Therapeutic interventions and clinical efficacy in Ayurvedic management of Vipadika (Palmoplantar Psoriasis): A Case Report

Abstract

Vipadika, a skin disorder mentioned in Ayurvedic literature as Kshudra Kustha attributed to Vata and Kapha Dosha imbalance, is analogous to palmoplantar psoriasis in contemporary science. It is a non-infectious chronic inflammatory disease of the skin bound to the palm and sole. It is characterized by pain, itching, and fissures in both soles. Contemporary treatment options often lead to temporary relief with frequent recurrence, leading patients to seek alternative therapies. The present case report aims to assess the therapeutic efficacy of Ayurvedic management in treating Vipadika. A 58-year-old female presented with pruritus, fissures in both sole and severe pain with oozing of bleeding from fissures across both soles; diagnosed as Vipadika. The treatment approach exclusively involved Shamana Chikitsa, including the oral administration of Panchatikta Ghrita, Gandhaka Rasayana, and Avipattikara Churna. Topical care was provided by washing the affected area with Panchavalkala Kwatha mixed with Shuddha Tankana for debridement. After washing, the patient was advised to use a foot scrubber for scrubbing the dead skin around the fissures followed by Jatyadi Malam for topical use. The patient's response was assessed over ten weeks, with follow-up for four weeks to determine using symptom improvement, patient-reported outcomes, and Auspitz sign. This case demonstrates the potential of Ayurvedic therapies for the effective management of Vipadika, suggesting a viable alternative to conventional treatment approaches.