Study of Triphala Churna Dhaara and Kaishore Guggulu in Treatment of Dushta Vrana W.S.R Hidradenitis Suppurativa (HS)

Abstract

Background: Hidradenitis Suppurativa (HS) represents a severe, chronic, and deeply debilitating auto-inflammatory dermatosis of the folliculopilosebaceous unit. Within the classical nosology of Ayurveda, this recalcitrant condition closely mirrors the pathogenesis of Dushta Vrana (chronic, vitiated ulcers) and Nadi Vrana (communicating sinus tracts), resulting from profound Tridosha dysregulation and deep-seated Rakta and Mamsa Dhatu Dushti. Conventional allopathic interventions often yield unsatisfactory long-term outcomes, necessitating sustainable, disease-modifying therapies.
Case Presentation: A 30-year-old male presented with Hurley Stage II/III HS, characterized by 10 to 15 concurrent mucopurulent abscesses, profound localized induration, and epithelialized sinus tracts spanning the bilateral axillary and inguinal regions. The patient exhibited elevated systemic inflammatory markers, including high ESR and leukocytosis. Following the ultimate failure of prolonged topical and oral Clindamycin therapy and his refusal of surgical intervention due to fear of recurrence, he sought Ayurvedic care.
Results: The patient underwent a rigorous, phase-wise Ayurvedic clinical protocol initiated by a targeted Shodhan Chikitsa (systemic purification) regimen, which was sequentially followed by a maintenance phase of Shaman Chikitsa (palliation) utilizing Triphala Guggulu, Gandhak Rasayana, and Mahamanjistha kwatha. Biostatistical evaluation revealed complete clinical remission within 24 weeks. This was marked by the total cessation of mucopurulent discharge, the regression of fibrotic sinus tracts, and the normalization of the International Hidradenitis Suppurativa Severity Score System (IHS4) from a baseline of 46 to 0, alongside the normalization of acute-phase reactants.
Discussion: The successful clinical resolution validates the sophisticated, multi-systemic logic of classical Ayurvedic medicine over purely allopathic suppressive strategies. Administering systemic Shodhan effectively cleared deep-seated metabolic endotoxins (Ama) and physically mobilized channel obstructions, allowing the subsequent Shaman therapies to achieve maximum biological bioavailability for structural wound healing (Vranaropana).
Conclusion: This case report substantiates the clinical rationale for executing systemic purification before palliation to effectively arrest the complex pathogenesis of HS. For patients facing the prospects of chronic antibiotic resistance or radical surgical excisions, this integrated Ayurvedic paradigm offers a scientifically rational, non-invasive path to long-term clinical remission.