Background: Shwitra, described in Ayurveda, is correlated with vitiligo, a chronic depigmentary disorder characterized by the loss of melanocytes. According to Ayurvedic literature, Tamra Twacha is considered the Adhisthana (site) of Shwitra and is correlated with the stratum granulosum of the epidermis. Histopathological evaluation helps to understand the structural changes occurring in this layer. Aim: To observe the histopathological changes in Tamra Twacha (stratum granulosum) with special reference to Shwitra (Vitiligo). Materials and Methods: An observational study was conducted on 43 clinically diagnosed patients of Shwitra aged 20–50 years attending the OPD and IPD of Shri Ayurved Mahavidyalaya, Nagpur. After obtaining informed consent, punch biopsy specimens were collected from representative untreated lesions and subjected to histopathological examination. Clinical assessment included Twak Shweta Varni, Twak Rukshata, Kandu, Daha, Rom Vivarnata, and number of patches. Results: The majority of patients presented with white depigmented patches (67%), absence of dryness (84%), absence of itching (89%), absence of burning sensation (88%), white hair discoloration (74%), and more than ten lesions (46%). Histopathological examination revealed complete absence of melanocytes in all cases (100%), keratinocyte alterations in 82% of patients, and inflammatory changes in 23% of cases. Conclusion: The study demonstrated significant histopathological changes in the stratum granulosum (Tamra Twacha) in patients with Shwitra (Vitiligo). The findings support the Ayurvedic concept that Tamra Twacha is the site of Shwitra and correlate well with the modern histopathological features of vitiligo. The study also emphasizes the importance of histopathological evaluation in understanding the disease and provides a basis for future research integrating Ayurvedic principles with modern dermatopathology.

Keywords: Shwitra, Vitiligo, Tamra Twacha, Stratum Granulosum, Melanocytes, Keratinocytes.