Childhood Vitiligo (Shwitra) in Ayurveda: A Comprehensive Review of Classical Concepts and Therapeutic Approaches
Main Article Content
Abstract
Vitiligo is an autoimmune dermatological disorder characterized by well-demarcated ivory-white macules and smooth patches resulting from the destruction of melanocytes triggered by factors such as allergens, chemicals, stress, diet, and sunlight. However, it is not a life-threatening disease. Still, the most important aspect of vitiligo is the cosmetic concern it arouses in the psyche of patients and their family members because of the stigma associated with it.
In Ayurvedic literature, Vitiligo may be correlated with Shwitra or kilasa, which is described under the Kushtha roga. Shwitra is developed, may be a vitiation of Tridosha, especially aggravation of Pitta Dosha, due to prolonged and excessive use of Aahar, which has properties of Amla- Katu-Ushna-Lavan-Madhur ras, Viruddhahar, along with Navann Sevan and Dahi (Curd), which may lead to loss of skin pigmentation due to destruction of melanocytes. The present review article compiles the etiology, prevention and management of Shwitra (Vitiligo) by Sansaman Chikitsa, followed by Sansodhana (purification) with exposure to sun rays in children.
Article Details
References
MedlinePlus. Vitiligo. U.S. National Library of Medicine. Updated August 18, 2020. Available from: https://medlineplus.gov/genetics/condition/vitiligo/.Accessed on Jan 10, 2023.
Krüger C, Schallreuter KU. A review of the worldwide prevalence of vitiligo in children, adolescents and adults. Int J Dermatol. 2012;51(10):1206–1212.
Yaghoobi R, Omidian M, Bagherani N. Vitiligo: A review of the published work. J Dermatol. 2011;38(5):419–431.
Iacovelli P, Sinagra JL, Vidolin AP, Marenda S, Capitanio B, Leone G, et al. Relevance of thyroiditis and other autoimmune diseases in children with vitiligo. Dermatology. 2005;210(1):26–30.
Pajvani U, Ahmad N, Wiley A, Levy RM, Kundu R, Mancini AJ, et al. The relationship between family medical history and childhood vitiligo. J Am Acad Dermatol. 2006;55(2):238–244.
Iacovelli P, Sinagra JL, Vidolin AP, Marenda S, Capitanio B, Leone G, et al. Relevance of thyroiditis and other autoimmune diseases in children with vitiligo. Dermatology. 2005;210(1):26–30.
Jin Y, Santorico SA, Spritz RA. Pediatric-to-adult shift in vitiligo onset suggests altered environmental triggers. J Invest Dermatol. 2020;140(1):241–243. doi:10.1016/j.jid.2019.06.131.
Hann SK, Lee HJ. Segmental vitiligo: Clinical findings in 208 patients. J Am Acad Dermatol. 1996;35(5 Pt 1):671–674.
Tripathi B, Astanga Hrdayam, Chaukhambha Sanskrit Pratishthan, Delhi; 2011. Nidan Sthan, Chapter 14, Verse 37. p. 533.
Shastri SN, editor. Charaka Samhita. Part 1. Varanasi: Chaukhambha Bharati Academy; 2009. Nidana Sthana, Chapter 5, Verse 6. p. 643.
Anti-vitiligoTM - An herbal formulation from True Herbals, Lahore, Pakistan and the main herbal ingredients are Berberis vulgaris L., Cocos nucifera L., Nigella sativa L, and P. corylifolia L.
Callumae - a product, which contains three herbs such as Ammi visnaga L., Ginkgo biloba, and P. kurroa Royle Ex Benth.
Barman S. Switra and its treatment in the Veda. Ancient Science of Life. 1995 Jul; XV(1):71-74.
Hann SK, Lee HJ. Segmental vitiligo: Clinical findings in 208 patients. J Am Acad Dermatol. 1996;35(5 Pt 1):671–674.
Sharma HP, Vrudha Jeevaka. Kasyapa Samhita. Kushtha Chikitsita Adhyaya. Varanasi: Chaukhambha Vishvabharati; 2105, p.172.
Sneha Patil, S.G. Ashwini, Ayurvedic management of Shwitra (vitiligo) – A Case Study. J Ayu Int Med Sci. 2022; 7(5):139-145.
Vrudha Jeevaka. Kasyapa Samhita Kushtha chikitsitadhyaya. Varanasi, India: Chowkhamba Viswabharati; 199
Tripathi B, Astanga Hrdayam, Chaukhambha Sanskrit Pratishthan, Delhi; 2011. Nidan Sthan, Chapter 14, Verse 37. p. 533.
