SHWITRA (vitiligo) white discoloration.pdf

Vitiligo and its ayurveda counterpart

1. Switra (Leucoderma) Its
Different Treatment
Modalities
By
Dr Deepti Patil
Dept. of
Dravyaguna

2. INTRODUCTION
“Black spot on white skin is a blessing; white
spot on black skin is a curse”
•No pain, itching etc.
•Causes more anxiety and social stigma in
Indian society.
•Disturbs the sufferer cosmetically more and
rarely functionally.

3. DEFINATION
•A whitish discolouration of the skin(sweta
varna twacha) is called switra
•VITILIGO- (Vitellos-Latin-White Sheep)
•'Leuco' means 'white' and 'derma' means
'skin', thus leucoderma means abnormal
whiteness of the skin LEUCODERMA

4. STIPULATION WORLD WIDE
•Ranges from 40-50 million.
• About 1 to 2% of people in the world.
• 2 to 5 million people have the disorder in the
United States.
•Affects all races and both sexes equally.
• 95 % of its victims are below the age of 40yrs.

5. INCIDENCES AND RISK PERSONALITIES
•More markedly noted in the dark people of
the tropical countries.
•Most commonly affected areas are face, neck,
back, wrist, hand, groin, genitals, armpits, etc.
•Occurance of leucoderma about 42 % is Stress
related , 28% Heriditory and 30%. Is Worms
infested.

6. MYTHS……

7. NIDANA
9
Aah
araja$
9
Viha
raja:
9

Papa
karmaj
a
Nidana

8. BHEDA $ 9
Vataja●
$
●
Aruna Varna:;9
Pittaja●
%$
●
Tamra Varna<9
Kaphaja●
+ $
●
Sweta Varna

9. Conti.. $
9
Vran
aja
9
Dos
haja2 Types

10. LAKSHANA

11. DIFFERENCE B/W SWITRA & KUSTA
SWITRA
•Sravarahita
•Caused due to vitiation of
one of the tridosha
•Involvement of only rakta,
mamsa, and meda dhatu
KUSTA
•Sravayukta
•Caused due to the vitiation
of all the tridosha
•Involvement of all the
saptadhatus.

12. SADHYA LAKSHNA
•Ashukla loma
•Thin skin
•No overlapping of patches
•Newly manifested
•Anagni dagda

13. ASADHYA LAKSHNA
•Switra in Guhya Sthanas like Linga, Yoni, Guda
•Switra in Pani, Tala, & Osta
•Agnidagda
- Asadhya Irrespective Of Purana & Naveena

14. LEUCODERMA
•Leucoderma is not a medical term
•Any white/light coloured skin patch
•Fed-up acquired skin disorder, making skin
white due to loss of the melanin pigment.
•Non-contagious disease.
•Also termed as vitiligo.

15. CAUSES
• Immune Hypothesis - Melanocyte destruction and
dysfunction or both may result into Hypo pigmentation.
• Neural Hypothesis - Neurochemical inhibitors are
released at nerve endings that destroy the melanocytes
or inhibit their functioning.
•Melanocyte Self-Destruction Hypothesis - Proposes that
an intermediate in melanin synthesis causes melenocyte
destruction.

16. Conti…
• Dietary deficiency of Proteins and Cupro
minerals is a major factor for causing vitiligo.
Serum skin and cerebro-spinal fluid copper
levels are low in these cases.
•GI Disorder like Chronic amoeboisis, chronic
Dyspepsia and Intestinal Worms .
•Use of Broad Spectrum Antibiotics ,especially
Chlormphenicol and Streptomycin

17. •Local irritation caused by wearing the sari or
Trousers too tightly.
•Composite Hypothesis : None of the theories
alone is entirely satisfactory.
•Actual mechanism of inhibition or destruction
of melanocytes is much more complex.

18. SYMPTOMS
•Odd, Harmless, White Spots Patches on the
skin surface
•More common in women than in men and is
mostly seen on the hands, neck, back and
wrist
•Mostly, no other symptoms can be noted
except whiteness of the skin.

19. Contd..
•May cause itching sometimes, due to
exposure to the sun or coming in contact with
chemicals
• Shows easy friability and susceptibility of the
skin.
• Sometimes appears pale, sometimes red and
some other times, milky white.

20. IS EVERY WHITE PATCH
LEUCODERMA…..???????

21. OTHER CONDITIONS WITH WHITE
PATCHES
Halo nevus
 - a pale mole with surrounding hypo pigmentation
Skin injury - causes a white or pale patch during skin recovery.
Tinea versicolor
Lichen sclerosis et atrophicus
Leprosy
Morphea
Pityriasis Alba

22. Halo nevus 
- a pale mole with
surrounding
 hypo pigmentation

23. Tinea versicolor

24. Lichen sclerosis et atrophicus

25. Leprosy

26. Morphea

27. Pityriasis Alba

28. White patch will in all probability be
Leucoderma if it:
Has an outline darker than the skin.
 
Is irregular in appearance.
 
Gradually increases in size.
 
Appears milky white under an ultraviolet light.

29. IS LEUCODERMA HEREDITARY?
 

30. HEREDITARY FACTOR
•28% Hereditary
•Parents where one or both have Leucoderma
are only at a fraction of a higher risk than the
general population.
• Even the general population is at a risk of
1-2 %.

31. DIAGNOSIS AND INVESTIGATION
•No other special investigations are necessary
for diagnosing the complaints.
•there won't be any change in blood or urine.
•Biopsy can reveal the absence of pigments.

