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Table of Contents
CASE REPORT
Year : 2020  |  Volume : 8  |  Issue : 2  |  Page : 141-146

Role of Putikadi Lepa in the management of Dadru Kushtha (Tinea corporis): A case study


Department of Agadtantra, Mahatma Gandhi Ayurveda College Hospital and Research Centre Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India

Date of Submission08-May-2020
Date of Decision25-Jun-2020
Date of Acceptance07-Jul-2020
Date of Web Publication07-Sep-2020

Correspondence Address:
Dr. Minakshi Avinash Urkude
Mahatma Gandhi Ayurveda College Hospital and Research Centre Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India, Wardha, Maharashtra.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JISM.JISM_45_20

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  Abstract 

Background: Developing and tropical countries such as India occurrence of skin diseases are more prominent in recent era. Dadru Kushtha (Tinea corporis) is one of Mahakushtha or Kshudra Kushtha explained by Acharya under the heading of skin diseases. In the present case study, Putikadi Lepa has been used to treat the patient having the symptoms of Tinea corporis which is mentioned in Sushruta Samhita. Aim and Objectives: The aim of this study was to assess the efficacy of Putikadi Lepa in the management of Dadru Kushtha (Tinea corporis). Setting and Design: This was an original case study. Materials and Methods: Putikadi Lepa includes leaves of Pongamia pinnata Pierre, Calotropis gigantean Linn, Cassia fistula Linn, Euphorbia neriifolia Linn, and Jasminum grandiflorum Linn pasted with cow urine. Putikadi Lepa is given to the patient having the symptoms of Tinea corporis for external application on affected area up to 21 days. Results: Clinical study shows the significant result of Putikadi Lepa to pacify the symptoms like itching, erythema, eruption, size of lesion, and number of lesion of Tinea corporis. Conclusion: Due to their antifungal and antibacterial properties of all the ingredients of Putikadi Lepa, it shows good results on patient. Putikadi Lepa is an herbal preparation and drugs are easily available. So it is very convenient treatment for Tinea corporis.

Keywords: Dadru Kushtha, skin diseases, Putikadi Lepa, Tinea corporis


How to cite this article:
Urkude MA, Chalakh SP, Manyala SS. Role of Putikadi Lepa in the management of Dadru Kushtha (Tinea corporis): A case study. J Indian Sys Medicine 2020;8:141-6

How to cite this URL:
Urkude MA, Chalakh SP, Manyala SS. Role of Putikadi Lepa in the management of Dadru Kushtha (Tinea corporis): A case study. J Indian Sys Medicine [serial online] 2020 [cited 2020 Oct 19];8:141-6. Available from: https://www.joinsysmed.com/text.asp?2020/8/2/141/294434




  Introduction Top


Economic development has led to a high rate of lifestyle changes. By lifestyle modification, environmental pollution, consumption of unhealthy food, or unhygienic condition, skin diseases were very common. According to Ayurveda, all skin diseases are categorized under the heading of Kushtha. Dadru (Tinea) is one of the commonly occurring skin disease, described under the Mahakushtha (major skin diseases) by Acharya Sushruta[1] and Kshudra Kushtha (minor skin diseases) by Acharya Charaka.[2]Dadru (Tinea) should be diagnosed by the symptoms such as itching, erythema, eruption, and elevated circular patches.[3] These resemble like the symptoms of Tinea corporis. The causative factors of Dadru (Tinea) explained by Acharya are Aahar (incompatible food), Vihar (unhygienic), and Krimi (fungi/bacteria).[4] Here Krimi (fungi/bacteria)are mycelia fungus or dermatophytes that are responsible for Ringworm or Tinea corporis. They are highly contagious segmented fungal infection, characterized by circular lesions, usually having sharp margins with raised edges. Even though multiple plaques may also be found, they remain discrete or become condensed. The diagnosis may vary based on site of manifestation. In this case study, the patient was taken who was having the symptoms of Tinea corporis.

Present case study

A 42-year-old male patient visited the outpatient department (OPD) of Kayachikitsa Department, OPD No.1804200048 of Mahatma Gandhi Ayurveda College, Hospital and Research Centre (MGAC&RC), Salod(H), Wardha on April 20, 2018. He was working in Steel Industry, Bhugaon, Wardha, approach with severe itching over left thigh since 1 month. Gradually, the patient developed erythema and circular lesion with eruption on the affected area. The same complaints should be present before 4 months, at that time he had taken allopathic medicine. He got symptomatic relief. But since 1 month again the same complaint was developed.

Personal history



Past history

Same complaints should be present before 4 months:

No H/O any major illness/surgery

No H/O any drug allergy

Local examination

Severe itching present with disturbed the sleep over left thigh.

Circular lesion of 5cm present with erythema and eruption.