Shastri SN, Charaka Samhita. Part 1. Varanasi: Chaukhambha Bharati Academy; 2009. Nidana Sthana, Chapter 5, Verse 6. p. 643.
Shastri SN, Charaka Samhita. Part 1. Varanasi: Chaukhambha Bharati Academy; 2009. Sutra Sthana, Chapter 7, Verse 14. p. 153.
Tripathi B, Astanga Hrdayam, Chaukhambha Sanskrit Pratishthan, Delhi; 2011. Nidan Sthan, Chapter 14, Verse 1. p. 527.
Tripathi B, Astanga Hrdayam, Chaukhambha Sanskrit Pratishthan, Delhi; 2011. Nidan Sthan, Chapter 14, Verse 37. p. 533.
Shastri SN, Charaka Samhita. Part 1. Varanasi: Chaukhambha Bharati Academy; 2009. Nidana Sthana, Chapter 5, Verse 6. p. 643.
Shastri SN, Charaka Samhita. Part 2. Varanasi: Chaukhambha Bharati Academy; 2009. Chikitsa Sthana, Chapter 7, Verse 177. p. 275.
M. Levai, “The Relationship of Pruritus and Local Skin Conditions to the Development of Vitiligo,” A.M.A. Archives of Dermatology, Vol. 78, No.3; 372–377, 1958.]
Shastri SN, Charaka Samhita. Part 2. Varanasi: Chaukhambha Bharati Academy; 2009. Chikitsa Sthana, Chapter 7, Verse 173. p. 274.
Tripathi B, Astanga Hrdayam, Chaukhambha Sanskrit Pratishthan, Delhi; 2011. Nidan Sthan, Chapter 14, Verse 7. p. 531.
Murthy KRS, Sushruta: Sushruta Samhita, Hindi commentary by Ambikadat Shastri, Part-1, Chaukhambha Surabharti Prakashana, Varanasi 2006; 295
Hosamani R.B.,Critical analysis of Vitiligo (Shwitra): An Ayurvedic Perspective. J Ayurveda Integr Med Sci 2020; 1:133-144. Tripathi H, Harita Samhita, Tritiya Sthana, Chapter-39/50-51. Reprint edition. Varanasi: Chaukhambha Krishnadas Academy; 2009; 421.
https://www.ncbi.nlm.nih.gov/pubmed/17250545; Pigment Cell Res. 2007; 20:27–35. [PubMed]; https://www.ncbi.nlm.nih.gov/pubmed/28698094; Epub 2017 Jul 8[PubMed]]
Shastri SN, Charaka Samhita. Part 2. Varanasi: Chaukhambha Bharati Academy; 2009. Chikitsa Sthana, Chapter 7, Verse 176. p. 275.
Tripathi B, Astanga Hrdayam, Chaukhambha Sanskrit Pratishthan, Delhi; 2011. Chikitsa Sthan, Chapter 20, Verse 1. p. 797.
Gadanigraha: Gangasahaya Pandeya edited. Kayachikitsa Khanda Kushtadhikara / 227, 1st ed, 1996, Chaukamba Sanskrit Series Office, Varanasi. 804
Shastri SN, Charaka Samhita. Part 1. Varanasi: Chaukhambha Bharati Academy; 2009. Vimana Sthana, Chapter 1, Verse 29. p. 680.
Shastri SN, Charaka Samhita. Part 2. Varanasi: Chaukhambha Bharati Academy; 2009. Chikitsa Sthana, Chapter 7, Verse 162. p. 272.
Shastri SN., Charaka Samhita. Part 2. Varanasi: Chaukhambha Bharati Academy; 2009. Chikitsa Sthana, Chapter 7, Verse 172. p. 274.
Sarvangsundara of Acharya Arundutta.Charak Samhita, Agnivesha, revised by Charak and Dridbala, with Hindi commentary, Chaukhamba Sanskrit series, Varanasi, 2008.
Tripathi B, Astanga Hrdayam, Chaukhambha Sanskrit Pratishthan, Delhi; 2011. Uttar Sthan, Chapter 39, Verse 62. p. 1190.
Shastri SN, Charaka Samhita. Part 2. Varanasi: Chaukhambha Bharati Academy; 2009. Chikitsa Sthana, Chapter 1/3, Verse 24-29. p. 38.
Shastri SN, Charaka Samhita. Part 2. Varanasi: Chaukhambha Bharati Academy; 2009. Chikitsa Sthana, Chapter 7, Verse 82. p. 262.