Integrative Ayurveda Management of Steroid-Dependent Chronic Exudative Eczema: A Case Report

Abstract

Introduction: Chronic exudative eczema is a relapsing inflammatory dermatosis characterized by epidermal barrier dysfunction, immune dysregulation, intense pruritus, vesiculation, and serous discharge. Misdiagnosis, particularly as psoriasis, may result in prolonged corticosteroid use, steroid dependence, and recurrent exacerbations.

Aim: To evaluate the effectiveness of an integrative Ayurveda management approach in a case of steroid-dependent chronic exudative eczema (Vicharchika) and to highlight the importance of accurate differential diagnosis.

Methods: A 13-year-old female with a six-year history of recurrent pruritic, oozing skin lesions, previously diagnosed as psoriasis and treated intermittently with topical corticosteroids, was assessed clinically. Based on detailed evaluation, psoriasis and xeroderma were excluded, and a diagnosis of chronic exudative eczema was established. Ayurveda assessment correlated the condition with Vicharchika, characterized by predominant inflammatory and exudative features. The patient was managed with an integrative Ayurveda treatment protocol focusing on blood purification, metabolic correction, anti-inflammatory action, and topical wound-healing therapy.

Conclusion: The patient showed marked clinical improvement, with approximately 70% reduction in pruritus and exudation within 14 days, followed by sustained recovery over a four-month follow-up period without corticosteroid use. This case highlights the importance of accurate differential diagnosis, particularly in steroid-dependent dermatoses initially misdiagnosed as psoriasis, and demonstrates the potential of samprapti-based integrative Ayurveda management in achieving sustained steroid-free recovery.