  Materials and Methods Top


Putikadi Lepa: This Lepa includes leaves of Pongamia pinnata Pierre, Colotropis gigantean Linn., Cassia fistula Linn., Euphorbia neriifolia Linn., and Jasminum grandiflorum Linn pasted with cow urine.[5]

All these herbal drugs possess antifungal, antibacterial, and antimicrobial property by modern researches as shown in [Table 1].
Table 1: Ingredients of Putikadi Lepa and pharmacological action

Click here to view


Preparation method of Putikadi Lepa

Fresh and mature leaves of P. pinnata Pierre, Calotropis procera Linn, C. fistula Linn, E. neriifolia Linn, and J. grandiflorum Linn were collected from Herbal Garden of MGAC&RC and cow urine by local purchasing.

  • Washed it by tap water.


  • All the leaves are taken in the same quantity in Khalva Yantra and pasted with a sufficient quantity of cow urine and smooth paste had been done for local application on the affected area.[6]


  • Assessment criteria of symptoms

    (assessment criteria of patient based on gradation which is mentioned in the book Researches in Ayurveda)[7]

    1. Itching
      • Grade 0: No itching


      • Grade 1: Continuous itching (no disturbance while doing work)


      • Grade 2: Continuous itching (disturbs the work)


      • Grade 3: Continuous itching (disturb sleep)


    2. Eruption
      • Grade 0: No eruption


      • Grade 1: Eruption in 0%–25% of affected area


      • Grade 2: Eruption in 25%–50% of affected area


      • Grade 3: Eruption in 50%–75% of affected area


    3. Elevated circular lesion
      • Grade 0: No circular lesion


      • Grade 1: 1–3 circular lesion


      • Grade 2: 4–6 circular lesion


      • Grade 3: >7circular lesion


    4. Size of lesion
      • Grade 0: No lesion


      • Grade 2: <5cm lesion


      • Grade 3: 5–10 cm lesion


      • Grade 4: > 10 cm lesion


    5. Erythema
      • Grade 0: No erythema


      • Grade 2: Light red color


      • Grade 3: Moderate red color


      • Grade 3: Bright red color


    Treatment schedule

    Medicine: Putikadi Lepa applied on affected part of body

    Dose: Applied on affected area only

    Frequency: Morning and evening

    Total duration: 21 days

    Follow up during treatment: After 7th day, 14th day and 21st day

    Follow up after treatment: On 35th day

    Precaution: Washed by luke warm water after dried

    Dietary and Lifestyle modification

    Pungent (Tiktarasatmak) vegetables such as Karela (Bitter gourd), Parval (Ridge gourd), old ghee, and avoidance of Dadhi (curd), milk, and jaggery.[8]


      Result and Observation Top


    Before treatment, patient had severe itching, eruption, and erythema in Grade 3; after application of Putikadi Lepa patient got complete relief in the symptoms of itching, eruption, erythema, size of lesion, and number of lesion [Figure 1]. After completing the treatment, it is observed that significant result shown in the symptoms which were seen in graphical representation [Graph 1].
    Figure 1: Photographs of patient

    Click here to view
    Graph 1: Gradation criteria of symptoms

    Click here to view



      Discussion Top


    Putikadi Lepa is mentioned in the Sushruta Samhita and Ashtang Hridayam[8] for the treatment of Tinea (Dadru). The contents of these Lepa are fresh leaves of P. pinnata Pierre, Colotropis gigantean Linn, C. fistula Linn, E. neriifolia Linn, and J. grandiflorum Linn pasted with cow urine and then applied on affected part. When we used the fresh part of the drug, the potency is more.

    Common cause of Tinea corporis is incompatible food, unhygiene, and fungi. Due to industrialization and lifestyle modification, fungal infection is most commonly found in higher society and also in lower society due to unhygienic and incompatible food. Tinea corporis is not a life-threatening disorder but it makes worried due to disfigurement and due to its severity disturbing the routine work.

    Probable mode of action of Putikadi Lepa



    Click here to view


    The contents of Putikadi Lepa are fresh leaves of P. pinnata Pierre, Colotropis gigantean Linn, C. fistula Linn, E. neriifolia Linn, and J. grandiflorum Linn pasted with cow urine. All the drugs possess the antifungal, antimicrobial, anti-bacterial property by their modern researches. The cow urine used in the preparation of Putikadi Lepa contained a large number of various elements which produced hydration of skin and improved the activity of Lepa.[5] When Lepa was applied over the surface of skin opposite to the direction of hairs, through a proper base, the active principles of the ingredients of this Lepa were released into that base. After some time, the drug entered and absorbed through skin. It had done the cutaneous biotransformation and which had pacified the toxins and cleared the micro-channels.[9]Acharya Sushruta has been stated the potency of Lepa just like pouring water over a burning house the fire get extinguished very soon. In the same manner, aggravated Dosha should be subsided by application of Lepa.[10]

    Putikadi Lepa is the best herbal formulation easily prepared having no side effects and combined efficacy of all the ingredients of this formulation showed significant result.[11-21]


      Conclusion Top


    This study revealed the properties of Putikadi Lepa, which shows antifungal, antimicrobial, antibacterial property by their modern researches. Due to these properties, it shows the good results on patients by pacifying the symptoms of itching, eruption, erythema, size of lesion, and number of lesion of Tinea corporis. Putikadi Lepa is an herbal preparation and drugs are easily available and have no side effects. So it is a very convenient treatment for Tinea corporis (Dadru).

