DR HOZAIFA AYUBI, PG SCHOLAR, DEPARTMENT OF PRACTICE OF MEDICINE
R.B.T.S GOVERNMENT HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL, MUZAFFARPUR, BIHAR, INDIA.
Psoriasis is one of the most common skin disease now a days, as in the most of the cases, the exact cause is unknown. Psoriasis is thought to be an immune system problem that causes the skin to regenerate faster. The cause believed to be genetics and environmental factors play a role. Homoeopathy , however provides a better response in such condition, one such case report is presented below. Patient attended outdoor patient department(OPD) chiefly for complaints of itching, dandruff, scaling and shinning of scalp. She was suffering from scalp psoriasis for 2 years. After unsatisfactory outcome from modern medicine and ayurvedic, patient turned to homoeopathic treatment in our opd. After case taking and repertorisation SULPHUR was prescribed and gradually the potency was increased as pr response of medicine upon patient. Within 1.5 year of homoeopathic treatment, the patient started improving and continues to be free from his complaint at the time of last follow-up visit in OPD.
KEYWORDS- Psoriasis, Auto-immune disorder, Recurring, Sulphur, Homoeopathy, miasmatic treatment.
INTRODUCTION- Psoriasis is a chronic, non-communicable, painful, disfiguring and disabling disease for which there is no cure and with great negative impact on patients’ quality of life (QoL). It can occur at any age, and is most common in the age group 50–69. The reported prevalence of psoriasis in countries ranges between 0.09% and 11.4%, making psoriasis a serious global problem. The etiology of psoriasis remains unclear, although there is evidence for genetic predisposition. The role of the immune system in psoriasis causation is also a major topic of research. Although there is a suggestion that psoriasis could be an autoimmune disease, no auto-antigen that could be responsible has been defined yet. Psoriasis can also be provoked by external and internal triggers, including mild trauma, sunburn, infections, systemic drugs and stress. Psoriasis involves the skin and nails, and is associated with a number of co-morbidities. Skin lesions are localized or generalized, mostly symmetrical, sharply demarcated, red papules and plaques, and usually covered with white or silver scales. Lesions cause itching, stinging and pain. Between 1.3% and 34.7% of individuals with psoriasis develop chronic, inflammatory arthritis (psoriatic arthritis) that leads to joint deformations and disability. Between 42% and 69% of all patients suffering from psoriasis develops nail changes. Individuals with psoriasis are reported to be at increased risk of developing other serious clinical conditions such as cardiovascular and other non-communicable diseases (NCDs). Psoriasis causes great physical, emotional and social burden. There is also a significant cost to mental well-being, such as higher rates of depression, leading to negative impact for individuals and society. The treatment of psoriasis is still based on controlling the symptoms. Topical and systemic therapies as well as phototherapy are available. In practice, a combination of these methods is often used. The need for treatment is usually lifelong and is aimed at remission with so many side-effects on body by these tretmemt. So far, there is no therapy that would give hope for a complete cure of psoriasis.
CLINICAL PRESENTATION- The onset of scalp psoriasis is often with seborrheoric dermatitis. Dandruff tends to itch more and it has a greasy appearing yellow scale. Scalp psoriasis may itch and become easily irritated during a flake, however it may also affect your hairline or creep down onto your forehead, nape of neck or ears.
Psoriasis is common on scalp at least 50% of the people have plaque psoriasis.
– Red skin covered with flakes and shiny scale.
-Skin flakes(dandruff) that may attach to the hair shaft.
– patchy shiny scales or thick crust on the scalp that may bleed when removed.
– patches that may extend beyond hairline or appear on other parts of the body.
Itching and irritation will be there.
Inflammatory red sharp demarcated, raised, dry, differently sized plaques, usually coverd by silvery or white scales. Involves the scalp and the area behind the ear, the exterior surface of the forearm, skin on bends.
INVESTIGATION- Diagnosis of psoriasis is typically made by a physical examination, medical history and relevant family history. Somen lab test including microscopic examination of skin biopsy and X ray may be usefull.
As in modern medicine they use tropical treatment and tropical corticosteroid but these drugs are having side-effects which affect the body in several ways. The harms liver, kidney, causes acne, burning, dilated blood vessels , irritation and loss of skin colour. Loss of effectiveness- after some time the patient become usd to this type of treatment and these will not work on patient anymore.
A 20 yrs old female patient attended out-patient department in December 2018 with following complaints-
Scaling from scalp since 2 years especially in cold weather,or on becoming cold. Itching eruptions on head since 2 years with burning on itching with watery discharge after scratching espically in cold weather.
