Ayurveda management of Touraine–Solente–Gole syndrome: A clinical experience

Touraine–Solente–Gole syndrome, also known as pachydermoperiostosis (PDP) or primary osteoarthropathy, is a rare genetic disorder characterized by a distinctive triad: pachydermia (skin thickening), digital clubbing, and periostosis (excessive bone formation) of long bones. However, its rarity and clinical similarities with acromegaly make diagnosis challenging. In the presented case report, a 23-year-old male patient presented with a complex five-year history of bilateral ankle and knee joint swelling, enlarged hands and feet, excessive sweating, and distinctive facial skin and eyelid changes. Despite previous evaluations, a clear diagnosis was not established, prompting further investigation. The initial goal was to diagnose and provide symptomatic pain relief. Following a comprehensive diagnostic workup, the patient was diagnosed with PDP. Given the limited Ayurveda understanding of PDP, but noting similarities with Amavata (~rheumatism due to Ama), an Ayurveda approach was adopted, drawing on fundamental principles for management. The patient received Apatarpana chikitsa (~depleting therapy), including Agni chikitsa alepa (~therapeutic application of paste to stimulate digestive/metabolic factors), Dhanyamladhara (~therapeutic streaming of sour rice gruel over body), and Dashamoola parisheka (~therapeutic streaming) along with Shamana (~palliative) drugs. On discharge, the patient experienced significant symptomatic relief, with reduced swelling, pain, and sweating. This case provides valuable insights into the pathogenesis and management of PDP, aligning with Ayurveda principles and highlighting the benefits of integrating Ayurveda approaches into modern medical practice.