An Evidence-Based Ayurvedic Management of Palmoplantar Psoriasis (Vipadika): A Case Report

Introduction: Palmoplantar psoriasis is a chronic, non-infectious inflammatory skin disorder characterized by well-defined erythematous plaques, scaling, fissuring, and pruritus over the palms and soles, which significantly affect the patient’s quality of life. In Ayurveda, based on the similarity of clinical manifestations, it can be correlated with Vipadika (palmoplantar psoriasis), a type of Kshudra Kushta described under Kushta Roga. This case report aims to evaluate the effect of Jalaukavacharana (Leech therapy) along with Ayurvedic internal and external therapies in the management of palmoplantar psoriasis. Case Presentation and Intervention: A 55-year-old male patient presented with a 6-month history of itching, erythematous scaly lesions, and fissuring over right palm and was diagnosed with palmoplantar psoriasis (Vipadika). The patient was managed with Ayurvedic internal medications, external application of Gandhak malahar and three sittings of Jalaukavacharana (leech therapy). Results: Marked improvement was observed in symptoms such as itching, erythema, scaling, and fissuring of the palms within Four weeks of treatment. The intervention was well tolerated, and no adverse effects were observed during the treatment period Conclusion: The present case suggests that Jalaukavacharana as a form of Raktamokshana, along with appropriate internal and external Ayurvedic therapies, may be beneficial in the symptomatic management of palmoplantar psoriasis (Vipadika). Further clinical studies with larger sample sizes are required to establish its efficacy