ABSTRACT
Pityriasis versicolor, also called tinea versicolor is a superficial chronic recurring fungal infection affecting stratum corneum. Characterized by scaly, dyspigmented irregular macules most often occuring on the trunk and extremities. Caused by Malassezia yeast, which is a dimorphic fungus. Usually common in late teens and early 20s being its peak.[1]
The case study is of 19year old male diagnosed with Pityriasis versicolor which was successfully treated with constitutional homoeopathic medicine.
KEY WORD– Pityriasis versicolor, constitutionalhomoeopathic medicine.
INTRODUCTION
Pityriasis versicolor is a common fungal infection that causes small, discoloured patches of skin. It is caused by an overgrowth of yeast on the skin. Mostly often affects teens and young adults. The condition isn’t contagious. Symptoms includepatches of skin that are lighter or darker than the surrounding skin, often on the torso and shoulders.
CASE REPORT
Patient is a 19-year-old male, and is a painter by profession.He developed red scaly lesion on neck which were insidious in onset and gradually increased in size and spread to shoulder within 15 days associated with scales.
He took steroids for the same, but itching reappeared after he left the medicines.
PRESENTING COMPLAINTS
1. Scaly skin with shredding and hypopigmented patch over neck and shoulder with intense itching since last 2 months.
Agg: sun heat,atnight,heat of the bed
Amel: itching,open air.
2. Severe itching and burning,desire to itch all the time.
3. Weakness and lethargic feeling for last one month.
HISTORY OF PRESENTING COMPLAINTS
Patient was apparently well 2 months back when he developed red scaly lesion on neck which were insidious in onset and gradually increased in size and spread to shoulder within 15 days associated with scales.
He took steroids for the same, but itching reappeared after he left the medicines.
PAST HISTORY
- Dog bite at the age of 8 years.
Treatment – Vaccination
- Chest infection at the age of 15 years
Treatment-Allopathic
- Typhoid age at the age of 17 years
Treatment- Allopathic
FAMILY HISTORY
Father: Diabetic.
Mother: Hypertension, Arthritis
PaternalGrandparents: Grandmother-
T.BGrandfather- Deceased
MaternalGrandparents: Deceased.
PERSONAL HISTORY
Addiction: Chewing tobacco (Gutkha)15-17/day
Cigarette 2-3/day
Occupation: Painter
Accommodation: Well ventilated house
Diet: Irregular
Socio economic condition: Poor
Marital status: Unmarried
Relation with family members: Good
PHYSICAL GENERAL
Appetite: Loss of appetite, easy satiety 1 or 2 meals /day
Thirst:3-3.5 L / day, large quantity at a time, desire for cold water.
Desire:Spicy foods
Aversion:Meat
Intolerance:Milk
Tongue:Moist
Taste:Bitter taste of mouth
Perspiration:Profuse, mostly on trunk
Stool:Unsatisfactory, ineffectual desire, has to go 2-3 times/day
Urine:Sometimes yellowish along with burning sensation
Sleep:Disturbed (due to itching of skin)
Dreams: Sometimes of ghost, of dead people (grandfather)
Thermal reaction: Hot patient
MENTAL SYMPTOMS
- Angry at slightest things due to his itching he was like “dr sahab mujhe har baat pe chid chidahat mach rahi h pichle1 mahine se, kaam krne ki bhi ichcha ni hoti khujli ke karan, aap kuch bhi kr k meri khujli km kr do”
- Desire to be alone.(mujhe zyada logo ki bhid-bhad, ya logo ka mach-mach acha ni lgta,mai akela hi mast rahta hu)
- Anger leads to trembling and weeping.(jab mai gusse me rahta hu toh pura sharir kanpne lgta hai, mann to krta haisamne waley ko lga dun,but mera sharir sath ni deta isliye bahas k baad rona aa jata hai)
Consolation amelioration.
- Fear of animals specially dogs (dr sahab mujhe dar-war ni lgta kisi se upar wale k alawa, haa lekin janwaro me kutton se bhot dar lgta h) because in childhood he had dog bite incident.
PHYSICAL EXAMINATION
Mental status: conscious
Built and nutrition: Lean and thin, under nutrition.
Gait: Normal
Pallor:Present
Icterus:Absent
Cyanosis:Absent
Clubbing:Absent
Lymphadenopathy:Not enlarged
Respiratory rate: 18 breaths/min
Temperature:98°F
Height: 5’3”
Weight: 48kg
DIAGNOSIS
Based on clinical symptoms, physical examination – Pityriasis Versicolor
TOTALITY OF SYMPTOMS
- Scaly skin with shredding.
- Agg: sun heat, atnight, heat of the bed.
- Thirsty, large quantity at a time, desire for cold water.
- Aversion:Meat.
- Intolerance:Milk
- Perspiration:Profuse
- Thermal reaction: Hot patient
- Dreams: of ghost
- Anger leads to trembling and weeping.
- Fear of dogs
REPERTORIAL TOTALITY OF CASE
Synthesis 9.0 reportory was used for repertorization.[4]
SKIN – ERUPTIONS – scaly
SKIN – ERUPTIONS – itching – warm – bed – agg.
MIND – FEAR – dogs, of
MIND – WEEPING – anger – after
DREAMS – GHOSTS
GENERALS – FOOD and DRINKS – milk – agg.
GENERALS – FOOD and DRINKS – meat – aversion.
PRESCRIPTION
01/08/21
Rx
Sulphur 200 / OD / 2 days
Sac lac 200 / 4 pills / BD for 7 days
After repertorisation, Sulphur came up with highest mark and Pulsatilla and Belladonna were also indicated but Sulphur was selected on the basis of mental as well as physical symptoms of the patient.[2,3]
FOLLOW UP
07/08/21
- Reduction in hypopigmented patch over neck.
- Relief in Itching and burning sensation.
- Reduction in the amount of shredding of scaly skin.
- Appetite improved.
- Bowel movement got better.
Rx
Rubrum 200 / OD / 7 Days
FOLLOW UP
14/08/2021
- Hypopigmented patch over neck almost disappeared.
- No Itching and burning sensation felt.
- Nearly normal skin was seen over the affected area and no shreding of skin was present.
- Appetite very much improved.
- Bowel movement/stool was regular.
- Patient regained strength.
Rx
Sac lac 200/4 pills / OD for 15 days
CONCLUSION
Homoeopathic medicine are prescribed in very minute and controlled dose, keeping in mind the disease symptoms and individual miasms.
REFERENCES
1.Pityriasis versicolor: A clinicomycological and epidemiological study from a tertiary care hospital, Ghosh SK, Dey SK, et al., IJRH, 2008; 53(4): 182-185
2.Hahnemann S, Organon of Medicine 5th and 6th edition, New Delhi; B Jain Publishers (p) Ltd; 2016
3.Boericke W. Boericke’s New manual of Homoeopathic MM & Repertory, LPEed. New Delhi: B Jain Publishers(9) Ltd; 2014
4.Synthesis Repertory 9.1 (Radar Opus 10.0)
