E-ISSN:2456-3110

Review Article

Erythrodermic Psoriasis

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 8 August
Publisherwww.maharshicharaka.in

A review on Paranthimukuladi Kashayam in the management of Podivarppan w.s.r. to Erythrodermic Psoriasis

Aswathi P1*, Krishnan SK2, Krishnan A3, Reshma J4
DOI:10.21760/jaims.10.8.22

1* Aswathi P, Post Graduate Scholar, Department of Agadatantra, MVR Ayurveda Medical College, Parassinikkadavu, Kannur, Kerala, India.

2 Shidhin K Krishnan, Associate Professor, Department of Agadatantra, MVR Ayurveda Medical College, Parassinikkadavu, Kannur, Kerala, India.

3 Arathi Krishnan, Post Graduate Scholar, Department of Agadatantra, MVR Ayurveda Medical College, Parassinikkadavu, Kannur, Kerala, India.

4 Reshma J, Post Graduate Scholar, Department of Agadatantra, MVR Ayurveda Medical College, Parassinikkadavu, Kannur, Kerala, India.

Varppan is a skin condition explained in Arogyakalpadrumam, wherein the Kupitha Vata (vitiated Vata) moves out Raktha (blood) from Rakthashaya (seat of Raktha) and both moves together throughout the body and cause Vyadhi (disease). Podivarppan, a subtype, exhibits symptoms like Kandu (itching), Mandala Sopha (round swelling) and Dhumra Varna Raja (powdery discharge) on scratching. These symptoms of Podivarppan aligns with that of erythrodermic psoriasis, characterized by erythema, scaling of skin in sheets, edema, psoriatic plaques and pruritus. Paranthimukuladi Kashayam is a Yoga (formulation) mentioned in the management of Podivarppan, in Arogyakalpadrumam. This conceptual article examines the potential therapeutic applications of action of Paranthimukuladi Kashayam in managing Podivarppan and erythrodermic psoriasis.

Keywords: Arogyakalpadrumam, Varppan, Podivarppan, Erythrodermic psoriasis, Paranthimukuladi Kashayam

Corresponding Author How to Cite this Article To Browse
Aswathi P, Post Graduate Scholar, Department of Agadatantra, MVR Ayurveda Medical College, Parassinikkadavu, Kannur, Kerala, India.
Email: 		Aswathi P, Krishnan SK, Krishnan A, Reshma J, A review on Paranthimukuladi Kashayam in the management of Podivarppan w.s.r. to Erythrodermic Psoriasis. J Ayu Int Med Sci. 2025;10(8):127-130.
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https://jaims.in/jaims/article/view/4601/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-06-16 2025-06-24 2025-07-04 2025-07-14 2025-07-24
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None Nil Not required 11.36

© 2025 by Aswathi P, Krishnan SK, Krishnan A, Reshma J and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2025;10(8)127
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Aswathi P et al. A review on Paranthimukuladi Kashayam

Introduction

Arogyakalpadrumam, by Kaikulangara Rama Varier, a Keraleeya Ayurvedic text addresses specific skin conditions, including Karappan, and Varppan.

Varppan is condition wherein Kupitha Vata displaces Raktha from Rakthashaya & both moves together throughout body causing Vyadhi.[1] Podivarppan, subtype, exhibits symptoms like Kandu, Mandala Sopha & Dhumra Varna Raja on scratching.[2] Symptoms of Podivarppan align with that of erythrodermic psoriasis, an inflammatory type of psoriasis, characterized by erythema, scaling of skin in sheets, edema, psoriatic plates & pruritus.[3]

Paranthimukuladi Kashyam[4] is Yoga described in Arogyakalpadrumam in management of Podivarppan. Majority of ingredients of these drugs possess Kushtahara (alleviating skin disease) properties & has Vata Pithahara (alleviates Vata & Pitha) property. Therefore, this Yoga can also be used in management of erythrodermic psoriasis

Conceptual Study

For this study, basic conceptual materials were collected from Arogyakalpadrumam, text books of Dravyaguna Vignanam and scientific journals, research papers.

