Abstract:-
Pyoderma gangrenosum is a rare , non – infectious skin disease that causes painful ulcers to develop rapidly . It’s characterized by small bumps that can appear anywhere on the body but most often on the lower leg, ankle and feet the bumps can quickly break down skin .
Keywords:- Homoeopathy , Pyoderma gangrenosum , bumps, case report etc.
Introduction:-
Pyoderma gangrenosum causes is unknown, but it’s believed to be a disorder of immune system, often triggered in individuals with underlying autoimmune disease like ulcerative colitis, crohns disease and arthritis
Precipitating factors:-Autoimmune disorder,
Common site:- anywhere in body but most common site is lower leg , ankles and feet.
Clinical feature:-
The affected part shows small bumps in lower legs, feet, or ankle the bumps quickly break down , painful ulcer , watery discharge .
Differential diagnosis:- Infectious disease like Myco- bacterial infection and deep fungal infection Non infectious disease such as bromoderma
Other cause of ulcer arterial ulcer and mitral ulcer
Presenting complaint:-
Itching, bumps with watery and sticky discharge in the medial aspect of the left ankle since 7 months ago. After scratching burning
Location:-medial aspect of left ankle
Sensation:- burning
Modalities:- aggravation :- night , warmth
Amelioration:- cold
Concomitant:- general weakness
Duration:- 7month
History of present complaint:-
Onset:- gradual
Progress :- H/O develop bumps and then itching and scratching with thin watery and sticky discharge in left ankle
Treatment adopted:- allopathic
Result:- mild relief
Past history:- HTN
Family history :- mother :- anosmia
Personal history :-
Mind and disposition :- answer gives slowly ,anger easily , short temper ,
Physical generals :-
Diet : vegetarian and non vegetarian
Desire : salty things
Disagrees : no any
Tongue: moist
Taste: No altered taste as mentioned Salivation: profuse
Perspiration: whole body
Stool: normal bowel moment
Urine: passes urine 2-3 times/ hours Bathing: regular
Covering: Not specific
Dwelling place: well ventilated
Aversion: nothing specific
Habits /Addiction: alcohol occasionally Tobacco: No
Alcohol: yes
Coffee / tea: tea drinker
Drugs etc: no
Thermal reaction: HOT
Skin: red
Sleep: disturb due to burning, itching. Dreams: forget
Gynaecological history: not applicable
Obstetrical history: not applicable
General Examination:
Anaemia: slightly paleness
Cyanosis: not detected
Oedema: not present
Hair: gray, white
Neck glands: not palpate
Gum: reddish
Pupils: normal
Pulse: 60bpm
BP: 130/ 90 mm hg
Temperature: Afebrile
Laboratory Investigations Previously done : Duplex Doppler USG Biopsy
Laboratory Investigation advise :
CBC
PPBS
FBS
Provisional diagnosis:
Pyoderma gangreosum
Dominant miasm: Psora , syphilis
Rubric:-
MIND -ANGER
MIND- IRRITABILITY
SKIN- ERUPTION -SCRACHING AGG AFTER SKIN -ULCER -DISCHARGE WATERY GENERALS- FOOD AND DRINKS -SALT DESIRE GENERALS -WEAKNESS
Prescription:-
Date:- 21/5/24
Rx – MERCURIS SOLUBILIS 200 /OD/3days
Follow up:-
28/5/24 pt. complain relief watery sticky discharge reduced itching also reduced
Rx – RUBRUM METALLICUM 30 / BD/ 7days
04/6/24
Pt complain better
Rx – RUBRUM METALLICUM 30/BD /7 days
Before Treatment After Treatment
Bibliography:
1)Schmieder SJ, Krishnamurthy K. Pyoderma Gangrenosum. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482223/
2) Boericke, W., & Boericke, O. E. (1990). Homoeopathic materia medica with repertory comprising the characteristic and guiding symptoms of the remedies (R. B. Savage, Ed.; 2nd ed.). Homoeopathic Book Service.
3) Allen, H. C. (2022). Allen’s keynotes & characteristics: With comparisons of some of the leading remedies of the materia medica with bowel nosodes. B Jain.
AUTHOR
DR VARSHA MOURYA
MD scholar , department of homoeopathic materia medica
Govt. homoeopathic medical college and hospital Bhopal , Madhya Pradesh
UNDER THE GUIDANCE
DR SHOBHANA SHUKLA
HOD and Professor of homoeopathic materia medica
Govt. homoeopathic medical college and hospital Bhopal , Madhya Pradesh
& Ex joint Director of Ayush Bhopal
