Assessment of Efficacy of Virechanottara Pathyadi Pandi and Pathyadi lepa Over Narayana Rasa And Sikthadi lepa in the Management of Vipadika Kushta(Palmoplantar Psoriasis)-An Open Labelled Comparative RCT Study

Vipadika is kshudra kushta, vata and kapha dosha are predominant doshas involved with symptoms like pani pada sphutana(cracks in palms and soles), teevra vedana(severe pain), saragapidika(red patches) over palm and soles.Kandu(itching), daha(burning sensation), ruja(pain) specially over pada.

The symptoms of vipadika are similar to palmoplantar psoriasis, which is long lasting auto immune disease characterised by scaly erythematous plaques on palms and soles accompanied with scaling and keratinization,causing social isolation, cosmetic and psychological embarrassment as well as difficulties in leading social life. The palmoplantar variant of psoriasis comprises 3%-4% of all cases of psoriasis, which affects 2%-5% of population. People may experience exacerbations brought on by social changes, household work and detergents.Infact, palmoplantar psoriasis is more common amongst former, manual labourers and housewives.

The treatment in modern dermatology is not satisfactory with more chances of recurrence. Immunomodulators like thalimide, lenaliomide and topicals are usually preferred. These drugs can cause side effects such as drowsiness, low blood cell counts, neuropathy and also increased risk of serious blood clots.

Kushta is considered as rakta pradoshaja vikara, virechana followed by shaman rasayana aushadhi and lepa containing kushtahara dravyas plays vital role in the treatment of kushta. Virechana with triphaladi yoga, which is specially mentioned in kushta chikitsa having ingredients like trivrut churna and dantimula churna acts as rechana. Pathyadi pindi rasayana contains pathya, tila, guda and bhallataka which are kushtagna, kandughna and vishahara dravyas. Pathyadi lepa and Sikthadi lepa acts locally over the lesion redusing its itching and cracks penetrating deep into the skin. Narayana rasa contains shuddha parada, shuddha gandhaka, tamra bhasma,chavya, gajapippali it acts like vruna ropana,sputana hara and kadughna.