Ayurvedic Management of Vipadika (Palmar Kshudra Kushtha) Presenting with Fissures and Burning Sensation on the Dorsum of the Palm: A Single Case Report
DOI:
https://doi.org/10.52482/ayurline.v10i5.1116Abstract
Vipadika is a Kshudra Kushtha (minor skin disorder) described in classical Ayurvedic texts, characterised by Pani-Pada Sphutana (fissuring of the palms and soles) and associated pain or burning. It shows close clinical resemblance to palmoplantar dermatoses such as chronic hand eczema/palmoplantar psoriasis in contemporary dermatology. This report presents the case of a 34-year-old female with a two-year history of fissuring and burning sensation over the dorsum and palmar aspect of the hand, aggravated by occupational glove use and repeated water contact, who had shown limited response to prior Ayurvedic and allopathic treatment. She was diagnosed as a case of Vipadika based on Ashtavidha Pariksha and treated with Rakta Prasadana (blood-purifying) internal medication, Shatavari (Asparagus racemosus), Lodhra (Symplocos racemosa) and Sariva (Hemidesmus indicus), Gokshuradi Guggulu, Dhanyaka Hima as Anupana, and local application of Shatadhauta Ghrita combined with Haridra and Aloe vera pulp, together with Nidana Parivarjana (avoidance of gloves and direct water contact). Over five follow-ups spanning approximately three months, the patient showed progressive improvement — burning reduced by the second visit, mild relief in fissuring by the third, approximately 80% symptomatic relief by the fourth visit, and further sustained improvement after the addition of Paripathadi Kadha, Asthi-Majja Pachaka Rasayana, and Rasayana Vati at the fifth visit. This case supports the utility of a Vata-Kapha-Rakta pacifying, Pitta-soothing Ayurvedic protocol combined with lifestyle modification in the management of Vipadika, and illustrates the importance of differentiating Vipadika from the closely related entity Vicharchika for accurate Ayurvedic diagnosis and treatment planning.
References
1. Agnivesha. Charaka Samhita. Edited by R. K. Sharma and Bhagwan Dash, Nidana Sthana, chapter 5, 2nd ed., Chowkhamba Sanskrit Series Office, 2014.
2. Sushruta. Sushruta Samhita. In: Sharma PV, editor. Nidana Sthana, Chapter 5, Verse 11. Varanasi: Chaukhambha Visvabharti; 2010.
3. Vagbhata. Ashtanga Hridaya. In: Murthy KR, editor. Nidana Sthana, Chapter 14, Verse 23. Varanasi: Chowkhamba Krishnadas Academy; 2012.
4. Madhavakara. Madhava Nidanam. In: Upadhyaya Y, editor. Kushtha Nidana, Chapter 49. Varanasi: Choukhamba Sanskrit Sansthan; 2009.
5. Maurya T, Dhall B, Goel N. Conceptual review of Vipadika w.s.r. to palmo-plantar psoriasis. Int J Ayush. [Internet]. Available from: https://internationaljournal.org.in/journal/index.php/ijayush/article/view/1956
6. Salunke A, Gogate VE. Management of Vipadika through Shodhana and Shamana: A case study. Int J Ind Med. 2026 Jan;7(3):199-207. doi:10.55552/IJIM.2026.70327.
7. Agnivesha. Charaka Samhita. In: Sharma RK, Dash B, editors. Chikitsa Sthana, Chapter 7, Verses 21-22, 29-30. 2nd ed. Varanasi: Chowkhamba Sanskrit Series Office; 2014.
8. Ayurvedic management of Vipadika - A case report. J Ayurveda Integr Med Sci [Internet]. 2024 Aug 8 [cited 2026 Aug 23];9. Available from: https://jaims.in/jaims/article/view/3743 [1]
9. Shivappa, Shreevathsa, Bharathi BH, Dileepkumar K. Conceptual review on Anukta in Ayurveda. J Ayurveda Hol Med. 2015;3(1):14–19
10. Agnivesha. Charaka Samhita. In: Sharma RK, Dash B, editors. Sutra Sthana, Chapter 7. 2nd ed. Varanasi: Chowkhamba Sanskrit Series Office; 2014.
11. Shastry R, Joshi P. Understanding skin disorders through the concept of Rakta Pradoshaja Vikara: a critical review. Int J Dermatol Res. 2024;16(15):112-119.
