ABSTRACT
Eczema is an inflammatory condition of skin clinically presented with itching, dryness, scales and inflammation of skin.This is a case report of a 50 year old female having dry and itchy skin lesions on her forearms, for the past 6 months. A case of eczema is explained in this article which was cured with the well-selected homoeopathic remedy after detailed case taking and repertorisation.
KEYWORDS :Eczema, Dermatitis, Sulphur, Homoeopathy
INTRODUCTION
The term Eczema is an inflammatory response to many agents which act on skin such as chemicals, drugs, hypersensitivity to antigens etc.It is also known as Dermatitis. Clinically, it is presented by eruptions that may present with itching, redness with oedema, oozing and scaling.[1]
Types of eczema:[2]
1. Atopic eczema – It is due to formation of excessive IgE antibodies to antigens (inhaled, injected or ingested).
2. Discoid eczema – It presents as coin shaped lesions,mostly seen on the extremities.
3. Allergic contact eczema – It is due to delayed hypersensitivity reaction after contact with various antigens.
4. Lichen simplex – It is a localised plaque of thickened skin occuring as a result of repeated scratching or rubbing. It is usually seen on neck, lower legs and anogenital area.
5. Asteatotic eczema – It is usually seen in dry skinas a rippled pattern of fine fissuring, and seen commonly on the lower legs of elderly patients who are hospitalized.
6. Seborrhoeic dermatitis – It presents with a red scaly rash, usually affecting the scalp (presented as dandruff), eyebrows,central part of face, nasolabial folds and central chest.
7. Gravitational eczema – It is usually associated with venous insufficiency and seen in lower extremities.
8. Pompholyx– It presents in the form of vesicles and bullae which are itchy and usually affecting the palms, palmar surface and sides of the fingers and soles.
This case report will help to know the effectiveness of homoeopathic medicines in the cases of eczema along with better understanding of this disease.
CASE RECORD
A female patient of age 50 years reported with complaint of dry skin lesions on her forearms, since 6 months.
Presenting complaint:
The patient presented with dryness, redness with itching on bilateral forearms. The skin bleeds followed by scratching due to itching. Itching worse at night and from warmthand complaints were better by applying cold water.
History of presenting complaints:
Patient had history of these complaints since 6 months. Complaints started with minor eruptions on forearm of right handwhich were itchy and dry, and then it spread to both sides. She took allopathic medication and applied external application on eruptions which relieved for sometime, but as soon as she stopped the treatment, itching appeared severely with dry lesions covering both the forearms with bleeding from skin after scratching.
Gynae&Obs History
She experienced menopause at the age of 48 years with no further abnormalities.
Past History
H/O Injury on right knee joint at childhood and typhoid at the age of 44 years. She had taken allopathic treatment for those complaints and was cured.
Family History
Father – Deceased
Mother – Healthy and alive
Brother – Healthy and alive
Physical Generals
Appetite – adequate, 3 meals/ day, 3-4 chapatti/meal
Thirst – adequate, 3-4L/day
Desire – Salty
Aversion – Nothing specific
Stool – Satisfactory and regular bowel habits
Urine – Satisfactory, 4-5 times a day
Perspiration – Normal, generalized, non-offensive, non-staining
Thermal reaction – Hot
Sleep – Disturbed due to itching
Mental Generals
Patient was introvert and cannot share her emotions easily with anyone.She becomes irritable at trifles. She is very hurried when doing her daily activities.
Provisional Diagnosis
After ruling out all the other possible causes, and according to the history of the disease, it was diagnosed as Eczema.[2]
Analysis and Evaluation of symptoms
| Symptoms of patient | Intensity | Common/ Uncommon symptoms | Miasm |
| Mental Generals Irritable at triflesHurriedIntrovert | ++ + ++ | Uncommon Uncommon Uncommon | Psora Psora Sycosis |
| Physical Generals Desire – SaltyThermal reaction – HotDisturbed sleep due to itching | +++ ++ + | Uncommon Uncommon Common | Psora Syphilis Psora |
| Particulars Dry skin with itching. < night, warmthItching better by applying cold waterSkin eruptions bleeds on scratching | +++ ++ ++ | Uncommon Common Uncommon | Syphilis Psora Syphilis |
Miasmatic diagnosis :Psora-syphilitic[3]
Totality of symptoms
- Irritable at trifles
- Hurried
- Introvert
- Desire – Salty
- Thermal reaction – Hot
- Disturbed sleep due to itching
- Dry skin with itching. < night, warmth
- Skin eruptions bleeds on scratching
- Itching better by applying cold water
Reportorial totality
- MIND – IRRITABILITY – trifles, from
- MIND – HURRY – work, in
- MIND – RESERVED
- GENERALS – FOOD AND DRINKS – salt, desire
- SKIN – ERUPTIONS – bleeding – scratching; after
- SKIN – ERUPTIONS – eczema – dry
- SKIN – ERUPTIONS – itching – night
- SKIN – ERUPTIONS – itching – warmth – agg.
