Homeopathic Approach in Allergic Contact Dermatitis - homeopathy360
Clinical

Homeopathic Approach in Allergic Contact Dermatitis

Homeopathic Approach in Allergic Contact Dermatitis
 Introduction 
Allergic contact dermatitis is an allergic response caused by a contact with the substance known as allergen. It is termed as Type IV delayed hypersensitivity reaction involving cell mediated allergic reaction. Sensatisation produces specific type of allergic antibodies by the immune system resulting in a positive allergy test. The sensatisation to an allergen begins when the body is first exposed to it, or sometimes even months or years before the onset of an allergic reaction, which is characterised by itching, erythema, vesiculation and scaling.
Allergic contact dermatitis can affect the neonates as well as the elderly individuals. The development of allergic contact dermatitis can be delayed initially, but once developed, it is more persistent. Contact allergy to topical medications is common among the age group of more than 70 years. Individuals with allergic contact dermatitis can have persistence or relapse in their skin conditions, particularly if the material to wZhich they are allergic, is not identified or if they continue using the same allergic products like harsh chemicals etc. Some individuals suffering from allergic contact dermatitis have the past history of persistent dermatitis. Patients, who are able to identify the allergens that affect them and are able to avoid its exposure/use, have better prognosis of their condition. Besides removing the maintaining cause, Hahnemann suggests the permanent removal of totality of symptoms to remove the cause of the disease.
 Case Illustration
Preliminaries
Date:  02/12/12
Name: Mr RNB
Age/Sex: 85 yrs/male
Religion: Hindu, Brahmin
Education: B.Com
Occupation: Retired bank cashier
Marital Status: Married
Diet: Vegetarian
Address: Osmanabad, (Village in Maharashtra), India
 Chief Complaint
Location Sensation Modality Concomitant
Skin
Forehead
Since:1 year
Onset: Slow
Intensity:  Moderate
Duration: Continuous
Progress: Gradually↑
Itching3
Cracks3
Exfoliation2
Affections from: Application of vermilion (Since many years)
< Being alone (In general patient feels bad being alone)
Decreased appetite
 Past History 
Nothing significant
 Family History 
Nothing significant
 History of Treatment taken
Taking allopathic medication but prescriptions not available
 Physical Generals
Thirst:  Normal
Appetite: Decreased since one year
Desire: Sweets3, Warm food2
Aversion: Nothing specific
Thermal: Hot
 Life Space (Mental Generals)
85 years old male visits the outpatient department. He is a retired bank professional, where he has worked as a cashier. He is a calm person generally and has no specific hobbies since his childhood. He has never indulged in any kind of addictions, or any kind of quarrels with anyone. Since his retirement, the family responsibilities are dealt by his eldest son. He is having cordial relationship with all the family members.
 On Examination 
General Condition: Fair
Temperature: 98o F
Pulse: 60/min
BP: 140/80 mmHg
Systemic Examination:
Central Nervous System: NAD
Cardiovascular System: NAD
Respiratory System: Clear
Per Abdomen: Soft
Local Examination: 
Skin: Forehead- Cracks+
Erythema++
Exfoliation + (where patient puts vermilion as a ritual)
No bleeding
 Case Processing
Disease Diagnosis: Allergic Contact Dermatitis (affections from application of vermillion-an allergen; cracks, erythema, exfoliation)
Classification of Disease: Chronic
Miasm: Dominant; tubercular (hypersensitivity, cracks)
Susceptibility: Moderate
Sensitivity: High
Potency: Moderate; 200
Repetition: Infrequently
 Totality
Location Skin
Forehead
Sensation Itching3
Cracks3
Exfoliation/Scaling2
Modalities Affections from application of vermilion
Concomitants Decreased appetite
Physical Generals Hot person
Desire for sweets
< being alone
 Selection of Repertory
Since complete symptoms are available in the case, it can be repertorised by using Boger Boenninghausen Repertory.
 Repertorial Totality
Rubric Reason
Skin and Exterior Body-Skin- in general Location
Head-internal-in general Location
Skin & Exterior Body-itching-in general Sensations & Complaints
Skin & Exterior Body-cracks, fissures, chaps Sensations & Complaints
Skin & Exterior Body-desquamation, exfoliation, peeling etc of Sensations & Complaints
Conditions of Aggravation and Amelioration in General- Alone, when, agg Characteristic Modality
Appetite, want off Characteristic Physical Concomitant
Appetite-Desire-sweet, dainties, etc Characteristic Physical General
Appetite- Desire-warm or hot drinks-cooked food Characteristic Physical General
 Repertorial Result
Chilly Totality & Symptoms Covered Hot Totality & Symptoms Covered
Sepia officinalis 19/8 Lycopodium clavatum 24/8
Calcarea carbonica 18/8 Sulphur 24/7
Final Selection of Remedy: Lycopodium clavatum was selected as the final choice of remedy seeing the generals and Thermal (Hot).
 Prescription and Follow up
First Prescription: 
  • Lycopodium clavatum 200, 1 dose at bedtime
  • Placebo pills, TDS x7 days
Non Remedial Measures:
  • Avoid allergen i.e. application of vermilion
  • Avoid application of soap
Follow up Criteria 07/12/12 16/12/12 30/12/12 (Telephonic follow up)*
Appetite Improved Normal Normal
Skin itching- Intensity/Frequency >/> >+++/>+++ Absent
Skin- Cracks Same >+++ Absent
Skin- Exfoliation >+ >+++ Absent
Skin- Itching < when alone >+ >+++ Absent
On Examination: Skin
Cracks
Erythema
Exfoliation
No Bleeding
No Cracks
No Erythema
No Exfoliation
No Bleeding
Linear Depigmented Mark
Absence of Linear Depigmented Mark
Normal Skin
Action:
Lycopodium clavatum 200,
1 dose at bedtime. Placebo Pills, TDS x 7 Days
Lycopodium clavatum 200
1 dose at bedtime Placebo Pills, TDS x 7 Days
No Treatment
 Result:
                            
Before Treatment on 07/12/12                                                           Follow up on 16/12/12
Bibliograph
  1. Boger, CM 2012, Boenninghausen’s  Characteristics Materia Medica & Repertory with Word Index, 37th edn, B Jain Publications, New Delhi. 
  2. Burge, S, Wallis, D 2011, Oxford Handbook of Medical Dermatology,  Oxford University Press, Banglore.
  3. Haslett, C, Davidson, S, 2004, Davidson’s  Principles & Practice of Medicine, 19th edn,  Churchill, Livingstone.
  4. Dethlefsen, T, Rudiger, D 1995, The Healing Power of Illness, Element Publications, Rockport, MA.
  5. Kent, J T, 1995,  Lectures on Homoeopathic Philosophy,  BJain Publications, New Delhi.
  6. Tiwari, SK 2012, Essentials of Repertorization, 5th edn, BJain Publications, New Delhi.. 

Leave a Comment