32. PREVENTION OF SPREAD
•Maintain good general health and immunity.
•Non communicable disease.
•Any patch should be thoroughly examined first.
•Application of any unconfirmed tropical medication on
skin should be avoided.
•Use of synthetic clothes should be restricted.
•Avoid excess intake of Sour things.
•Avoid Steroids.

33. DO'S
•Take medicines regularly in the early days itself, so
that complete cure can be achieved.
•Don't worry about Leucoderma, since effective
treatment can arrest the course of the disease and
cure it.
•Use umbrella when out in the hot sun.
•Track all your eatables and habits to streamline all the
irritants or chemicals.

34. DON'TS
•Avoid direct exposure to sun rays.
•Avoid fast foods, citrus fruits, coffee, tea, cold
drinks, alcohol, beer, non-veg , egg, etc.
•Avoid multiple drugs or drug cocktails.
•Avoid chemical soaps.

35. Different Treatment
Modalities

36. CHIKITSA
•Included under Raktaja roga.
•Virechana, raktamokshana, upavasa
•First samshodhana followed by shamana
chikitsa.

37. TAILA
•Visha taila (Y.R)
•Jyotishmati taila (Y.R)
•Bhallatakadi taila (A.Hru)
•Aragvadadi Taila (Ck.D)
•Marichyadi Taila (Ck.D)
•Krishna sarpa bhasma sidda taila (su.sa)

38. GHRITAS
•Somaraji Ghrita (B.P)
•Mahaneela ghrita
•Tilvaka ghrita
•Mahatiktaka ghrita

39. KASHAYA’S
•Khadiradi Kashaya/Dhatrikhadira Kashaya

40. LEPA’S
As per Charaka Samhita Kustha Chiksta 8
th

chapter
•Mansiladi lepa
•Mayur pita + manasila
•Bakuchi (Seed) + Laksha + Gorochana + Anjana
(Rasanajan And Sauveera Anjana) + Pippali +
Loha(Krishna) bhasma
•Kathguular + Baakuchi + Chitraka + Gomutra etc.

41. Cont…
As per Chakardatta (Kustha chikista)
•Pootika Lepa
•Gajadicharma masi Lepa
•Avalgujabeeja Lepa etc.

42. As per Sushruta Samhita
•Pootikadi lepa
•Krisnasarpa bhasma lepa
•Kilasahara lepa
•Shivtrahara lepa
•Tutthyadi lepa
•Tilavakadi lepa etc.

43. Cont…
As per Bhavaprakasha
•Bakuchi + Haratala + Manasila + Gunja (Seed)
+ Chitraka (Moola) + Gomutra
•Neela Aparajeta (moola) lepa etc.
As per Yogaratnakar
•Shiladi lepa
•Triphaladi lepa
•Ayorajadi lepa etc.

44. Cont…
As per Baishijya Ratnavali
•Pootikadi lepa
•Pootikeetadi lepa
•Shwetajayantimoola lepa
•Osta switra nashaka lepa

45. EFFECTIVE HERBS IN SWITRA
CHIKITSA
•Bakuchi
•Khadira
•Triphala
•Nileeni
•Brungaraja

46. GOMUTRA
PROPERTIES OF GOMUTRA (Acc to Yogaratnakara)
•RASA: Katu, Tikta, Kshara.
•GUNA: Ushna, Laghu.
•KAGMA: Deepana, Medhya, Sara, Lekhana.
•DOSHAKRIYA: Kaphavatanashaka, Pittakara.
•ROGANASHAN: Shoola Gulma, Udara, Anaha

47. Conti…
•Mainly its Kshar guna is highlighted.
•It contains various minerals- Copper, Iron,
Calcium, Sodium, Magnesium, Potassium,
Phosphate, Sulphur.

48. PATHYAPATHYA

49. PATHYA
•Laghu anna
•Tikta Shakas
•Nimba yukta anna
•Ghrita prayoga
•Jangala pashu-pakshi mamsa
•Water kept in copper vessel

50. APATHYA
•Amla
•Lavana
•Maricha
•Dadhi
•Dugda
•Guda
•Anupa mamsa
•Tila
•Masha
•Tikshna Aahara

51. GENERAL TREATMENT
•There is no scheduled, conservative
treatments at all.
•No single therapy for Leucoderma produces
good results in all patients.
•Treatment course and medicines always vary
and are unpredictable.
•Treatment is a long process which may take
months or years.

52. Cont…
•To control the disease
•To produce pigmentation
•Surgical treatment
•Melanocyte culture
•Cosmetic treatment

53. MEASURES TO CONTROL THE DISEASE
•Replacement of vitamins and minerals
•Topical steroids
•Short course of systemic steroids

54. FOR PIGMENTATION
•Photo chemotherapy (PUVA therapy for
psoralens and UVA)
• Narrow band UVB (NBUVB)
•Targeted phototherapy

55. SURGICAL TREATMENT
•Removing of vitiligenous skin and
replacing with an autologous graft
•Useful in stable disease
•Segmental vitiligo

56. MELANOCYTE CULTURE
•Culture melanocytes in the laboratory-
transplant them in to affected area.
Treatment of future

57. COSMETIC TREATMENT
Micropigmentation
Introduction of Iron pigments into the
dermis

58. COMPLICATIONS
•Common side effects of photochemotherapy
like nausea, vomiting, catatact, skin
cancer(long term treatment).

59. CONCLUSION

60. REFERENCES
•Charaka Samhita
•Susruta Samhita
•Astanga Hrudaya
•Astanga Samgraha
•Yogaratnakara
•Chakradatta
•Bhavaprakasha
•Baishajya Ratnavali
•Sahasrayoga
•http://www.ayurveda
physician.com

61. THANK YOU