Reportorial chart
Repertorisation was done using synthesis repertory using RADAR 10.0 Homoeopathic software.[4]
Treatment
SELECTION OF REMEDY AND POTENCY :Sulphurwas selected and prescribed to the patient on the basis of repertorisation and final consultation with materia medica. Sulphur was the remedy of choice as it covers the mental as well as physical disposition of the patient.[5,6]30C potency was selected based upon patient’s susceptibility, duration and nature of disease.
Intervention
First prescription (09/04/2022) – Sulphur30/OD/3 days followed by placebo for 1 week.
Patient was advised to moisturize the skin with coconut oil and not to use any other treatment for the same condition.
Follow up
| Date | Symptoms | Prescription |
| 16/04/2022 | Itching slightly reduced. No change in dryness. Skin bleeds occasionally on scratching. Irritability same as before.No change in sleep. | Sac lac 30/TDS/1 week |
| 25/04/2022 | Skin itching – reduced. Dryness reduced. No bleeding on scratching.Irritability slightly better.Sleep – improved . | Sulphur 30/OD/3 days Sac lac 30/TDS/2 weeks |
| 09/05/2022 | No change seen in symptoms. | Sulphur 200/1 dose/ stat Sac lac 30/TDS/2 weeks |
| 23/05/2022 | Itching much relieved. Dryness markedly reduced. Irritability much better. Sleep – improved. | Sac lac 30/TDS/2 weeks |
| 04/06/2022 | Skin healed up. No itching, dryness and bleeding. Irritability – negligible. Sleep – normal. No other new complaints. | Sac lac 30/TDS/2 weeks (since all the complaints were relieved, only placebo was given for 2 weeks and treatment was stopped thereafter) |
DISCUSSION
This case report shows the effectiveness of homoeopathic medicines in treatment of eczema. It also shows the importance of complete case taking and prescription of constitutional medicine. It also helps to confirm the symptoms written in Homoeopathic materia medica and Repertory, as the medicine was prescribed with the help of repertory and final consultation with Homoeopathic materia medica.
CONCLUSION
This case report confirms the effectiveness of Homoeopathic treatment in the cases of Eczema and it is also confirmed through this case report that homoeopathy is useful to cure skin diseases other than eczema also. As Sulphuris already a well known medicine for skin diseases, this case report further helps in proving the effectiveness of Sulphur in cases of Eczema. It also shows that homoeopathic medicines can cure patients in the most rapid and gentle way.
Consent of patient was obtained for writing the manuscript.
REFERENCES
- Mohan H. Textbook of Pathology. Seventh. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2015. p-761.
- Davidson’s principles and practice of medicine, 23rd ed. Elsevier limited; 2018. p-708-711.
- Patel, RP, Chronic Miasms in Homoeopathy and their cure with Classification of theirRubrics/Symptoms in Dr. Kent’s Repertory (Repertory of Miasms). Kottayam, Kerala:Hahnemann Homoeopathic Pharmacy; 1996.
- RADAR 10.0 Homoeopathic Software, Schroyens F synthesis repertory.
- Boericke W. Boericke’s new manual of homoeopathic materia medica with repertory: Including Indian Drugs, Nosodes, Uncommon Rare Remedies, Mother Tinctures, Relationships, Sides of the Body, Drug Affinities & List of Abbreviations, 3rd Revised and augmented edition based on 9th ed. New Delhi: B. Jain Publishers (P) LTD; 2018. p-545-548
Kent JT, Lectures on Homoeopathic Materia Medica, Student edition, New Delhi, B. Jain Publishers (P) Ltd; 2017. p-951-976.
