Abstract: Acne Vulgaris is a common Chronic skin disease involving inflammation of Pilosebaceous unit (hair follicles and their accompanying sebaceous gland) and a commonest problem faced by a adolescent age group. Common causative factors is Mental (emotional) stress; Hormonal Imbalance, Menstruation etc and craving for farinaceous food is one of the triggering factor for Acne. Acne has 4 main pathogenetic mechanism are increased sebum production, follicular hyperkeratinisation, Propionibacterium acne (P.acne) and product of inflammation. This case shows how Homoeopathy cured the Acne Vulgaris as well as took care of mind symptoms.
Case
Preliminary Data
Date: 27/2/16
Name: Miss XYZ
Age: 15 years
Sex: Female
Religion: Hindu
Address: Kharghar
Occupation: Student (10th Standard)
Marital Status: Single
Chief Complaint (C/C):
Patient came with a chief complaint of Acne on face (forehead and both cheeks) since 1 year. Acne: small, red, painful+++ with pustular and bloody discharge. Acne< before menses+. Patient had taken allopathic treatment for complaints for 6 months. Acne was better during allopathic treatment but again appeared with severe intensity after allopathic treatment stopped. Patient was very much irritable before and during menses.
Physical General
Appearance: wheatish, stocky oily, dull looking face.
Appetite: Normal.
Craving: Sweets++, Salt+( sprinkle salt on food during lunch and dinner), Farinaceous Food++
Aversion: Milk++, Green leafy vegetables.
Food disagrees: nothing specific.
Thirst: thirstless( 1-1.5 litre/day)
Perspiration: Profuse on scalp. Palms and soles moist.
Urine: 3-4 times a day and time at night, no burning micturition, no dribbling.
Stool: Once a day, constipated occasionally.
Sleep: 8-9 hours, refreshing. Salivation during sleep. Startling not present.
Dreams: of daily routine, nothing specific.
Menstrual History
FMP: 13 years of age LMP: 3/2/16
Duration: 4-5 days Cycle: 28-30days, regular
Quantity: moderate Colour: stain, red, indelible, no clots
Before and during menses: pain in abdomen and gets irritable++
No complaints after menses.
Leucorrhea: not present
Thermals: Ambithermal towards Hot.
Family History: Mother – Nothing Specific; Father- Nothing Specific
GrandFather (paternal): Hypertension; GrandMother (paternal): Arthritis
Past History:- Chikenpox at the age of 5 years
MindSpace
Patient Stays with parents, 1 younger brother and grandparents. Patient is introvert+++ by nature. Takes time to mix with people. Doesn’t share her feelings. Easily gets hurt by others.
Stage fear (cannot give speech on stage or cannot perform dance on stage.) Lack Of Confidence++. Due to acne on face her confidence level has become very low. Anger is expressed by keeping quiet. Fear of dark+; Fear of Height+. Answers only when asks questions to her, otherwise remains quiet. Very close to mother and have only 1 friend. In studies patient is Average, weak in Maths (while making calculation, doesnot like maths subject.) Now in 10th standard, takes tension about studies (especially Maths subject). Tension about future.
General Examination
Temperature: 98 0F Pulse: 76 beats/min RR: 16 cycles/min
BP: 110/ 72 mmHg Lymph node: not palpable Weight: 55kgs
Pallor: absent Cyanosis: absent Icterus: absent
Oedema: absent
Local Examination
Face( both cheeks and forehead) : multiple, small, red papular eruption (acne) with bloody discharge. Dull look of face.
Diagnosis: Acne Vulgaris (Grade I).
(Note: Patient was not giving her Consent to share her picture in the article.)
Totality Of Symptoms
- Introvert+++
- Lack Of Confidence++
- Fear Of Dark+
- Fear Of Height+
- Weak in Calculation
- Anger expressed by keeping quiet
- Craving: Salt+
- Craving: Farincaeous Food++
- Craving: sweets++
- Aversion: Milk++
- Thirstless
- Perspiration: Scalp++
- Perspiration: palms++
- Perspiration: soles++
- Salivation: sleep during.
Treatment
Natrum Mur 200 IP
Sl 4-4-4 x 15 days.
