Integrative Ayurveda management of a chronic unilateral diabetic plantar lesion: A case report

Chronic plantar lesions in patients with diabetes mellitus present a significant therapeutic challenge due to microangiopathy, peripheral neuropathy, and delayed wound healing. Unilateral plantar lesions originating from follicular infection may rapidly progress into chronic non-healing ulcers with hyperkeratosis, often mimicking diabetic foot ulcers rather than classical bilateral dermatoses.

To document the integrative Ayurveda management of a chronic unilateral plantar lesion in a patient with long-standing diabetes mellitus and to correlate the clinical presentation with Ayurveda diagnostic concepts.

A 68-year-old male with type 2 diabetes mellitus for 25 years presented with a unilateral fissured plantar lesion that began as a pimple and worsened following irritant topical applications (gentian violet and potassium permanganate). Clinically, the lesion resembled an infected diabetic foot ulcer (Wagner grade 1-2). From an Ayurveda perspective, the condition was interpreted as Dushta Vrana occurring in the background of Prameha with associated Vata-Pitta aggravation. The patient was treated with a structured four-month Ayurveda regimen including Vata-Pitta pacification, metabolic regulation, wound cleansing (Vrana Shodhana), and tissue-healing (Ropana) therapies.

The Ayurveda intervention resulted in complete healing of the chronic unilateral plantar lesion without recurrence or adverse effects. This case suggests that an individualized, physiology-oriented Ayurveda wound-care approach may serve as a supportive integrative strategy in the management of chronic diabetic plantar lesions and highlights the potential value of integrating traditional wound-care principles with modern clinical monitoring in complex chronic wounds associated with metabolic disease.