Varppan

Arogyakalpadrumam explains about a skin condition named Rakthanavastha[5]/ Varppan. They are of 18 types.

Nidhana (Causative Factors)[6]

Vata and Raktha Prakopaka Ahara Vihara (food and activities that vitiate Vata and Raktha)

Samanya samprapthi of Varppan (General Pathogenesis)

Nidana
↓
Vata and Raktha Prakopa
↓
Obstruction of Vata by Raktha in Rakthashaya
↓
Vitiates each other
↓
Prakupitha Vata moves out Raktha from Rakthashaya

↓
Moves together throughout body
↓
Rakthanavastha

Podivarppan

Podivarppan is one among the 18 types of Varppan

Nidhana - Aganthuja[7]( external)
Dosha - Kevala Vata[8] (Vata alone)
Synonym - Kshodaka[9]

Symptoms

  • Kandu (itching)
  • On Nakha Sankharsha (scratching with nails) - white powdery discharge
  • Mandala Sopha (round swelling)

Erythrodermic Psoriasis

Erythrodermic psoriasis is an inflammatory type of psoriasis. Though rare, it is a severe variant of psoriasis. In this type of psoriasis, there will be inflammatory erythema involving at least 75% of body surface.

Clinical Features

  • Erythema
  • Edema
  • Pruritus
  • Ill-defined psoriatic plaques
  • Scaling – Skin sheds in sheets
  • Hair loss
  • Occasionally exudative lesions
  • Palmoplantar or diffuse desquamation

Systemic Symptoms

  • Fever
  • Tachycardia
  • Fatigue
  • Malaise
  • Dehydration
  • Myalgia

Paranthimukuladi Kashayam

Paranthimukuladi Kashayam is a Yoga described in Arogyakalpadrumam in the management of Podivarppan.


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Aswathi P et al. A review on Paranthimukuladi Kashayam

Table1: Ingredients of Paranthimukuladi Kashayam

SNIngredientsBotanical name[10]Family[11]
1.ParanthiIxora coccinea L.Rubiaceae
2.AkhoraFlacourtia indica SynFlacourtiaceae
3.NirgundiVitex nirgundo LinnVerbenaceae
4.VasukaSpermacoce alata AublRubiaceae
5.IkshuraHygrophila auriculata (Schumach.)HeineAcanthaceae
6.MurvaMarsdenia tenacissima W&AAsclepiadaceae
7.VrschivaBoerhavia diffusa L.Nyctaginaceae
8.ShamyakaCassia fistula L.Fabaceae
9.KatukiPicrorhiza kurroa Royale ex BenthScrophulariaceae
10.DevadaruCedrus deodara (Roxb. ex D. Don) G. Don f.Pinaceae
11.VairiSalacia reticulata WightHypocrataceae
12.AmbhodaCyperus rotundus LCyperaceae
13.IndravaruniCitrullus colocynthis LCucurbitaceae

Table 2: Properties of the Ingredients [12]

