Effect of Shodhan Chikitsa (Virechan and Raktamokshana) in Vipadika With Special Reference to Palmoplantar Psoriasis

Background: Palmoplantar Psoriasis (PPP), a chronic inflammatory skin disorder impacting daily functionality, correlates closely with Vipadika (Vata-Kapha dominant Kshudra Kushta) in Ayurveda, characterized by painful cracks on the palms and soles. Case Description: A 36-year-old female presented with severe dryness, scaling, itching, and deep, bleeding cracks on both palms for four months. The condition was diagnosed as Vipadika resulting from Dosha vitiation and dietary triggers. Intervention: The patient underwent a 16-day Ayurvedic protocol combining Shodhana (purification) and Shamana (palliative) therapies. Treatment included Amapachana, Snehapana with Mahatiktaka Ghrita, Virechana (purgation) via Trivruttavleha, and two sessions of Raktamokshana (bloodletting), supplemented by external applications. Results: The integrated therapy led to a significant reduction in symptoms. By the end of a 15-day follow-up period, scaling, pain, itching, and bleeding fissures were successfully resolved. Conclusion: This case demonstrates that Vipadika (Palmoplantar Psoriasis) can be effectively managed without side effects through a structured Ayurvedic approach utilizing Virechana, Raktamokshana, and targeted internal medications.