INTEGRATED AYURVEDIC APPROACH IN THE TREATMENT OF VIPADIKA (KSHUDRA KUSHTHA) - A CASE REPORT

Dr. Twinkle Sharma*, Dr. Dipsinh B. Chavda, Dr. Prashant Ramachandra Madane

Vipadika is a distinct clinical entity classified under Kshudra Kustha in Ayurveda, characterized predominantly by Vata-Kapha vitiation with underlying Rakta and Mamsa dhatu involvement. Clinically correlated with Palmoplantar Psoriasis or severe hyperkeratotic eczema, it manifests as extreme dryness (Rukshata), scaling, painful fissures (Pani-Pada Sphutana), and persistent itching. Chronic, deep-seated presentations require intensive bio-purificatory interventions to clear the cellular toxins (Dushita Doshas) and restore epidermal integrity Ayurveda emphasizes a holistic management approach through internal medications virechana and Siravedhana therapy. Methods: This case report outlines the management of a 47-year-old female patient who presented with a 7-year history of severe generalized body dryness and distressing itching, heavily localized in both the palmar and plantar regions. The patient exhibited thick hyperkeratosis, painful cracks, and scaling on her palms and soles, which severely restricted her daily manual activities and compromised her overall quality of life. The patient was managed through a combined Panchakarma and Shalya Tantra approach. Systemic detoxification was achieved via Virechana Karma (therapeutic purgation) to alleviate the Dosha burden and cleanse the Srotas (channels). This was followed by targeted local bloodletting via Siravedhana (therapeutic venesection) at the affected extremities to drain localized Rakta dusti (vitiated blood). The bio-purificatory therapy was paired with a structured course of internal and topical Shamana (palliative) Ayurvedic formulations to facilitate skin tissue healing. Results: Following the Ayurvedic intervention, patient showed marked clinical improvement. The patient reported complete relief from itching, pain, burning sensation, and bleeding, with significant reduction in dryness. Objectively, there was complete healing of fissures, absence of scaling and redness, and restoration of normal skin texture over the palms and soles. No adverse effects were observed during the course of treatment, and the patient expressed overall satisfaction with the outcome and improvement in quality of life. Discussion: The Ayurvedic treatment provided significant and sustained relief in both subjective and objective symptoms, including dryness, itching, pain, fissures, scaling, and redness, leading to improved skin texture and quality of life. Early improvement after Siravedhana and sustained benefits following Virechana and Shamana therapy indicate that the response was mainly due to the Ayurvedic intervention confirming the therapy).