SNName of drugRasaGunaViryaVipakaDoshagnataKarma
1.ParanthiKashaya (astringent) Tiktha (bitter)Grahi
(absorbent)		Sheeta (cold)Katu (pungent)Vata- Pitha haraJwarahara (anti -pyretic)
Prasadana (purifying)
2.AkhoraAmla, (sour) Madhura (sweet)Laghu
(Light)		SheetaMadhuraVata-Pitha haraDeepana (stomachic)
Pachana (digestive) Asrgna (pacifies vitiated Rakta)
3.NirgundiKatu, TikthaLaghu, Ruksha
(dry)		Usna (hot)KatuVata-KaphaharaSula, Sotha, Krimi, Kushta Visarpa, Visharogahara (cures pain, swelling, worm, skin disease, herpis and poison)
4.VasukaKatu ThikthaLaghuUsnaKatuVata-Pithahara
5.IkshuraMadhura Amla, TikthaSnigda, PichilaSitaMadhuraVata-Pitha haraBalya (strengthening)
Vatarakta (gout) Sothahara (anti-inflammatory)
6.MurvaTiktha, KashayaGuru (heavy) RukshaUshnaKatuKapha-VataharaKushta, Jwarahara
7.VrschivaMadhura, Tiktha KashayaLaghu, RukshaUsnaKatuKapha-VataharaDeepana,
Sothahara
8.ShamyakaMadhuraGuru, Snigdha (unctuous)SheetaMadhuraKapha-PithaharaKushta,
Vatarakta Jvarahara
9.KatukiTiktha,Ruksha, LaghuSheetaKatuKapha-PithaharaLekahana (bio scrapping) Deepana, Kushta Krimihara
10.DevaduruTiktha, Katu, KashayaRuksha LaghuUsnaKatuKapha-VataharaDeepana, Krimi, Kandu. Kushta, Sopha, Dushta-Vranahara (wound healing)
11.VairiKashaya, TikthaLaghu,rukshaUsnaKatuKapha-PithaharaMadhumeha
(diabetics)
12.AmbhodhaTiktha, Katu, KashayaLaghu,rukshaSheetaKatuKapha-PithaharaDeepana Pachana
Jvara ,Krimi, Kandu,
Rakthavikara, Visarpa, Kushta
13.IndravaruniTikthaLaghu, ruksha, TikshnaUsnaKatuKapha-PithaharaRechaka (purgative), Kushta, Krimi,

Anupana

Sita (Sugar), Madhu (Honey), Grtha (Ghee)[13]

Discussion

Paranthimukuladi Kashayam is mentioned exclus-ively in management of Podivarppan. In Varppan, there will be Prakopa of both Vata & Raktha. Given presence of Raktha Kopa, Pitha Kopa can also be inferred (Ashraya - Ashrayi Bhava)[14] Also, Podivarppan is said to be Kevala Vataja Vyadhi.

Thus, Yoga used in this disease should be Vata-Pithahara in nature. Upon analyzing ingredients of this Yoga, it is observed that Paranthi, Akhora Nirgundi, Vasuki & Ikshura exhibit Vata-Pithahara properties. Also, drugs, Nirgundi, Murva, Vrschiva, Devaduru are Vatahara in nature & Shamyaka, Katuki, Vairi, Ambhodha, Indravaruni are Pithahara in nature. Collectively, these drugs act as potent Vata Pithahara, effectively alleviating Vata-Pitta imbalance that underlies Podivarppan. Additionally, Paranthi, is prominently featured in Kerala's traditional medicine for treating skin ailments.


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Aswathi P et al. A review on Paranthimukuladi Kashayam

Moreover, the majority of the Yoga's constituent drugs exhibit Kushtahara properties, rendering it an effective formulation for managing Podivarppan. Erythrodermic psoriasis presents with Vata-Pithaja symptoms such as scaling, itchiness, erythema and inflammation. Thus, Paranthimukuladi Kashaya can be effectively used in the management of this skin condition. Also, the ingredients of this Yoga possess anti-inflammatory, anti-toxic and anti-oxidant property, making it an effective remedy in Erythrodermic psoriasis.

Conclusion

In conclusion, the formulation of Paranthimukuladi Kashayam has been shown to be an effective treatment for Podivarppan. The collective Vata Pithahara properties of its constituent drugs, effectively alleviate the underlying Vata-Pitta imbalance. Furthermore, the presence of Kushtahara properties in many of the Yoga's constituent drugs renders it a potent formulation for managing Podivarppan. The traditional use of Paranthi in Kerala's medicine for skin ailments also lends credibility to its inclusion in this Yoga. Overall, Paranthimukuladi Kashayam emerges as a well-formulated and efficacious treatment for Podivarppan and also in the management of erythrodermic psoriasis.

Declaration of generative AI and AI-assisted technologies in the writing process

During the preparation of this work the author(s) used Meta AI in order to improve the language. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication.

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