Management of Uttana vatarakta (limited cutaneous systemic sclerosis): An experience through Ayurveda management strategies

Scleroderma (systemic sclerosis) is a group of rare diseases that involve the hardening and tightening of the skin and connective tissues. Diffuse cutaneous scleroderma and Limited Cutaneous Systemic Sclerosis (LcSSC) are the two major classifications of it. LcSSc usually affects the skin and further spreads to muscles and joints, but in about 10% cases, involvement of internal organs like gastrointestinal tract and manifestations like pulmonary hypertension is seen even after 10–15 years. The prevalence of the disease is 17.6/100,000 population. As far as the management of LcSSC in conventional medicine is concerned, other than symptomatic relief; immunosuppressive drugs are given, but long-term use of such medicines suppresses the immunity of the patient and hence the patient may get affected with opportunistic infections and causes severe complications. Hence, some alternatives in this direction are being explored from other systems of medicines for the betterment of patients. The direct description of the disease scleroderma is not available in Ayurvedic literature, but based on its presentation, it can be correlated with different stages of Vatarakta (~rheumatism due to blood tissue). A 20-year-old young male patient with presentation of limited scleroderma managed with Ayurveda therapy by Virechana (~therapeutic purgation) followed by Shamana (~palliative) therapy for one and half months and obtained encouraging results, inferring that Ayurveda therapeutic protocols can be successfully adopted in cases like LcSSC.