A Review on Punarnavadi Kashaya – A Polyherbal Formulation in the Management of Vipadika (Palmoplantar Psoriasis)

Abstract

Psoriasis is characterized by hyperproliferation and abnormal differentiation of epidermal keratinocytes. It causes great physical, emotional, and social disability. Quality of life is also significantly impaired. Disfiguration, disability, and marked loss of productivity are common challenges for people with psoriasis. Palmoplantar psoriasis is a variant of psoriasis in which there are erythematous, scaly, indurated lesions which on later stage changes to fissured plaques localized to palms and soles. It affects individuals of all ages, with an average age of onset between 20 and 60 years of age. Although only a small body surface area is affected, because of the discomfort produced, this site carries a definite significance. Based on its symptoms, it can be correlated with Vipadika, which is one of the types of Kshudrakushtha. It involves Vata and Kapha doshas predominantly and is characterized by Pani-pada Sphutana (Fissures in the palms and soles) and Teevra vedana (with severe pain). Punarnavadi kashaya, which is mentioned in sahasrayoga, consists of eight drugs, namely punarnava, nimba, patola, sunti, tiktha, amrutha, darvi, and abhaya. These drugs have the potential to cure symptoms such as inflammation and pain. This review paper emphasizes the probable pharmacodynamic actions of the drugs in treating palmoplantar psoriasis.