RESUMO
Melasma is a skin condition characterized by dark spots and patches on the nose, cheeks, forehead and jaw line. Although it is completely harmless, it causes skin discoloration which is difficult to fade away with routine skin care. Melasma can lead to social isolation and stigmatization adversely affecting the quality of daily life which definitely has a major impact on individual’s psychological state and social relationship. The symptomatology of Vyanga given in various available Ayurvedic classics are Mandala (circular patches), Shyava (brown), Tanu (thin), Niruja (painless), etc. The clinical features of melasma can be correlated with Vyanga and condition can be treated based on the Vyanga Chikitsa. Objectives: To evaluate the efficacy of Haritakyadi Lepa in the management of Vyanga and to review the etiopathology and the clinical aspect of the Vyanga. Result: Based on the collected data, efforts were made to evaluate the efficacy of Haritakyadi Lepa followed by Sadyo Virechana with Manibhadra Guda in the subjects of melasma vis-à-vis Vyanga. Conclusion: In contemporary science, topical steroids have been described in the management of melasma. Alternative to that Haritakyadi Lepa along with Madhu selected for treatment, has shown very effective result in Vyanga.
RESUMO
La melanosis coli consiste en una pigmentación negruzca de la mucosa del intestino grueso, producida por absorción de productos aromáticos, por uso excesivo de laxantes derivados del antraceno. Se presentó el primer caso de melanosis coli diagnosticado en los últimos 30 años de trabajo, en el departamento de Gastroenterología del Hospital Faustino Pérez, de Matanzas. Se trata de un paciente con antecedentes de estreñimiento crónico, al cual se le diagnóstica esta entidad por estudio videoendoscópico del colon, corroborándose por estudio histológico, concluyéndose que esta entidad constituye una condición inocua que no traduce manifestaciones clínicas. Casi siempre, aparece de forma accidental en pacientes a los que se les realiza estudios endoscópicos del tracto digestivo inferior y con historia de abuso de laxantes. Para evitarla se recomienda régimen higiénico dietético adecuado, consumo de alimentos ricos en fibras, ejercicios físicos sistemáticos y proscribiendo el uso de laxantes derivados de las antroquinonas. Por tanto, es de gran importancia para Gastroenterólogos estar conscientes de su existencia. A pesar, de que no esté dilucidada todavía la importancia clínica de esta entidad.
The Melanosis coli consist in a blackish pigmentation of the large intestine mucosa, produced for the absorption of aromatic products due to the excessive usage of anthracene-derived laxatives. We present the first case of Melanosis coli diagnosed in the Gastroenterology Department of the Hospital “Faustino Perez”, of Matanzas in the last 30 years. It is the case of a patient with antecedents of chronic constipation, to whom the disease is diagnosed as a result of a colon videoendoscopic study, corroborated by histological study, concluding that this disease is an innocuous condition without clinical manifestations. It almost always appears in an accidental way, in patients to whom endoscopic studies of the low digestive tract are carried out, and having a history of laxatives abuse. To avoid it, an adequate hygiene-epidemiologic regime, rich-in-fibers food consumption, systemic physical training and the proscription of anthraquinone-derived laxatives are need. It is very importance for the gastroenterologists to be conscious of the existence of this entity, although its clinical importance is not elucidated yet.