History of present complaints-
She was under treatment I both aloopathuc and ayurvedic systm of medicine but it gives temporary relief after 2 years of suffering she visited our OPD in December 2018.
Past history- patient suffered from chicken pox 3 years ago.
Family history- Both mother and father suffered from diabetes. And brother suffers from dandruff.
Her appetite was good and con not remains empty stomach for prolonged period. She has desire for sour food, acid, bitter, and warm food and thirst is moderate amount with scanty perspiration. Bowel movement us regular and has to go in early in the morning. Thermal reaction of patient is hot patient (prefer winter and cannot tolerate heat) and always irritable in morning with religious affection. A general feeling of weakness accompanies the patient most of the time.
Local and systemic examination-
Tongue was clean and moist. Anemia- mild, cyanosis- absent, lymph node- not enlarged, pulse-74/min, B.P- 110/70 mmhg.
Diagnosis – it probably a case of Scalp psoriasis.
Analysis of case- after analyzing the symptoms of the case the characteristics mental, physical and particular symptoms were considered for framing totality-
Morning irritability with religious affection , lassitude in general, desire for sour food and acid with early morning diarrhea were the important general symptoms. tongue was clean and moist, aversion to milk were included I totality.
Miasmatic evaluation for the present symptom was done with the help of “The chronic disease by Dr Samuel Hahnemann “ shows the predominance of Psoric miasm.
Considering the above mentioned symptoms Kents repertory was preferred and using RADAR software systemic repetorisation was done. Repertorisation sheet is given below.
Sulphur 200, 1 dose was prescribed along with rubrum 200 on first visit on 18 dec 2018 considering the reportorial totality and miasmatic background. The patient was improved symptomatically as compared to before on 12/01/2019.
Discussion and conclusion-
Homoeopathy treats the person as whole, it eliminate the exciting and fundamentals cause by annihilating the disease manifestation (sign and symptoms). In this case, important mental generals , physical generals and particulars.
After repertorization many medicine were competiting with each other namely, sulphur, arsenic, lycopodium, Rhus toxicodendron, sepia, hepar sulp, lachesis etc, but after consulting material medica SULPHUR was prescribed which remain unchanged in the subsequent follow up was responding well to medicine.
Sulphur is not only the homoeopathic most specific medicine but also covers the miasmatic background of the case.
Time including follow up-up of the case-
Follow-up/date/Indication for prescription/Medicine with dose
18.02.2019 Scaling is better,Itching is better,Pain in abdomen since 1 week in empty stomach,Thirst- moderate,Tongue- Clean Sac lac 200/ 2 doses ODRubrum 200/ 1 dr BD
On 04.03.2019 Scaling better,Itching better,Pain abdomen better,Thirst- moderate
Nihilinum 30/ 6 doses OD,Rubrum 1M/ 1 dr BD
On 15.04.2019 Itching is better,Scaling is better,Loss of appetite is better,Irritable in morning is better
Tongue- clean Sac lac 1M/ 4 doses OD,Rubrum 1M/ 1 dr BD
15.05.2019 Itching aggravated than before ,Scaling aggravated than before ,Loss of appetite is better,Irritable in morning is better
Nihilinum 200/ 6 doses OD,Rubrum 30/ 1 dr BD
27.05.2019 Itching aggravated ,Scaling aggravated
Loss of appetite is better,Irritable in morning is better,Thirst- moderate
Tongue- clean Sulphur 1M/1 dose OD,Rubrum 30/ 1 dr BD
24.06.2019 Itching is better,Scaling is better
Loss of appetite is better,Thirst moderate
Sac lac 200/ 4 doses OD,Rubrum 200/ 1 dr BD
31.07.2019 Itching is better,Scaling is better,Loss of appetite is better,Cough and cold
Bryonia alb 30/ 4 doses OD,
Rubrum 200/ 1 dr BD
5.09.2019 Itching is better, scaling is better, loss of appetite is better, cough and cold is better, thirst- moderate, tongue- clean, stool- satisfactory, urine- clear Phytom 200/ 4 dose, lactogen 200, 1 dr, bd.
05.03.2020 There is no itching , no scaling, no lesion found, thirst- moderate, tongue clean, urine clear, stool- satisfactory. Lactogen 1M, 1 dose, sac lac 200/ 1 dr , bd, phytum 200/ 1 dr, bd
08.04.2020 Better Rubrum 200/2 dr OD
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