Significance of Ayurvedic Shodhana Therapy in the Management of Palmoplantar Psoriasis (Vipadika): A Case Report

Abstract

Background: Palmoplantar psoriasis is a chronic, non-contagious, inflammatory skin disorder that primarily affects the palms and soles. Despite advances in biologic therapies, its management remains challenging. The condition leads to considerable discomfort and disability, limiting a patient’s ability to perform daily tasks and occupational duties. Owing to its complex, multifactorial etiology, effective management usually requires a comprehensive, multimodal treatment strategy. In Ayurveda, its clinical presentation closely resembles Vipadika, a condition marked by Paani-Paada Sphutana (cracking of the palms and soles) accompanied by Teevra Vedana (severe pain). Findings: A 6-year-old boy presented with a 1-year history of patchy, dry, scaly, itchy, and bleeding lesions on bilateral palms and soles, diagnosed as Palmoplantar Psoriasis, and was successfully managed with Ayurveda. Intervention: Shamana Chikitsa (Pacification therapy) according to the Avastha (clinical presentation) of the patient for 11 months, followed by Shodhana (Bio purification), that is Vamana (Therapeutic emesis). Results: The patient reported significant improvement in complaints and Palmoplantar Psoriasis Global Assessment (PPPGA) score reduction from 4 to 1 after Shodhana (Bio-purification). The Dermatology Life Quality Index (DLQI) score improved from 25 to 2. Conclusion: Shamana (Pacification), along with Shodhana (Bio-purification), proved to give more efficient results in terms of reduced interventional duration, rather than Shamana alone in this case. Treatment was well tolerated, and no adverse drug reaction was reported during the entire course. Ayurveda showed great results in clearing the lesions without any complications and without the use of topical or systemic steroids during the whole course of treatment.