Reversing Cutaneous Microangiopathy in Diabetic Dermopathy as Prameha Vyadhi Upadrava Through Classical Ayurvedic Shodhana

Diabetic dermopathy is the most common cutaneous manifestation of type 2 diabetes and it is considered a clinical marker of underlying microangiopathy. It presents as asymptomatic, well demarcated, hyperpigmented macules over the pretibial region and it is frequently associated with long standing diabetes and poor glycemic control, in Ayurveda, it may understand as Prameha with predominant involvement of Rakta, Meda and Kleda. Case Report: A 49-Year-old male patient with history of Type 2 Diabetes since last 5 years presented with multiple reddish brown, round to oval macules over both shin bone for 2 years. The lesions were asymptomatic, without sensory changes. Fasting blood glucose at presentation was 160mg/dl. Based on clinical features and history, a diagnosis of diabetic dermopathy was made. Patient underwent Virechana Karma followed by Shamana medicine and four sittings of Jalokavacharana at weekly intervals. Gradually decreasing pigmentation and reduction in lesion prominence were observed during follow-up. No new lesions developed, and blood glucose levels showed betted control. Conclusion: The combined systemic and local Ayurvedic intervention were associated with clinical improvement in this case. This approach may be beneficial in managing diabetic dermopathy by addressing both metabolic and microvascular factors.