PĀDUKĀVIṢA, THE GARAVIṢA ADHIṢṬHĀNA, IN VIEW OF FOOTWEAR CONTACT DERMATITIS- A CASE STUDY

Abstract

Footwear contact dermatitis or footwear dermatitis is defined as dermatitis on the feet caused by any footwear. The pathophysiology is either a CD4-T-lymphocyte mediated type IV hypersensitivity reaction or an irritant dermatitis.^[1] Its prevalence in India is 11.7% but is often misdiagnosed and mismanaged.^[2] The common culprit agents are products in leather, colorants, adhesives like formaldehyde or even agents in stocks and stockings.^[3] These agents could be equated to “Garaviṣa” (Kṛtrima viṣa / artificial poison) mentioned in Ayurveda. The diagnosis of footwear dermatitis is done by Patch test to determine the specific allergen. Ācārya Suśruta explains the different modes of administration (adhiṣṭhāna) of garaviṣa, which include ‘Pāduka’ (footwear), whose clinical features-  śopha (edema), srāva (oozing), swāpa (numbness) and sphoṭa (blisters) on feet are comparable with those of footwear dermatitis.^[4] Since the modern management consists of avoiding contact with the allergen as well as conservative methods including good skin care, use of barrier creams, etc. and the use of corticosteroids could cause adverse effects like thinning of skin,^[5] Ayurvedic treatment modalities especially in the lines of management of viṣa could be utilized for good results. A 19 year old female, presented with itching, discoloration and oozing over both feet was well managed with Ayurvedic treatment protocol.

Key words: Footwear contact dermatitis, pāduka viṣa, garaviṣa, Agada management