Unani therapeutic approach in the management of spongiotic dermatitis: A case report

Abstract

Spongiosis refers to the accumulation of edema fluid in the keratinocytes which in some cases may progress to the formation of cysts or bullae. The type of spongiotic reaction is characterized by changes in the epidermis associated with accumulation of intracellular edema. Unani medicine has enormous potential in treating chronic and recurring skin conditions like Nare Farsi (Eczema). According to Unani medicine, Nare farsi results from excessive production of abnormal safra mixed with abnormal sauda or saudae muhtarika. The aim of this case study is to evaluate the effect of combined Unani formulations in the management of spongiotic dermatitis. A 69-year-old patient presented at the OPD of the NAHSL with a three-year history of recurrent fluid-filled lesions on the hands and feet. Clinical examination revealed bullae and erosion of stone flakes on plantar surfaces of hand and foot. Microscopic finding showed a hyperkeratotic epidermis and focal intraepidermal bulla lesions containing polymorphs and scattered lymphocytes. The papillary tissue and superficial dermis showed capillaries surrounded by lymphocytes and polymorphs. Patient was treated with Majoone Dabeedul vard, Ithripale Shahathra, and Habbe Musaffie khoon internally. Roghane Khas was applied externally. Outcome was assessed using both subjective and objective parameters. Significant improvement in the fluid-filled lesions, with a marked reduction in vesicles and bullae on the hands and feet were observed. Liver function test showed stabilization of previously elevated AST and ALT levels. This case highlights the value of Unani formulation in the management of spongiotic dermatitis and further clinical studies are required to validate these findings.