case study

1. MAHATMA GANDHI AYURVED COLLEGE HOSPITAL AND
RESEARCH CENTRE
SALOD (H) WARDHA
DEPARTMENT OF KAYCHIKITSA
TITLE :MANAGEMENT OF PALMOPLANTER
PSORIASIS(VIPADIKA) THROUGH
AYURVEDA: A CASE STUDY
PRESENTER
Dr Yogesh Jakhotiya

2. INTRODUCTION
 Palmoplantar psoriasis is a chronic, recurring
condition that affects the palms and soles 1.
 There is hyperkeratosis, fissures, and erythema, and
occasionally inflammation and pustules.
 symptoms may seriously interfere with the patient’s
quality of life and may be disabling 2.
 There is very limited treatment in modern medicine
such as topical steroids and some symptomatic drugs
like methotrexate .

3.  Palmoplantar psoriasis can be correlated with
Vipadika.
 It is included in Ksudrakushtha with Vata-Kaphaja
Dosha involvement.
 It is characterized by Pani-Padasphutna (fissure in
palms and soles) and Tivravedana (with severe pain)3.
 The treatment which is given in Ayurveda is Shamana
and Shodhana4.

4. CASE REPORT
 Patient name : ABC
 OPD NO : 1608030014
 Address : Pulgaon, Wardha
 Age : 19 years
 Sex : Male
 Occupation : student

5. Chief complaints
- Fissures & scaling on the soles and palms
- Itching of bilateral soles and palms 2 Yrs
- Mild pain with discharge .

6.  H/O PAST ILLNESS : Not significant
 FAMILY HISTORY : Not significant
 PERSONAL HISTORY : Not significant
 DIET : Mixed diet
 NIDRA : Samyak (6-8 hours )

7. ASHTAVIDH PARIKSHA
 Nadi : 76/min,regular, Vatapradhan pittaj
 Mala : Niram
 Mutra : 4 to 6 times/ day
 Jivha : Niram
 Shabda : spashta
 Sparsha : Anushnashita
 Drika : No Pallor , No icterus
 Aakruti : Madhyam

8. DASHVIDH PARIKSHA
 Prakruti : Vatapradhan pitta
 Vikruti : DOSHA- Vatapradhan kapha ,
DUSHYA-twacha ,rakta,mamsa ,lasika
 Sara : Madhyam
 Sahnana : Madhyam
 Pramana : Madhyam
 Satmya : No allergy to any food & drug
 Satva : Madhyam
 Aaharshakti : Madhyam
 Vyayamashakti : Madhyam
 Vaya : Taruna

9. VITAL PARAMETERS
 Temprature : Normal
 Pulse : 76/min
 B.P : 120/80 mm/hg
 R.R : 18/ min

10. SYSTEMIC EXAMINATION
 RS : AE = BS
 CVS : S1 S2 audible , no any abnormal sound
 P/A : Soft non tender , no any oraganomegaly

11. SKIN EXAMINATION
 Multiple fissures with scales and erythema with
mild discharge and blackish color are seen on
both palm and soles .
 No local tenderness

12. Before t/t

13. TREATMENT GIVEN FOR TWO MONTHS
ABHYANTARA CHIKITSA
Sr.No DRUG DOSE ANUPAN DURATION
1 Arogyavardhini vati 250mg BD water First15 days
2 Gandhak rasayan 250mg BD water First 15 days
3 Chopchini churna 3gm BD water First15 days
4 Haritaki churna 5gm HS Warm water First1 month
5 Panchatiktaghruta 10ml BD Warm water First 1 month
6 Yashad bhasma
Rasamanikya
Guduchi churna
250mg
50mg BD
6gm
Water last15 days
7 Cap Neem 250mg BD Water last1 month
8 Mahamanjishtha
quath
20ml BD water 2 month

14. BAHYA CHIKITSA
SR NO DRUG USE DURATION
1 Triphala quath Dhavan First 15 days
2 Karanja tail Local
application
First1 month
3 Jatyadi ghruta Local
application
last1 month
4 Neem tail Local
application
last1 month

