Role of Vamana and Padhabhayanga in the Management of Vipakdika With special reference to Plantopalmar Psoriasis

Ayurveda described various skin diseases under the single heading Kushta. In Charaka Samhita, Acharya Charaka explained Ashtadasha Kushtas in two main categories namely ‘Maha Kushta’ and ‘Kshudra Kushta’. Kushta is tridoshaja vyadi, however, the symptoms appear according to the dosha predominance. Vipadika is one of the Kshudra Kushta with predominance of vata kapha doshas and it is charactrised by Pani Pada sputana (fissures in palms and soles) and Teevra vedana (severe pain). According to clinical manifestations, Vipadika is more similar to ‘Planto Palmar Psoriasis’ which is long lasting Auto Immune disease. It is found to be 3-4% of all Psoriasis cases. In modern science, many treatment modalities are available to treat the disease. They may cause many side effects and recurrence after subside is also very common which gave a big scope to alternative system of medicines to treat Vipadika. In the present case study, the line of management followed was mentioned by Acharya Charaka, according to dosha Predominance. The patient, initially administered sneha pana with Maha Tiktaka gritha for 7 days which was beneficial to pacify pitta dosha and kapha dosha utkleshana before Vamana. Later on, Vamana therapy was conducted to eliminate kapha dosha which gave good symptomatic relief to the patient. However, in view of the severity, chronicity and recurrence of the disease, Mridu Lavana jala Avagaha Sweda followed by Padhabyanga with pinda taila was also performed which resulted in excellent improvement in very short period of time.