12. Mishra A, Deshpande V. Rakta Pachak Vati: a comprehensive review of its phytoconstituents, pharmacological properties, and therapeutic potential in metabolic and dermatological disorders. Int J Ayurvedic Herb Med. 2026;11(4):2221-2228. doi:10.47070/ijayush.v11i4.2221.
13. Ayurveda interventions: a clinical case evaluation. J Ayurveda Integr Med Sci. 2020;5(3):89-94. doi:10.21760/jaims.v5i3.949.
14. Dwivedi S, Tiwari R. Safety and efficacy of Charakokta Raktapachak Yoga in the management of chronic urticaria (Kotha) and associated inflammatory skin conditions: a randomized controlled trial. Pharma Res J India. 2024;12(2):67-74.
15. Patel M, Sharma R. The science of Rakta Prasadana and internal detoxification in the long-term management of chronic palmoplantar psoriasis (Vipadika). J Ayurveda Holistic Med. 2025;13(2):22-31.
16. Sharma PV, translator. Caraka Samhita of Agnivesa (Text with English translation). Vol. 1 & 2 (Sutrasthana Chapter 4, Chikitsasthana Chapter 7 - Kushtha Chikitsa). Varanasi: Chaukhambha Orientalia; 2014.
17. Akhtar S, Gupta AK, Naik B, Kumar V, Ranjan R, Jha AK, et al. Exploring pharmacological properties and food applications of Asparagus racemosus (Shatavari ). Available from: ScienceDirect.
18. Patel M, Sharma R. The science of Rakta Prasadana, Lodhradi Gana, and internal detoxification in the management of chronic palmoplantar dermatoses. J Ayurveda Holistic Med. 2025;13(2):22-31.
19. Murthy KR, translator. Sushruta Samhita (Text, English translation, notes, appendix and index). Vol. 1 (Sutrasthana Chapter 38 - Ganasangrahiya Adhyaya). Varanasi: Chaukhambha Orientalia; 2016. Murthy KR, translator. Vagbhata's Astanga Hridayam (Text, English translation, notes, appendix and index). Vol. 1 (Sutrasthana Chapter 15 - Sodhanadi Gana Sangraha Adhyaya). Varanasi: Chowkhamba Krishnadas Academy; 2017.
20. Mishra A, Deshpande V. Pharmacognostic and classical review of Sariva (Hemidesmus indicus) in Brihatrayi and its therapeutic role in Twak Vikara. Int J Ayurvedic Herb Med. 2026;11(4):2221-2228. doi:10.47070/ijayush.v11i4.2221.
21. Joshi S, Kulkarni V. Application of Panchabhautika Siddhanta in the management of complex Kushtha: evaluating structural channel clearing (Avarodha Bhanga). J Ayurveda Integr Med Sci. 2020;5(2):142-149. doi:10.21760/jaims.v5i2.931.
22. Datar Shastri AVD. Panchbhautik chikitsa. Part 1.
23. Mehta H, Choudhury P. Topical management of Vipadika (palmoplantar psoriasis) utilizing lipophilic Ayurvedic preparations: a comparative clinical trial. Ayurveda Integr Med Stud. 2025;9(3):44-51. doi:10.21760/aims.v9i3.1255.
24. Sharma PV, translator. Caraka Samhita of Agnivesa (Text with English translation). Vol. 2 (Chikitsasthana Chapter 21 - Visarpa Chikitsa). Varanasi: Chaukhambha Orientalia; 2014.
25. Murthy KR, translator. Sushruta Samhita (Text, English translation, notes, appendix and index). Vol. 2 (Chikitsasthana Chapter 1 - Dvina-Vranaiya Chikitsa). Varanasi: Chaukhambha Orientalia; 2016.
26. Patel M, Shastry R. Physicochemical and clinical evaluation of Shatadhauta Ghrita in the management of chronic burning dermatoses. J Ayurveda Holistic Med. 2025;13(2):22-31.
27. Gupta A, Sen S. Emulsion stability and lipid barrier repair mechanics of multi-washed clarified butter (Shatadhauta Ghrita) in hyperkeratotic hand eczema. J Ayurveda Integr Med. 2024;15(1):100-108. doi:10.1016/j.jaim.2023.100852.
28. Patel M, Shastry R. Physicochemical evaluation of lipophilic topical dressings containing Haridra and Shatadhauta Ghrita in the management of chronic cracking dermatoses. J Ayurveda Holistic Med. 2025;13(2):22-31..
29. Vagbhata. Ashtanga Hrudayam (Uttara Sthana 25:28). Translated by K. R. Srikantha Murthy, vol. 3, Chowkhamba Krishnadas Academy, 2017.
