PLAMO PLANTER PSORIASIS TREATED WITH AYURVEDA

case study

1. MAHATMA GANDHI AYURVED COLLEGE HOSPITAL AND RESEARCH CENTRE SALOD (H) WARDHA DEPARTMENT OF KAYCHIKITSA TITLE : Management Of PalmoPlanter Psoriasis(VIPADIKA) Through Ayurveda: A Case Study PRESENTER Dr Yogesh Jakhotiya

2. INTRODUCTION Palmoplantar psoriasis is a chronic, recurring condition that affects the palms and soles 1 . There is hyperkeratosis , fissures, and erythema , and occasionally inflammation and pustules. symptoms may seriously interfere with the patient’s quality of life and may be disabling 2 . There is very limited treatment in modern medicine such as topical steroids and some symptomatic drugs like methotrexate .

3. Palmoplantar psoriasis can be correlated with Vipadika . It is included in Ksudrakushtha with Vata - Kaphaja Dosha involvement. I t is characterized by Pani-Padasphutna (fissure in palms and soles) and Tivravedana (with severe pain) 3 . The treatment which is given in Ayurveda is Shamana and Shodhana 4 .

4. CASE REPORT Patient name : ABC OPD NO : 1608030014 Address : Pulgaon , Wardha Age : 19 years Sex : Male Occupation : student

5. Chief complaints - Fissures & scaling on the soles and palms - Itching of bilateral soles and palms 2 Yrs - Mild pain with discharge .

6. H/O PAST ILLNESS : Not significant FAMILY HISTORY : Not significant PERSONAL HISTORY : Not significant DIET : Mixed diet NIDRA : Samyak (6-8 hours )

7. ASHTAVIDH PARIKSHA Nadi : 76/ min,regular , Vatapradhan pittaj Mala : Niram Mutra : 4 to 6 times/ day Jivha : Niram Shabda : spashta Sparsha : Anushnashita Drika : No Pallor , No icterus Aakruti : Madhyam

8. DASHVIDH PARIKSHA Prakruti : Vatapradhan pitta Vikruti : DOSHA- Vatapradhan kapha , DUSHYA- twacha , rakta,mamsa , lasika Sara : Madhyam Sahnana : Madhyam P ramana : Madhyam Satmya : No allergy to any food & drug Satva : Madhyam Aaharshakti : Madhyam Vyayamashakti : Madhyam Vaya : Taruna

9. VITAL PARAMETERS Temprature : Normal Pulse : 76/min B.P : 120/80 mm/hg R.R : 18/ min

10. SYSTEMIC EXAMINATION RS : AE = BS CVS : S1 S2 audible , no any abnormal sound P/A : Soft non tender , no any oraganomegaly

11. SKIN EXAMINATION Multiple fissures with scales and erythema with mild discharge and blackish color are seen on both palm and soles . No local tenderness

12. Before t/t

13. TREATMENT GIVEN FOR TWO MONTHS ABHYANTARA CHIKITSA Sr.No DRUG DOSE ANUPAN DURATION 1 Arogyavardhini vati 250mg BD water First15 days 2 Gandhak rasayan 250mg BD water First 15 days 3 Chopchini churna 3gm BD water First15 days 4 Haritaki churna 5gm HS Warm water First1 month 5 Panchatiktaghruta 10ml BD Warm water First 1 month 6 Yashad bhasma Rasamanikya Guduchi churna 250mg 50mg BD 6gm Water last15 days 7 Cap Neem 250mg BD Water last1 month 8 Mahamanjishtha quath 20ml BD water 2 month

14. BAHYA CHIKITSA SR NO DRUG USE DURATION 1 Triphala quath Dhavan First 15 days 2 Karanja tail Local application First1 month 3 Jatyadi ghruta Local application last1 month 4 Neem tail Local application last1 month

15. RESULTS SR. NO LAKSHANA(SIGN & SYMPTOMS) B.T A.T 1 Scaling of skin ++ -- 2 Erythematous ++ -- 3 Fissure(B/L U.L & L.L) +++ --- 5 Itching +++ +

16. Before t/t

17. After t/t

18. DISCUSSION Panchatikta ghruta is described as best for all types of kushtha roga and it also pacifies vata which is main cause of fissures and pain 5 . Arogyavardhani is indicated in kustha roga 6 . Gandhak rasayan is having antifungal and antimicrobial activity so it is chosen to avoid any secondary infection 7 . Mahamanjishtha qutha is given in kustha chikitsa in vrindamadhav as its is raktashodhak , kaphghna and kushtha nashak 8 .

19. Haritaki churna is given for koshtha shudhi Yashad bhasma contains zinc which promotes healing 9 . Rasamanikya is said to be antimicrobial in one study in text it is indicated in kustha as its active ingredient is haratala 10. Neem tail , karanja tail and jati ghruta are used for local application Neem is kandughna , jati has kusthaghna , vrnashodhan , vrnaroopan and karanja has jantughna , kandughna , vrnaroopan , vedanasthapan 11 12 13.

20. CONCLUSION From the above case it can be concluded that palmo planter psoriasis i.e Vipadika can be successfully managed with Ayurvedic intervention . Treatment according to dosha dushya can be taken into consideration can gives positive results in vipadika .

21. REFRENCES Pettey AA, Balkrishnan R, Rapp SR, Fleischer AB, Feldman SR. Patients with palmoplantar psoriasis have more physical disability and discomfort than patients with other forms of psoriasis: implications for clinical practice. J Am Acad Dermatol . 2003;49:271---5. Neeta Khanna , Trilok Raj Tejasvi , 2012: Step by Step Psoriasis Management . First Edition. Jaypee Brothers Medical Publishers, New Delhi. Acharya Charaka , Charak Samhita , Ayurveda Dipika commentary by Shree Chakra Panidatta , Edited by Vaidya Yadavji Trikamji Acharya , Chaukhamba Surbharti Prakasan , Varanasi, Re-printed 2013, Chikitsha chap. 7/22, 29, 451. Acharya charaka , Charak samhita , Ayurveda Dipika commentary by Shree Chakra Panidatta , edited by Vaidya Yadavji Trikamji Acharya , Chaukhamba Surbharti Prakasan , Varanasi, Re-print: 2013, Chikitsa chap. 1/3, 377.

22. 5.Vrndamadhav ,Dr Premvati Tivari chapter 51 kushthadhikar verse no 113-116. 6. Rs.rtn.sam.kushtha . chi. 20/108-114. 7. International Journal of Recent Trends in Science And Technology, ISSN 2277-2812 E-ISSN 2249-8109, Volume 8, Issue 2, 2013 pp 134-137 8.Vrndamadhav ,Dr Premvati Tivari chapter 51 kushthadhikar verse no 208-212. 9.Ayurveda sara aangraha , Shri Baidynath Ayurveda, 18 th edition 1996;243-244 10.Shalini T.V et al / IJRAP ,2011,2(5) 1455-1456. 11.Sharma PV. Dravyagunavijanana ,second part , chaukhamba bharti academy Varanasi repriented ; 2003 12.Chunekar KC and Sahay Gangaprasad , Bhavprakash nighantu , Hindi commentry , chukhamba bharti academy varanasi , reprint 2004. 13.Mishra Bramashankar and Ruoalal JI Vaisya , Bhavprakash – vaidyotini Hindi commentry . chukhamba sanskrit bhavan Varanasi, edition ;2012

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