An Open Labelled Comparative Clinical Study to Evaluate the Effect of Tilakusumadi and Sarjarasadi lepa with Manibhadra guda in the management of vipadika with special reference to Palmo-plantar psoriasis.

All the skin diseases in  Ayurveda have been considered under the heading kushta which is one among the Ashta Mahagada.  Vipadika is one of  the  kshudra kushta .It is a Vatakapha pradhan Tridoshaja Twakvikara.It is characterized by Pani pada sphutana, Tivra  vedana,Manda kandu, Saraaga pitika.Acharya Susruta has also explained similarly with one more symptoms Daha.

Due to Nidana Sevana,the thridoshas are vitiated  and cause vitiation of Twak , Rakta, Mamsa and Ambu end up in manifestation of kushta. Based on the similar clinical features,Vipadika Kushta can be compared with Palmoplantar Psoriasis.

 Prevalence rate of Palmoplantar variant of psoriasis comprises 3% to 4% of all cases of Psoriasis, which affects 2% to 5% of the population. Palmoplantar psoriasis is a chronic variant of psoriasis that characteristically affects the skin of the palms and soles and produces significant functional disability. It features hyperkeratotic,pustular.

Palmoplantar psoriasis is considered to be caused by a combination of genetic and environmental factors.

Modern medicine treatment modalities includes oral retinoids with or without photochemotherapy, corticosteroids and cyclosporine these may be helpful in symptomatic management of disease and symptoms may reoccur by triggering factors and these medicine are having its own side effects in long term use so there is need to find safe and effective medicine in the management of vipadika.

 In classics Shodhan, Shamana, Bahirparimarjan Chikitsa are explained.Lepa are applied against the hair follicular direction to facilitate quicker and better absorption .Tilakusumadi lepa mentioned in Bhaishajya Ratnavali is indicated in Vipadika. having ingredients like Tila  pushpa, Saindhava lavana,Gomutra,Katu tail mainly having Tikta, Kashya rasa, Laghu, Ruksha guna act as  Kushtahara, Shodhan,Ropana , Vatakaphahara,Twachya.

 Sarjarasadi lepa mentioned in Bhaishajya Ratnavli is indicated in Vipadika having ingredients like Sarja rasa, Saindhava lavana, Guda, Madhu, Guggulu,Gairika churna,

Go ghrita,Sikta having Tikta, Kashaya rasa and Laghu, Ruksha,Snigdha guna and  act as   Kushtaghan,Tridoshahara, Shodhan,Ropana,Twachya.

Manibhadra Guda mentioned in Ashtanga Hrudaya is indicated in Kushta.Having ingredients like Vidanga,Amalaki,Abhaya,Trivruta,Guda, mainly having Tikta,Kashaya rasa and Laghu,Ruksha guna and act as Kushtaghna Anulomak,Virechak,Rasayana property.

Hence present study will be aimed to evalute and compare the effect of Tilakusumadi  and Sarjarasadi  lepawithManibhadra Gudain Vipadiak with special reference toPalmo-plantar psoriasis.