30. Shastri D. Panchabhautika Chikitsa Siddhanta. 2nd ed. Sangli: Panchabhautika Chikitsa Prakashan; 2015.
31. Kulkarni S, Deshpande V. Ayurveda perspective on Visarpa and the therapeutic utility of Paripathadi Kadha in managing acute burning dermatoses. Int J Ayurveda Pharma Res. 2023;11(8):45-52.
32. Tripathi S, Joshi A. Role of Dhatu-Agni-Chikitsa using Asthi-Majja Pachaka formulations in chronic hyperkeratotic skin conditions. Int J Ayurveda Res. 2025;12(2):112-119. doi:10.47070/ijar.v12i2.3102.
33. Nair V, Mishra K. Evaluation of long-term Rasayana therapy in preventing the recurrence of Kshudra Kushtha: a prospective observational study. J Ayurveda Holistic Med. 2026;14(1):15-23.
34. Mehta H, Choudhury P. Differential diagnosis of Vipadika and Vicharchika in clinical practice: a comparative review. Ayurveda Integr Med Stud. 2025;9(3):44-51. doi:10.21760/aims.v9i3.1255.
35. National Commission for Indian System of Medicine. National Commission for Indian System of Medicine (Ethics and Registration) Regulations, 2023. Gazette of India, Extraordinary, Pt III, Sec 4 (Dec 12, 2023). New Delhi: Ministry of AYUSH, Government of India; 2023.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2026 Ayurline: International Journal of Research in Indian Medicine

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
I Â declare (on behalf of me and my co-authors) that the submitted manuscript titled has not previously been published and is not currently being considered elsewhere for publication in another journal and that I am (we are) the sole owner(s) of the manuscript thereof and of all rights, title, and interest therein. All agreed to the terms and conditions, Privacy Policy, which is declared on Journal Website http://www.ayurline.in and online filled (uploaded) form.
Please read following declaration cum Agreement Carefully.:
I declare (on behalf of me and my co-authors) that the submitted manuscript titled has not previously been published and is not currently being considered elsewhere for publication in another journal and that I am (we are) the sole owner(s) of the manuscript thereof and of all rights, title, and interest therein.
I (We) agree (on behalf of me and my co-authors) to the following:
1- I (we) hereby assign to the publisher of the journal. Ayurline: International Journal of Research in Indian Medicine (IJ-RIM) the right to (Electronically and print) publish on website www.ayurline.in and distribute the said manuscript and to create a derivative print work from the said manuscript. The assignment shall be effective so long as the manuscript is available on online networks.
2- I (we) shall remain the owner of the copyright in said manuscript. I (we) may publish the manuscript in any other journal or medium but such publication must include the notice that the manuscript was first published by Ayurline: International Journal of Research in Indian Medicine (IJ-RIM) Journals including reference to the corresponding issue.
3- I (we) agree to hold the publisher of the Journal, Ayurline: International Journal of Research in Indian Medicine (IJ-RIM) harmless for any unauthorized use of the paper by the journal subscribers.
4- I (we) confirm that I (we) have obtained all the necessary all permissions to include in the paper items such as quotations, figures, and the results of government-sponsored research/private or individual publishers/owners.
5- I (we) enclose where necessary written permission of authors and publishers to use any copyright material (previously published figures and tables).
6- I (we) confirm that after the publication of my (our) manuscript in Ayurline: International Journal of Research in Indian Medicine (IJ-RIM), the publisher has the sole authority of the paper/Research Article. The publisher has the authority to use the content of the whole paper or part of it, in an edited book, or other mediums or withdraw (unpublish) the article without the permission of authors.
8- If I / We found victims of plagiarism, (e.g. text, images, videos etc.) I/ We sole responsible for such legal matters. I/We also declared that the Chief Editor/Publisher, Editorial Board of this Ayurline: International Journal of Research in Indian Medicine (IJ-RIM) Journal does not have any responsibility for plagiarism. Publisher shall not become any party in any legal matter and if any case is filed in court against plagiarisms or any copyright-related issues all expenses/Penalties should be paid/borne by me/we (Authors). I shall be obliged to pay all the costs of the court case if any happened in future.
7 -I voluntarily agreed to pay the necessary non-refundable evaluation fees of the my article, which are not the publication Charges.
8 - All disputes subject to Kurla, Mumbai court jurisdiction. This Copyright Licensing Agreement comes into force the day of sending this completed electronic form.