Management of Vipadika through Ayurveda: A case analysis

All skin diseases in Ayurveda have been considered under Kushtha roga (~integumentary disease). Vipadika is one of the Kshudra kushtha (~minor integumentary disease) characterized by Pani - pada sphutana (~cracks in hands and feet), Tivra vedana (~severe pain) and can be correlated with Palmoplantar psoriasis based on signs and symptoms, such as cracks in hands and feet along with well-defined indurated plaques. Palmoplantar psoriasis accounts for 3%–4% of all psoriasis cases, and it is the second most common type of Psoriasis, followed by Chronic plaque-type psoriasis. There is no definite treatment available in modern medicine for Palmoplantar psoriasis. However, Ayurveda advocates its treatment based on three major triads of management, i.e., Shodhana chikitsa (~purificatory therapy), Shamana chikitsa (~palliative therapy), and Nidana parivarjana (~avoidance of etiological factors). In the present case report, a 46-year-old female patient visited the outpatient department with complaints of blackish discoloration, dryness, itching, and cracking of the bilateral soles and palms, associated with bleeding on scratching and intense pain for one year. On the basis of the presented signs and symptoms, she was diagnosed with Vipadika and managed with Shamana chikitsa and Nitya virechana (~therapeutic purgation on daily basis). Further, the Psoriasis Area and Severity Index score reduced to 3.0 from 14.4, along with significant reduction and healing of psoriatic lesions, and associated signs and symptoms after 30 days of continuous treatment, with no recurrence after 15 days of follow-up. Since, Vipadika impacts the social and personal lives of the patients, thus, Ayurvedic therapeutic approach may emerge as a promising solution for effective cure of such patients, with long-term benefits and no recurrence.