Auxillary Mode Of Treatment
- Avoid oily and farinaceous food
- Drink plenty of water
- Wash and clean face regularly and maintain hygiene
- Avoid stress.
Follow Up Criteria
- Acne and its intensity
- Based on Mental sphere
- Based on Physical Generals
Follow Up: Date: 12/3/16
Acne: Redness reduced 10% on both cheeks and forehead
Acne: Painful reduced 20%
No new eruptions of Acne.
Fear of Dark and Height –SQ-
Lack Of Confidence – SQ-; Anxiety about Future – SQ-
LMP: 3/3/16, regular. Complaints before and during menses: not present.
Physical Generals: Appetite- normal, thirst- thirstless, urine: normal, stool: once a day, sleep : sound.
Perspiration: scalp reduced 10%, palms and soles – SQ-
Rx
SL single powder
SL 4-4-4 x 15 days.
Date: 28/3/16
Acne: Redness reduced than before by 20% on both cheeks and forehead.
Acne: painful reduced 50%
Face sees bit clear than before. No new eruptions of Acne.
Fear of dark and height :SQ
Introvert :SQ, Lack Of Confidence –SQ-;Anxiety of Future: SQ
Physical Generals : Normal. Salivation during sleep reduced.
Perspiartion: scalp reduced 30% and Palms and Soles –SQ-
Rx
Natrum Mur 1M single powder
SL 4-4-4 x 15 days
Date: 12/4/16
Acne: Redness on both cheeks and forehead reduced to 40-50%
Acne: painful –O-. No new eruptions
Fear of Dark and Fear of Height reduced to 70% ( Recently patient went to Essel world with family, where she enjoyed every rides with no fears.) Lack Of Confidence : Not present ( this time patient presented her project alone at school with confidence.)
Physical Generals: Normal. Sleep: no salivation during sleep.
LMP: 5/4/16, regular.Complaints before and during menses: not present.
Perspiration: Scalp reduced . Palms and soles –SQ-
Rx
SL single powder
SL 4-4-4 x 15 days
Date: 28/4/16
Acne: Redness on cheeks and forehead reduced to 80%
Acne: painful – O- .No new eruptions on face. Face looks more clearer.
Fear of Height – O – ; fear of dark reduced. Tension about future reduced 40-50% but still present. Patient looks confident and dullness of face is not present.
Physical Generals: Normal. Sleep: sound. Perspiration: palms and soles reduced to 30-40%
Rx
Natrum Mur 1M single powder
SL 4-4-4 x 1month
Date: 28/5/16
Acne: Redness on both cheeks and forehead –O-
Acne: painful – O-. No new eruption on face. Face looks clearer
At mental sphere patient is much more better than before. Patient is confident and has increased concentration in studies.
Physical Generals: Normal
LMP: 5/5/16, regular. No complaints before and during menses.
Rx
SL IP
SL 4-4-4 x 1month
Discussion and Conclusion
In this case there were prominent and characteristics Mental symptoms and Physical Generals, which were considered as totality of symptoms for Repertorisation. After Repertorisation with the help of Homoeopathic Software (HOMPATH – Complete Repertory) Nat Mur was prescribed. The prescribed remedy acted very well on both Psyche and Somatic level of the patient, which helped the patient in getting rid of chronic acne vulgaris within 2 to 3 months and cure the patient.
ABBREVIATION
(a) SQ: status Quo
(b) –O- : Absent
(c) LMP: Last Menstrual Period
(d) FMP: First Menstrual Period
About Author
Dr Amruta Pawar M.D(Hom) is Assistant Professor in the Department Of Repertory at Y.M.T Homoeopathic Medical College, Kharghar, Navi-Mumbai.
Dr Shrutika Sawant M.D(Hom) is Associate Professor and P.G Guide at Y.M.T Homoeopathic Medical College in the Department of Repertory. She has also completed P.G. Diploma course in Clinical Research from Academy Of Clinical Excellence in Collaboration with Bombay College of Pharmacy.
Dr Vidhya Sawant M.D(Hom) is Assistant Professor in the Department Of OBGY at Y.M.T Homoeopathic Medical College, Kharghar, Navi-Mumbai.
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