History of the present and past illness of the patient
Six years ago, one fine day, the patient felt mild dilatation of veins
in the right lower limb, followed by severe pain present while walking.
The pain began gradually and intensified over time. She suffered from
dragging-type pain that became worse when she stood for a long period
and went away when she lay down. In the beginning, she consulted at St.
Thomas Hospital, Chethipuzha, Changanassery, Kerala, where she was
diagnosed with varicose veins and suggested following the treatment. So,
she underwent allopathic treatment with internal medication and external
treatment like sclerotherapy three times (6/01/18, 15/9/18, and 12/9/19)
and got a mild recovery. Then, after doing heavy work, the dilatation of
veins progressed well, leading to the development of an ulcer in the
medial malleolus of the right lower limb with mild oozing, redness, and
swelling. It started slowly and developed over time. It was modest
initially and got bigger over time. Trauma has never occurred in the
past. There was pain around the ulcer and discharge which was
sero-purulent in nature, scanty in amount, and not foul-smelling from
the ulcer. There was hyperpigmentation of the skin around the ulcer.
There was no associated fever or any other significant findings. As the
days passed, she felt more pain, and itching and the ulcer was spreading
and it was aggravated over the last 3 months. Then, she approached the
Outpatient Department of Santhigiri Siddha Medical College and Hospital,
Trivandrum, Kerala, at her friend’s suggestion. After a proper
interrogation of her and a proper evaluation of the state of the
patient, she was admitted to the IPD. All the personal history and
general examination of the patient were observed and noted. Local
examinations of ulcers in the skin and assessment for varicose veins
were observed and noted in Table 1. Assessment criteria for varicose
ulcers were evaluated by the VCS Score before treatment and noted in
Table 2. After evaluating the Siddha aspects, the results were examined
and recorded in Table 3.