15. RESULTS
SR. NO LAKSHANA(SIGN
& SYMPTOMS)
B.T A.T
1 Scaling of skin ++ --
2 Erythematous ++ --
3 Fissure(B/L U.L &
L.L)
+++ ---
5 Itching +++ +

16. Before t/t

17. After t/t

18. DISCUSSION
 Panchatikta ghruta is described as best for all types of kushtha roga
and it also pacifies vata which is main cause of fissures and pain 5.
 Arogyavardhani is indicated in kustha roga 6.
 Gandhak rasayan is having antifungal and antimicrobial activity so
it is chosen to avoid any secondary infection 7.
 Mahamanjishtha qutha is given in kustha chikitsa in vrindamadhav
as its is raktashodhak ,kaphghna and kushtha nashak 8.

19.  Haritaki churna is given for koshtha shudhi
 Yashad bhasma contains zinc which promotes healing 9 .
 Rasamanikya is said to be antimicrobial in one study in text it is
indicated in kustha as its active ingredient is haratala 10.
 Neem tail , karanja tail and jati ghruta are used for local application
 Neem is kandughna ,jati has kusthaghna , vrnashodhan ,vrnaroopan
and karanja has jantughna , kandughna , vrnaroopan ,vedanasthapan
11 12 13.

20. CONCLUSION
 From the above case it can be concluded that palmo planter
psoriasis i.e Vipadika can be successfully managed with
Ayurvedic intervention .
 Treatment according to dosha dushya can be taken into
consideration can gives positive results in vipadika .

21. REFRENCES
1. Pettey AA, Balkrishnan R, Rapp SR, Fleischer AB, Feldman SR. Patients
with palmoplantar psoriasis have more physical disability and discomfort
than patients with other forms of psoriasis: implications for clinical
practice. J Am Acad Dermatol. 2003;49:271---5.
2. Neeta Khanna, Trilok Raj Tejasvi, 2012: Step by Step Psoriasis
Management. First Edition. Jaypee Brothers Medical Publishers, New
Delhi.
3. Acharya Charaka, Charak Samhita, Ayurveda Dipika commentary by
Shree Chakra Panidatta, Edited by Vaidya Yadavji Trikamji Acharya,
Chaukhamba Surbharti Prakasan, Varanasi, Re-printed 2013, Chikitsha
chap. 7/22, 29, 451.
4. Acharya charaka, Charak samhita, Ayurveda Dipika commentary by
Shree Chakra Panidatta, edited by Vaidya Yadavji Trikamji Acharya,
Chaukhamba Surbharti Prakasan, Varanasi, Re-print: 2013, Chikitsa
chap. 1/3, 377.

22. 5.Vrndamadhav ,Dr Premvati Tivari chapter 51 kushthadhikar verse no 113-
116.
6. Rs.rtn.sam.kushtha .chi. 20/108-114.
7. International Journal of Recent Trends in Science And Technology, ISSN
2277-2812 E-ISSN 2249-8109, Volume 8, Issue 2, 2013 pp 134-137
8.Vrndamadhav ,Dr Premvati Tivari chapter 51 kushthadhikar verse no 208-
212.
9.Ayurveda sara aangraha, Shri Baidynath Ayurveda, 18th edition 1996;243-
244
10.Shalini T.V et al / IJRAP ,2011,2(5) 1455-1456.
11.Sharma PV. Dravyagunavijanana ,second part , chaukhamba bharti
academy Varanasi repriented; 2003
12.Chunekar KC and Sahay Gangaprasad , Bhavprakash nighantu , Hindi
commentry ,chukhamba bharti academy varanasi, reprint 2004.
13.Mishra Bramashankar and Ruoalal JI Vaisya , Bhavprakash –vaidyotini
Hindi commentry .chukhamba sanskrit bhavan Varanasi, edition ;2012