Management of Recurrent Nasal Vestibular Furunculosis by Jalaukāvacaraṇa and Palliative Treatment

Nasal vestibular furunculosis is a common bacterial skin infection among the general population mostly affecting adults and children. It is characterized by acute localized infection of hair follicle in the skin lining of the nasal vestibule caused by Staphylococcus aureus. Immunodeficiency also plays an important role in recurrent skin and soft tissue infections (SSTI) including Nasal furunculosis. Though, the lesion is small, it is extremely painful and tender. Treatment is mostly conservative which consists of warm compresses, analgesics to relieve pain, topical and systemic antibiotics directed against staphylococcus. With rapidly increasing resistance to antibacterial agents, management of these bacterial infections is becoming increasingly difficult. In Ayurveda, it can be correlated with Nāsāruṇaśikhā (Nasal furunculosis). Morphologically, it appears like pīḍikā (Furuncle) which is characterized by Rāgayuktaśotha (inflammation with reddening. Jalaukāvacaraṇa (Leech therapy) is one of the ancient and important parasurgical procedures described in Ayurveda for treatment of various diseases. In this case, a leech has been applied at the affected area. After leech treatment, throbbing pain was reduced in its intensity followed by gradual reduction in swelling and reddening in two days. This case suggests the utility of leech application in Nasal vestibular furunculosis.