Author:
Dr Melita Alva
Associate Professor
Department Of Homoeopathic Materia Medica And Therapeutics
Yenepoya Homoeopathic Medical College, Deralakatte
Warts are a very in skin problem in practice, particularly among the children especially (water wart) Molluscum. It can affect any part of the body. In countries with highly developed medical services, referral rates of warts to dermatology clinics have greatly increased in last four decades.
Incubation period: The time of acquisition of the infection can seldom be ascertained. An estimated period ranges between a few weeks and more than a year.
Modes of transmission: Spread is by direct or indirect contact.
Histopathology: Is the vacuolation in cells in and below the granular layer, often with basophilic inclusion bodies composed of viral particles, and eosinophilic inclusions representing abnormal keratohyaline granules. This cytopathic effect may show detailed features typical of the HPV type involved and is almost always accompanied by epidermal acanthosis and often papillomatosis.
Aetiology/Causes:
Warts are caused by the human papilloma virus (HPV). There are about 130 known types of human papilloma viruses. HPV infects the squamous epithelium, usually of the skin or genitals, but each HPV type is typically only able to infect a few specific areas on the body. Many HPV types can produce a benign growth, often called a “wart” or “papilloma”, in the area they infect. Many of the more common HPV and wart types are listed below.
Types:
- Common wart (Verruca vulgaris), a raised wart with roughened surface, most common on hands, but can grow anywhere on the body. Sometimes known as a Palmer wart or Junior wart.
- Flat wart (Verruca plana), a small, smooth flattened wart, flesh-coloured, which can occur in large numbers; most common on the face, neck, hands, wrists and knees.
- Filiform or digitate wart, a thread- or finger-like wart, most common on the face, especially near the eyelids and lips.
- Genital wart (venereal wart, Condyloma acuminatum, Verruca acuminata), a wart that occurs on the genitalia.
- Periungual wart, a cauliflower-like cluster of warts that occurs around the nails.
- Plantar wart (verruca, Verruca plantaris), a hard, sometimes painful lump, often with multiple black specks in the center; usually only found on pressure points on the soles of the feet.
- Mosaic wart, a group of tightly clustered plantar-type warts, commonly on the hands or soles of the feet.
Pathophysiology
Common warts have a characteristic appearance under the microscope. They have thickening of the stratum corneum (hyperkeratosis), thickening of the stratum pinosum (acanthosis),thickening of the stratum granulosum , rete ridge elongation, and large blood vessels at the dermoepidermal junction.
Therapeutically based remedies
Antimonium crudum: Hand-hard, horny, soft or smooth with stinging pain, especially suited to those who have tendency to put on weight.
Baryta carbonicum: Hands, fingers. Small warts with stinging pains, gradually due to friction warts get excoriated and start oozing. Typically dwarfish, mentally and physically; with tendency for enlargement of the glands.
Calcarea carbonicum: Face, neck, upper extremities, male genitalia, canthi, fingers. They are fleshy, black, hard, horny sometimes inflamed and painful. Development of warts having a history of suppression of eruptions and perspiration.
Causticum: Nose, eyebrows, face, lips, near nails, tips of fingers, upper limbs. They are large, horny, broad, flat and hard, moist and pedunculated, small and fleshy. They can bleed easily.
Ferrum picricum: Multiple warts, especially on hands, usually pedunculated. There is sensation as if warts are growing on the thumb.
Flouricum acidum: Hands and fingers. They are flat and hard with presence of elevated red blotches, which resemble fleshy warts.
Graphites: Female genitalia: cauliflower shaped. They discharge sticky exudation, which smells like old cheese or herring brine.
Lachesis: Hard, smooth, small warts with bluish, purple surrounding. It has strong tendency to bleed.
Lycopodium: Isolated warts, warts in crops on face, tongue, male genital, upper limbs and fingers. Warts are associated with terrible itching.
Medorrhinum: Warts are small, pedunculated resembling small button mushrooms on thighs and other parts of the body.
Nitric acidicum: Female genitalia, anus, cervical region, inside the nose, external throat, sternum, eyelids, canthi. Cauliflower like rhagadic, large indented inflamed.
Thuja occidentalis: Back, cervical region, upper limb, face, nose, eyebrows, eyelids, external throat. They are reddish in colour, bleed easily.
Staphysagria: Anus, tongue, male genitalia. They are moist pedunculated and extremely sensitive to touch.
Treatment review: Through my clinical experience I have observed that majority of the warts cases have a cure, where constitutional remedies are given. Sometimes an intercurrent remedy like thuja is required. It is always wise to restudy the case as the patients would come to follow ups.
Guidelines for selecting remedies in warts
According to Organon of Medicine, Dr Samuel Hahnemann has explained about the method of treatment for warts in aphorism 282 stating that warts are considered to be chronic, where in the mode of treatment is anti miasmatic (Psora, Sycosis, Syphilis) with repeated doses with suitable potency according to the susceptibility of the patient.
Case 1:
Name: Miss Vijetha
Age: 20 years
Occupation: receptionist
Presented with the complaints of painful pedunculated/filiform wart (1 in number) over the right upper eyelid since 2 months.
25/2/2015
23/3/2015
15/4/2015
| Date | Complaints | Remedy | Potency | Dosage | Days |
| 25/2/2015 | Wart over the right upper eyelid since 2 months, painful | Pulsatilla Nigricans | 200 | 1 powder | 1 week |
| 10/3/2015 | Complaints of pain reduced, wart size no change. | Thuja Occidentalis | 200 | 1 powder | 2 weeks |
| 23/3/2015 | Complaints of weakness, no pain | Alfa Alfa tonic | tincture | 30ml | 1 week |
| 15/4/2015 | Wart reduced in size, decreased in size | Sac lac | No 30 pills | 2 dram | 2 weeks |
Reason for prescription:
Pulsatilla as a constituition was selected of moderate potency because the patient had good susceptibility.
Conclusion:
Patient came with the complaints of painful pedunculated wart over the right upper eyelid since 2 months.
Pulsatilla 200 was given as a constitutional remedy and thuja 200 as an intercurrent remedy was given. The patient complaints improved, wart dried and fell off within a month.
References:
1. www.wikipedia.com
2. Textbook of skin (Homeopathic approach to Dermatology) -Dr Farokh J. Master.
