Introduction

In Ayurveda, all skin diseases described under a single heading “Kushtha”. Acharya Sushrutha described palmoplantar psoriasis under padadari.^[1] Acharya Charaka had described that all Kushthas are Tridoshaja in nature.^[2] Acharya Charaka described palmoplantar psoriasis under Vipadika.^[3] Palmo plantar psoriasis is a disease mentioned in Ayurveda but to a certain extent based on its symptoms, it can be correlated with Vipadika which is one type of Kshudrakushtha. It involved predominantly Vata and Kapha Dosha and is characterized by Pani-Pada Sphutana (fissure in palm and soles) Kandu (itching) and Teevra Vedana (severe pain).^[4]

Vipadika is corelated with palmo planter psoriasis. Palmo plantar psoriasis is a widespread, non-contagious, chronic inflammatory proliferative skin disease that is mostly caused by environmental factors, with genetic predisposition being a major contributing factor.^[5] Psoriasis is a long-term inflammatory and immune-mediated condition that negatively affects a patient's standard of living. The incidence of psoriasis in India ranges from 0.44 to 2.8%.^[6] The second most frequent kind of psoriasis is palmoplantar psoriasis.^[7] The most affected areas are the palms and soles, which can significantly impair social and functional abilities and interfere with day-to-day activities.^[8]

Case Report

A 61 year old female patient visited skin OPD of Sri Dharmasthala Manjunatheshwara Ayurveda Medical Hospital, Hassan with the complaints of cracks over planter aspect of lateral foot associated with itching, burning sensation and powdery discharge in the last 4 years which was disturbed her daily activities. she approached nearby hospital however she didn’t get relief and the symptoms recurred frequently. So, she approached our hospital for better management. No history of prolonged illness no surgical history.

Clinical Findings

On the day of general examination, the patient was of normal built without any pathological presen-tation. On local examination there were cracks over planter aspect of lateral foot associated with itching, burning sensation and powdery discharge.

Before Treatment

After Treatment: after second follow-up

Discussion

Shamana Chikitsa is being opted in this case as a line of treatment. Considering the potent action of Panchatikta Gritha for its Tridoshahara and Kanduhara properties it has been opted for Shamana Chikista. Mahamanjistadi Kwatha is particularly effective in helping to maintain Pitta vitiation it also helps to balance Vata and Kapha Dosha.^[9] Local application of Gandhaka Malahara is highly effective in treating chronic cases of Vipadika.^[10] L.S Vati is Pitta Shamaka and helps in reducing Kandu. Chakramarda Taila is a proprietary medicine indicated in skin diseases ingredients of these are known for their Kandugna, Kushtagna and Dadrugna effect.^[11]

Conclusion

Vaipadika is explained in context of Kshudra Kushta which is having a close resemblance with Palmo Plantar Psoriasis. Such a disease can be effectively managed through Shamana. After treatment there was much reduction in signs and symptoms of Vaipadika like cracks, itching, burning sensation and powdery discharge which were presented on bilateral soles of foot. From current case study, we can draw a conclusion that Vaipadika Kustha can be successfully treated and managed through Ayurvedic line of treatment. No adverse reactions were observed during course of treatment and later patient was advised to follow proper Ahara and Vihara to avoid recurrences of disease.