ABSTRACT– In the following article, a case of 9-year old girl suffering from tinea capitis, is being discussed which was treated using holistic approach of homoeopathy with the help of Synthesis repertory.
KEYWORDS– Tinea capitis, homoeopathy
ABBREVIATIONS– once a day (OD), twice a day (BD), potassium hydroxide (KOH)
INTRODUCTION
Infection of the skin by fungus is very common in our country due to warm and humid climate and it’s incidence of fungal infection is found to be more during summer and rainy seasons. The common fungal infections of the skin include ringworm, candidiasis and pityriasis versicolor.
RINGWORM– This is the most common fungal infection of the skin caused by the organism belonging to any of the three genera, namely, microsporon, trichophyton and epidermophyton. The clinical features and nomenclature of the ringworm depend upon the site of involvement, such as-
Tinea capitis- When infection occurs on scalp
Tinea barbae- When infection involves the coarse hair of beard and moustache.
Tinea corporis- When infection occurs on trunk and extremities.
Tinea cruris- When infection occurs around groin region.
Tinea faciei- When infection occurs on skin of face excluding moustache and beard area of the adult male.
Tinea manum- When infection occurs on palms.
Tinea pedis- When infection occurs on soles or toes.
Tinea unguim- When infection occurs on nails.
TINEA CAPITIS
When the infection occurs on the scalp, the term tinea capitis is used. It is very common in children but rarely seen in adults. It manifests as a localised form of partial alopecia associated associated with itching, erythema and scaling.
A few patients may present with localised, painful, boggy swelling called kerion. In both these conditions, the hairs in the patches are dry, lustreless, brittle and broken at varying lengths from the surface of the skin.
In another variety, the hairs break at the level of the skin surface producing the picture of black dots in an area of alopecia. This is known as black dot tinea capitis.
DIAGNOSIS-
Tinea can be confirmed by demonstrating the presence of fungal hyphae in the scrapings from the skin, hair or nails as the case may be in a 10% KOH solution. The causative fungus can be cultured on sabouraud’s medium where fungal colonies appear in approximately two weeks.1
Case study
Chief complaints
A girl aged 9 years, came with the complaint of itching on scalp and hair falling in patches from her scalp. Itching on scalp, mainly at night.
History of presenting complaints
The patient was apparently well 6 months back, according to her mother, she gradually started with itching on scalp with gumma-like raised red eruption, after a month, oozing of yellowish discharge occurred, followed by yellow crust. After then, loss of hairs started in that particular region. It keeps on progressing, ultimately causing patches on scalp, devoid of hairs in various spots.
Past history: When she was of 5years, history of fungal infection on her hand and back, undergone for allopathic treatment.
Family history: Her father also has history of fungal infection in his adolescents.
Personal history: Milestones early, teething was before time.
Gynaecological history: Menarche not approached yet.
Physical generals: Her appetite was average with 2 meals a day including 2 chapattis, dal and rice, drank water only at the time of meals (thirstless) or 1-2 glasses of water a day. Desire for milk and spicy, sour food. Hot patient cannot tolerate heat. Perspiration profuse on palms and soles, but especially on her scalp, slight offensive. She had sound sleep, frequent dreams of ghosts wearing white clothes and dream of her class teachers. She was usually constipated, had to go to closet every 2nd and 3rd day.
Mental generals: Desire for company, fear of dark, fear of ghosts, couldn’t see blood, or hear sad news, it made her anxious. She had an urge for urination if she heard sad news. Fastidiousness, wanted everything neat and clean, in order. According to her mother, she felt jealous in seeing other persons having good homes, other children having costly toys, she used to complain to her mother that she also wanted that.
Diagnosis– Tinea capitis (based on clinical symptoms and physical examination of patient), includes primary lesions as plaques, pustules and nodules followed by secondary lesion, viz. scales, alopecia which is reversible, erythema and exudates.2
Miasmatic analysis-3
- Anxiety- cruelties, after hearing of- psora
- Desire for company- psora
- Envy- sycosis
- Fear of dark – psora
- Fear of ghosts – psora
- Desire for milk- psora
- Desire for sour food, acids – sycosis
- Perspiration of scalp- syco-syphilis
- Constipation in children – psora
- Loss of hair on scalp- syphilis
- Itching of scalp at night- psora
Analysis and evaluation of symptoms
| S.no. | Symptom type | Symptom | Intensity |
| 1. | Mental general | Desire for company | +++ |
| s2. | Mental general | Anxiety after hearing about cruelties | +++ |
| 3. | Mental general | Fastidious | + |
| 4. | Mental general | Fear of dark | +++ |
| 5. | Mental general | Fear of ghosts | ++ |
| 6. | Mental general | Envy | ++ |
| 7. | Mental general | Dreams of ghosts | + |
| 8. | Physical general | Desire for milk | +++ |
| 9. | Physical general | Desire for spicy food | + |
| 10. | Physical general | Desire for sour food and acid | ++ |
| 11. | Physical general | Thirstless | +++ |
| 12. | Physical general | Constipation | +++ |
| 13. | Physical general | Perspiration on scalp | ++ |
| 14. | Common symptom | Itching on scalp at night | +++ |
| 15. | Common symptom | Loss of hair in patches on scalp | +++ |
Totality of symptoms
- Anxiety, hearing cruelties of others
- Desires company
- Fear of dark
- Fear of ghost
- Envy
- Desires for milk
- Desire for sour acid food
- Thirstless
- Constipation, ineffectual urge
- Perspiration profuse especially on scalp
- Loss of hair on scalp
- Itching of scalp at night.