    Financial support and sponsorship

    Nil.

    Conflicts of interest

    There are no conflicts of interest.



     
      References Top

    1.
    Sushruta. English translation of text and Dalhana’s commentary along with critical notes on Sushruta Samhita. Sharma PV, editor. volII. Varanasi, India: Chaukhambha Visvabharati;2013. Nidanasthana, 5/5, 6, 7, 8, p.36-8.  Back to cited text no. 1
        
    2.
    Murthy SKR. Ashtanga Hrdayam. vol II. Varanasi, India: Chowkhamba Krishnadas Academy; Reprint ed.,2010. Nidanasthana, 14, p.136-42.  Back to cited text no. 2
        
    3.
    Shukla V, Tripathi RD, Charaka Samhita of Agnivesha. vol II. Delhi, India: Chaukhamba Sanskrit Pratishthan; Reprint ed.,2015. Chikitsasthana, 7/23, p.184.  Back to cited text no. 3
        
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    5.
    Sharma A. SushrutaSamhita. vol II. Varanasi, India: Chaukhamba Vishvabharti; Reprint ed.,2005. Chikitsasthana, 9/40, p.256.  Back to cited text no. 5
        
    6.
    Rao GP. Bhaisajya Kalpana Vijnanam. New Delhi, India: Chaukhambha Publication; Reprint ed.,2016. p. 318-28.  Back to cited text no. 6
        
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    Baghel MS, Rajgopal S. WHO-DFC sponsored project on Developing Guidelines for Clinical Research Methodology in Ayurveda University. Jamnagar,India: Institute for Post Graduation Teaching and Research in Ayurveda;2011.  Back to cited text no. 7
        
    8.
    Shukla V, Tripathi RD. CharakaSamhita of Agnivesha. vol II. Delhi, India: Chaukhamba Sanskrit Pratishthan; Reprint ed.,2015. Chikitsasthana, 7/23, p.192.  Back to cited text no. 8
        
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    Tripathi B. Ashtanga Hrdayam of Srimad Vagbhata, edited with Nirmala’ Hindi commentary along with special deliberation. Delhi, India: Chaukhamba Sanskrit Pratisthan;2007. Chikitsasthana, 20/ 9, p.798.  Back to cited text no. 9
        
    10.
    Singh P, Chaudhari P, Ranjan R. Cow urine: A magical remedy W.S.R. to Brahattrayi. Int J Ayurveda Pharm Chem 2016;5: 37-49.  Back to cited text no. 10
        
    11.
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    12.
    Ujwal P, Pramod Kumar MPM, Raja HN, Hosetti BB. Antimicrobial activity of different extracts of pongamiapinnata. Med Aromatic Plant Sci Biotechnol 2007:1:285-7.  Back to cited text no. 12
        
    13.
    Suraj SK, Chatterjee P. Antifungal activity of 50% aqueous-ethanolic extract of leaves of Calotropis procera R.Br. Int J Sci Res Publ 2015;5:230-5.  Back to cited text no. 13
        
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    Lai TK, Liew KC. Antifungal activity of Cassia fistula L. extract at different portions (Bark, Stem, Root, Leaf) and age classes. Agric Forest 2013;59:19-27.  Back to cited text no. 14
        
    15.
    Bhalodia RN, Shukla VJ, Antibacterial and antifungal activities from leaf extracts of cassia Fistula I: An ethnomedicinal plant. J Adv Pharm Technol Res 2011;2:104-9.  Back to cited text no. 15
        
    16.
    Sultan S, Kimaro CC, Amri E. Antifungal activity and phytochemical screening of different solvent extracts of Euphorbia tirucalli Linn. J Adv Biol Biotechnol 2016;7:1-9.  Back to cited text no. 16
        
    17.
    Reddy YR, Babu VH. Evaluation of antimicrobial and antibacterial activity of Euphorbia nivulia. Int J Pharm Sci Rev Res 2016;38: 262-5.  Back to cited text no. 17
        
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    Santhanam J, Ghani FNA, Basri DF. Antifungal activity of Jasminumsambac against Malassezia sp. and non- Malassezia sp. isolated from human skin samples. J Mycol2014:1-7.  Back to cited text no. 18
        
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    Sandeep P, Paarakh P, Gavani U. Antibacterial activity of Jasminumgrandiflorum Linn leaves. J Pharm Res 2009;2:1206-7.  Back to cited text no. 19
        
    20.
    Jian MH, Dhanshree B. Antifungal effect of cow’s urine distillate on Candida species. J Ayurveda Integr Med2017;8:233-7.  Back to cited text no. 20
        
    21.
    Kumar S. Analysis of cow’s urine for detection of lipase activity and anti- microbial properties. IOSR J Pharm Biol Sci 2013;7:1-8.  Back to cited text no. 21
        


        Figures

      [Figure 1], [Figure 2], [Figure 3]
     
     
        Tables

      [Table 1], [Table 2]



     

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