Management of Vipadika through Shodhana and Shamana: A Case Study

Abstract

Kustha is a comprehensive term in Ayurveda that encompasses a wide spectrum of skin disorders. Among these, Vipadika is categorized under Kshudra Kushta and is primarily characterized by Pani-Pada Sphutana (cracks and fissures in palms and soles) along with Teevra Vedana (severe pain). Based on its clinical presentation, Vipadika can be correlated with palmar-plantar psoriasis in modern dermatology, a chronic and often relapsing condition affecting the palms and soles. This disorder significantly impacts the patient’s quality of life due to persistent symptoms such as dryness, scaling, discoloration, itching, burning sensation, and painful fissuring. Contributing factors include unhealthy dietary habits, irregular lifestyle, and psychological stress, which lead to the vitiation of Vata, Kapha, and Pitta/Rakta doshas. This case report presents a patient suffering from discoloration, itching, continuous pain, burning sensation, and deep cracks over both hands and feet for the past eight years. The patient was managed through a classical Ayurvedic treatment approach involving Shodhana and Shamana therapies. Virechana (therapeutic purgation) was administered as a primary purification procedure to eliminate vitiated doshas, particularly Pitta and Rakta. This was followed by internal medications (Shamana Aushadhi) to pacify residual doshic imbalance and improve skin health. Additionally, Raktamokshana using Jalouka (leech therapy) was performed to further purify the blood and reduce inflammation at the local level. The combined therapeutic approach resulted in significant improvement in symptoms, including reduction in fissures, pain, itching, and burning sensation, along with visible healing of the affected areas. This case highlights the effectiveness of Ayurvedic management in chronic skin conditions like Vipadika, not only by alleviating symptoms but also by addressing the root cause and preventing recurrence through systemic detoxification and dosha balance.