Management of Hydradenitis Suppurativa by Apamarga Kshara Sutra - A Case Study

Hydradenitis suppurativa (HS), also known as Acne Inversa, is a chronic disease characterized by recurrent, painful, deep-seated, rounded nodules and abscesses. Subsequent hypertrophic scarring and suppuration of apocrine gland bearing skin: axilla, groin, peri-anal and perineal regions are main features. Onset is usually after puberty. The disease tends to become chronic with subcutaneous extension leading to indurations, sinus and fistula having a profound impact on the quality of life. The exact aetiology remains unknown. The clinical features of HS can be compared with Naadivrana mentioned in classics. Treatment modalities of Naadivrana includes mainly Ksharataila Poorana and Ksharasutra application are adopted in the present case. A case report of patient suffering from HS since 4.5 years (c/o multiple pus discharging abscesses and hardened area in both axillary region) was treated by number of allopathic surgeons and physicians but there was minimal relief and recurrence (6-7 times) even after Incision and Drianage (IandD) and wide excision. The patient was under Ayurveda treatment for approximately 5 months and pus discharge, hardness reduced completely and is on followup since 8 months there is no recurrence, patient was treated internally with Gandakarasayana, Triphala Guggulu and Varunadi Kashaya. Apamarga Kshara Taila infiltration followed by Apamarga Kshara Sutra application to the intercommunicating sinuses, adviced to maintain local hygiene.