A Case Study of Psoriasis with Homoeopathic Treatment According to Individualistic Approach

Abstract–

Psoriasis is a chronic autoimmune skin condition characterized by red, scaly, and inflamed skin lesions, affecting approximately 2-4% of the global population. It is a complex and multifaceted disease, involving an abnormal immune response, genetic predisposition, and environmental triggers, leading to excessive skin cell proliferation, inflammation, and angiogenesis. The clinical features of psoriasis include dryness, itching, and burning sensations, nail and joint involvement, and significant emotional and mental distress. ongoing research focuses on identifying genetic and environmental triggers, developing targeted therapies and biologics, and investigating the role of the gut-skin axis and microbiome, aiming to improve patient outcomes and quality of life. A comprehensive understanding of psoriasis is essential for effective management, and individualized treatment approaches are crucial to address the unique needs of each patient. By exploring the intricacies of psoriasis, researchers and healthcare professionals can work towards developing innovative solutions to alleviate the physical and emotional burden of this debilitating condition.

Keywords- Psoriasis, Auto-Immune, Homoeopathy.

Definition- Psoriasis is a chronic dermatosis characterized by an unpredictable course of remissions and relapses and presence at typical sites of well-defined erythematous papules and plaques, which are surmounted with large, silvery loose scales. there is frequent nail and joint involvement.

Etiology

Genetic

• May be Autosomal dominant (with incomplete penetrance) or polygenic. 

• Genetic basis supported by: 

• Increased familial cases.

• Greater concordance in monozygotic twins (70%) than in dizygotic twins (30%).

• Increased association of HLA-CW 6 (20 times increased risk) with early onset psoriasis.

• Identification of psoriasis genes

Triggers

Physical trauma scratches, surgical incisions and injuries (isomorphic or koebner’s phenomenon).

Infections:β Hemolytic Streptococcal Infection: Precipitates guttate lesions, HIV infection: precipitates explosive psoriasis.

Drugs: Antimalarials, Lithium, β-Adrenergic Blockers, NSAIDS, Corticosteroid. Withdrawal may aggravate psoriasis or may precipitate pustular lesions.

Epidemiology

Prevalence:

• Global Prevalence: 2-4% of the global population (around 150-200 million people)
• United States: 2-3% (around 6-9 million people)
• Europe: 2-5% (around 10-20 million people)
• Asia: 0.5-2% (around 20-50 Million People 

Incidence:

• Annual incidence rate: 40-60 per 100,000 people
• Peak age of onset: 20-30 years old

Age and Sex:

– Psoriasis can occur at any age, but most cases appear between 20-50 years old

– Men and women are equally affected, but women tend to develop psoriasis earlier in life

Some Homoeopathic Remedies:

1. Arsenicum album: for dry, scaly, and itchy skin with anxiety and restlessness.
2. Graphites: for dry, rough, and cracked skin with emotional instability.
3. Sulphur: for red, inflamed, and scaly skin with burning sensations and irritability.
4. Natrum muriaticum: for dry, scaly, and itchy skin with emotional sensitivity and depression.
5. Phosphorus: for red, inflamed, and scaly skin with burning sensations and anxiety.

Clinical Feature- Evolution of disease, usually chronic, indolent lesions, which persist for months. Less frequently, acute onset; two forms of acute presentations recognized: acute guttate psoriasis. Generalized pustular psoriasis.

Case Summary:

Identification of Patient

Mrs. Abc 35 year old of kolar road sarvadharm B sector Bhopal visit to govt homoeopathic medical college and hospital Bhopal 

Presenting Complaint- A case of 35-year-old female presented in opd with chief complaint of red scaly moist itchy plaques 

Location- forearm

Sensation– burning 

Modalities- aggravation from cold, perspiration, from scratching

– duration: 3 years

– previous treatment: topical corticosteroids, moisturizers, and phototherapy

History of presenting complaint

Patient was apparently well 3 years back when she gradually developed eruption on for arm it was small in size then it become bigger red moist and scaly

Physical general 

• General modalities – most of the complaint aggravated by perspiration, cold, scratching 
• Thermal reaction – chilly 
• Appetite – increased 
• Thirst – 3-4 liter in sips
• Bowel – all gone feeling sensation in abdomen, constant nausea feeling 
• Tongue – clean 
• Sleep – not sound due to metal restlessness changes change places
• Dreams – not specific 
• Menstrual history – normal 

Mental general –

• Stressful job and personal life
• Anxiety and irritability 
• She is concerned about the security, protection, routine, safety, task and shelter. The main concern is about lacking formation, maintaining or losing the structuring of being “trapped” and “helpless”
• Fear of death 
• Fear of being alone desire company 
• Convey her complaint in a exaggerated way
• Anxiety about health not easily console 

General Examination

•         Built – healthy 
•         Pulse – 72/min 
•         Respiratory rate – 17 / min 

Analysis and Evaluation of Symptoms 

• Anguish ++
• Anxiety ++
• Fear of death +
• Anger +
• Irritability +

• Increased appetite
• Thermal reaction chilly 

Totality of Symptoms 

• Mental restlessness driving from one place to another 
• Convey her complain in exaggerated way 
• Anxiety about 
• Required company for security fear of being alone 
• Irritability and anger about trifle 
• Increased appetite, constant nauseated feeling 
• All gone sensation in abdomen 
• Eruption on forearm which is moist scaly 
• Burning and itching which is aggravated by scratching 

Rubrics 

• MIND –ANGER
• MIND –ANGUISH driving from place to place 
• MIND –ANXIETY – evening 
• MIND –ANXIETY -alone when 
• MIND –ANXIETY – health about
• MIND- FEAR 
• STOMACH – APPETITE – increased 
• STOMACH- NAUSEA 
• ABDOMEN – EMPTINESS 
• SKIN – ERUPTION – CRUSTY- MOIST 
• SKIN – ERUPTION- SCALY
• SKIN – ITCHING- SCRATCHING – agg.
• SKIN- PSORIASIS 

Repertorisation

Working method- Computed method 

Software used- Synthesis

Repertorisation method – Synthesis repertory used. 

Repertorial Analysis –

• Arsenic album – 11/31 
• Phosphorous – 11/35 
• Sepia – 11/24 
• Rhus tox – 11/23 
• Sulphur – 10/24