Repertorial totality
The following mental general, physical general and particular symptoms were taken into consideration and repertorisation was done with the help of Synthesis repertory (Radar opus 10.0).4
Repertorial result
Calcarea carbonicum – 23/12
Arsenicum album – 18/9
Lycopodium clavatum – 18/9
Sepia officinalis- 14/9
Sulphur- 11/9
Phosphorus- 19/8
Selection of remedy– After repertorisation, Calcarea carbonicum came up with highest marks and Arsenicum album, Lycopodium clavatum possessed second highest marks. But Calcarea carbonicum was selected on the basis of mental as well as physical symptoms of patient. In this case, patient had fear excited by reports of cruelties, fear of darkness and ghost, solitude in unbearable, loss of appetite, constipation, head sweats profusely, scabs on scalp, falling off the hair from sides and temples, boils in the scalp which tend to suppuration.5
Prescription– Prescribed on 05/03/2021
Calcarea carbonicum 1M single dose, early morning empty stomach mix with half cup of water for 1day along with placebo every day, two times before meal for 15 days.
Selection of dose and Potency- As per Organon of medicine, aphorism 247 5th edition, and according to the susceptibility of the patient, potency was selected. Here the patient’s susceptibility was high. Since she suffered from long time due to that affection, so the prescription was started with higher potency.6
Advise– Patient was asked to clean the area with water regularly, maintain hygiene. Avoid sharing towels and soap. Avoid any other topical application and apply coconut oil.
Follow up-
| DATE | SIGNS AND SYMPTOMS | PRESCIPTION |
| 06/04/2021 | No new eruption and patch, itching same Appetite – slightly improved Stool every alternate day but constipated | Placebo 30 /BD /1month |
| 07/05/2021 | No new eruptions, itching improved Appetite- better, Thirst- improved, 1-2litres/day Stool- constipation slightly improved Dreams- of daily routine | Placebo 30/BD/1 month |
| 10/06/2021 | Appetite good Urine – clear Patches covered by tiny baby hairs but hairs becoming dry and lusterless with itching. | Calcarea carbonicum 1M/4 pills/OD/2 day Placebo 30/BD/1 month |
| 05/07/2021 | Weight increased by 2 kg Patient was happy, mentally felt relaxed, no anxiety All patches disappeared and covered with hairs, also quality of hair was shiny and healthy. | Placebo 30/BD/15 days. |
Repetition of dose: Calcarea carbonicum 1M repeated on 10/6/21 as case shows no further progress, it came to a standstill and appearance of itching was noted.
Conclusion
Homoeopathy is an artistic and holistic treatment for such kind of a case. If the medicine is selected according to the symptom similarity and individualisation, most of the cases are curable. One must emphasis on totality. With the help of homoeopathic treatment, the intensity of itching and lesions gradually diminished and patient is on the path of recovery.
REFRENCES-
- Manchanda R.K, Gupta Ramji, Textbook of Dermatology for Homeeopaths, fourth edition, New delhi: B.jain publishers (P) Ltd; 2011
- DynaMed [Internet].Ipswich(MA): EBSCOInformationServices. 1995-.Record No. T116543,Tinea Capitis; [updated 2018 Nov 30] https://www.dynamed.com/condition/tinea-capitis
- Banerjea SK, Miasmatic Diagnosis, Practical Tips With Clinical comparisons, B. Jain Publishers (P) Ltd. 2007
- Synthesis Repertory 9.1 (Radar Opus 10.0)
- Clark JH. A dictionary of practical Materia medica: vol.1 35th impression 2018 B. jain publisher(P) Ltd New Delhi.
- Hahnemann S, Organon of Medicine, 5th& 6th ed. New Delhi: B. Jain publishers (P) Ltd; 2016.
ABOUT THE AUTHORS
Dr Minali Dubey, PG scholar, Department of Homoeopathic Materia Medica, Government Homoeopathic Medical College & Hospital, Bhopal (M.P)
