Introduction

Skin diseases is a major cause of low confidence due to cosmetic issue and it not only affects the mental health of a person but also has a great impact on his social life.

Skin diseases do not cause mortality but hampers the daily life activities. In Ayurveda, all the skin disorders have been mentioned under the topic “Kushtha”. Kushtha Roga is a broad topic which is further classified into Maha Kushtha and Kshudra Kushtha.^[1]

Vipadika

Vipadika is one of the Kshudra Kushtha which is characterized by “Panipada Sphutana” and “Teevra Vedana”.^[2] Symptoms of Vipadika as mentioned by various Acharyas are as follows:

The causative factors^[6] leading to Vipadika Roga include Viruddha Ahara, Atidrava Ahara, Ati-Snigdha Ahara, Guru Ahara, Vegadharana, Asatmya Ahara, Papa Karma, Mansika Bhava and exposure to adverse environmental conditions. These Nidanas aggravate the Tridosha leading to Agnimandya and further inducing Dhatu Shaithilya.

Among the Tridosha, Vata and Kapha Dosha are particularly susceptible to disturbance, infiltrating the Rasa-Raktadi Dhatus disrupting the circulation in the Tiryakgata Siras and settle in the Twaka thereby causing Vipadika Roga. According to Acharya Charaka, all types of Kushtha are Tridoshaja which vitiate the Twaka, Rakta, Mamsa, Lasika collectively causing Kushtha. Vipadika can be correlated with Palmoplantar Psoriasis on the basis of symptoms.

Palmoplantar Psoriasis

Palmoplantar psoriasis is a chronic type of psoriasis that characteristically affects the skin of the palms and soles and produces significant functional disability. It features hyperkeratotic, pustular, or mixed morphologies.

• Margins: Irregular
• Signs: Dryness, Scaling, Itching, Cracks, Bleeding

Nidana Panchaka

Nidana - Katu, Tikta Rasa Pradhana Ahara, Viruddha Ahara

Purvarupa - Kandu

Rupa - Cracking of skin on bilateral sole associated with dryness of skin, itching, pain and bleeding.

Upashaya - Sneha application

Samprapti

Nidana Sevana
↓
Agni Dushti
↓
Tridosha Vikruti along with Rasa, Rakta, Mamsa and Lasika Dushti
↓
Sanga and Vimargagamana of Dosha
↓
Sthanasamshraya in Pada and Hastha
↓
Vipadika

Treatment Given

External:

Yamaka Sneha: Jatyadi Taila + Jatyadi Ghrita for local application.

Internal:

Assessment Criteria

1) Sphutana (Cracks)

• Ghrita: Sheeta Guna, Vata and Pitta Dosha Shamaka, Daha Shamaka, Vranaropana.

2) Maha Tikta Ghrita^[8]: Mahatiktaka Ghrita useful in treating Amlapitta, Rakta Pitta, Vatarakta, Kushtha, Visarpa, Asragdara. In Kushtha Roga there is excessive accumulation of Tikta Rasa acts as Amapachaka and Kleda Soshaka. Mahatikta Ghrita contains drugs like Saptaparna which detoxifies and cleanses blood, Aragvadha is used for skin diseases and is a mild laxative, Patha is used for skin infections, Musta corrects digestion and metabolism, Usheera, Dhanvayasa and Shweta Chandan pacifies Pitta dosha, Triphala is best anti-oxidant combi-nation, Patola purifies blood and relieves itching, Nimba is a good anti inflammatory drug useful in allergic skin rashes and wound healing. Nimbidin, Curcuminoids have Broad spectrum Antibiotic action against both Gram Positive and Gram Negative Bacteria thus effectively healing Chronic Skin Ulcers, Diabetic Ulcers, and possess Anti-Viral property to manage Herpes infections. Nimbidin promotes wound healing activity through increased inflammatory response and neovascularization heals chronic skin ulcers and inflammatory skin lesions making it effective in various skin diseases such as furunculosis, seborrheic dermatitis.

3) Panchatikta Ghrita Guggulu^[9]: Panchatikta Ghrita Guggulu contains ingredients with Tikta Rasa, Laghu, and Ruksha Guna. Thus, it is effective in Kandu, Kleda Shoshana and Guggulu, which is characterized by its Katu, Tikta, Kashaya, Madhura Rasa, Ushna Veerya, and Katu Vipaka properties, effectively targets the Vikruta Kleda, Meda, and Mamsa Dhatu.

4) Arogyavardhini Vati ^[10]: According to Rasa Ratna Samucchaya, Arogyavardhini Vati acts Rasayana and Kushtha Nashaka, while also serving as a Pathya, Deepana, Pachana, Medonashaka, Mala-Shuddhikara and Sarva Roga Prasamana. Arogyavardhini Vati removes the Srotavrodha and helps in healing Vipadika by reducing the dryness and pain.

5) Nimbadi Churna^[11]: Nimbadi Churna contains ingredients such as Nimba, Khadira and Bakuchi that pacifies the Pitta and Kapha doshas by the action of Sheeta Virya and Katu Vipaka and these drugs also have Kandughna, Krimighna and Raktashodhaka Haritaki, Amalaki and Guduchi are Tridosha Shamaka, Kandughna, Krimighna, Anulomaka in action.