Purpose: Palmoplantar Psoriasis (PPP) constitutes approximately 3–4% of psoriasis cases in India and is associated with significant functional impairment and psychosocial distress. It is frequently observed among individuals involved in manual occupations such as farmers, labourers, and housewives.

Methods: Unani preparations have long been utilized in the management of chronic dermatoses, including psoriasis and eczema. We report a case of a 52-year-old male presenting with thick, indurated, pruritic plaques over both palms for two years. The patient had undergone multiple treatments including topical corticosteroids, immunosuppressants, antibiotics, and antihistamines without sustained relief. Initially, the patient was treated with a standard Unani regimen routinely prescribed in the general OPD, resulting in only partial improvement. However, upon the addition of a Unani drugs with musaffi-e-khoon (blood-purifying) properties administered as zulal after overnight soaking, a drastic therapeutic response was observed.

Results: Complete clinical resolution occurred within four weeks. PASI score improved from 4.4 to 0, and DLQI reduced from 9 to 0, indicating full symptomatic and quality of life recovery. The patient continues to remain in remission with no relapse for four years.

Conclusion: This case not only underscores the potential of zulal-based Unani therapy as an effective, durable, and accessible treatment for chronic and treatment-refractory PPP but also highlights the need to strengthen and standardize the quality of Unani formulations to enhance their reproducibility and clinical outcomes.

KEYWORDS: Psoriasis, Palmoplanter Psoriasis, Unani Treatment, PASI, DLQI, Zulal, Blood Purifier.