Lichen Planus Managed with Staphysagria: A Case Report.
Abstract
Lichen planus is a chronic inflammatory condition of the skin and mucous membranes. This case is unique because it demonstrates a complete symptomatic resolution with individualized homeopathic therapy. It contributes to the medical literature by highlighting the role of Staphysagria in managing lichen planus with minimal interventions.
Patient Information / Clinical Findings: A 35-year-old female presented with pruritic, violaceous, polygonal papules on the forehead and right arm. She had a history of eruptions since adolescence and associated symptoms including frightful dreams, suppressed anger, and urinary disturbances.
Diagnosis and Therapeutic Interventions: The patient was diagnosed with lichen planus clinically. Staphysagria 30C and later 200C was prescribed based on individualized homeopathic principles with adjunct supportive remedies (Thuja 1M, Calcarea phosphorica 6X) as needed. Lifestyle and emotional factors were addressed. The patient showed progressive improvement, with complete resolution of lesions and normalization of sleep and systemic symptoms over 6 months.
Conclusion: This case emphasizes the effectiveness of individualized homeopathic therapy in lichen planus. Emotional factors play a significant role in totality-based prescription, and careful remedy selection can lead to complete recovery.
Key words– case report, lichen planus, autoimmune, frightful dreams, suppressed emotions.
Introduction
Lichen planus is a chronic, inflammatory, autoimmune-mediated disorder affecting the skin, mucous membranes, hair, and nails. It commonly presents as pruritic, violaceous, polygonal papules and plaques, often arranged in a symmetrical distribution. The disease predominantly affects adults and follows a relapsing and remitting course, significantly impairing quality of life due to persistent itching, cosmetic concerns, and psychological stress.
The exact etiopathogenesis of lichen planus remains unclear; however, immunological mechanisms involving T-cell–mediated cytotoxicity against basal keratinocytes are considered central to its development. Emotional stress, drug intake, systemic illnesses, and infections have been identified as triggering or aggravating factors. Conventional management includes topical and systemic corticosteroids, immunosuppressive agents, and antihistamines, which primarily provide symptomatic relief and are often associated with adverse effects and frequent recurrences.
CASE PRESENTATION
Preliminary data
| Name- S J Rathod | Age- 35 years |
| Sex- female | Qualification- 10th grade |
| Occupation-Housewife | diet- pure veg |
| Marital status- Married | Address- Bhavnagar |
| Religion- hindu | Date – 19/01/2025 |
Chief Complain
Dark, blackish, circular, flat-topped patches on forehead and arm(right side). Which itch slightly (not much), taking allopathic treatment for 1 year – ointment Beclomethasone, No any discharge from eruption. Itching < in summer, threading(?)
h/o same eruptions around vulva at the age of 15 years which itch violently and taken allopathic medicines for around 1 month and eruptions go on remission, then before 1 year after threading it reappear on forehead and gradually increasing in size (pea size to size of a coin.)
Associated Complain
Leucorrhea sometimes which is watery, odorless, bland, <before menses.
Dream of dead body is talking with her, she afraid from these types of dreams and can’t sleep. Dreams < sleeping on back.
Physiological Functions
- Appetite-
- Frequency- 3 times /day, adequate.
- Desire for fried food, junk food and spicy++,
- Thirst– 2 to 3 Liters /day, drinks about half a glass each time, thirst varies with season.
- Urine – frequent, has to go 15 to 16 times a day, frequency increased after marriage, scanty, yellowish in colour.
- Bowel-
- 2- 3 times a day, semisolid, Satisfactory, no any complain.
- Consistency- semisolid
- Colour- yellowish brown
- Odor- not specific
- Before/during/after- no any complain
- Sleep and dreams – 6 -7 hrs , sound sleep generally, sometimes disturbed due to repeated dreams of dead bodies, fearful dreams which are aggravated by sleeping on back.( Once, when her maternal aunt’s daughter passed away, she had dressed her like a bride. Since then, she has been seeing dead bodies in her dreams. she feels very scared, wakes up at night, and cannot sleep.)
- Thermal- hot patient (never wear sweater in winter and can’t tolerate heat)
- Bath- seasonal water,
- covering- no need to cover in summer and put on thin blanket in winter,
- fan- always,
- season- likes winter and open air,
- sun exposure- headache.
- Perspiration-
- Quantity – moderate,
- Location – more on axilla, buttocks ,
- Staining – no stain,
- Odor – no odour,
- Nature – bland .
Allergy- no any
Addiction– no such
- Menstrual history – FMP- 13 Yrs of age
- LMP- 10/01/2025
- Duration of Cycle – regular,4-5 / 25- 28 days,
- Flow – profuse bleeding with large dark red clots
- Before/ during/ after – Complain of lower abdominal pain, calf muscles cramps, and weakness before and during menses, and itching in pubic region.
- Leucorrhoea- before menses,
- Colour – white,
- Quantity- scanty,
- Nature- watery and bland
- Staining – no any
- Odor- not specific
- Obstetric history– G3P2A1L2
- 2 FTND, 1 girl and 1 boy alive, and 1 induced abortion
- Past history
- jaundice at the age of 14 years recovered with allopathic treatment
- chickenpox during childhood
- Headache (all over the head) cured after pregnancy by its own.
- Family history-
- Father-alive- goitre(surgery done
- Mother-alive- OA,
- Brother-alive- healthy,
- Sister(3)-alive- healthy,
- grand father and grand mother– died in childhood- reason of death not remembered
- Husband- alive- recurrent spasmodic hiccup,
- son-alive- healthy
- daughter- alive- healthy.
- Physical examination–
- Built- short stature, obesity only around abdomen
- Weight- 52kg
- Pulse- 66/min
- Tongue- pale, clean
- Teeth- white
- No any lesion was found on mucosa or nails.
- Local examination – inspection of plaques on forehead and arm – dark, purplish and brownish, flat topped plaques, painless on palpation.
Wickham’s striae is visible with a magnifying lens.
Distribution- it is distributed in right arm an forehead.
- Systemic examination –
- CVS- S1S2 heard, NAD
- CNS- fully conscious and well oriented, all motor and sensory functions are normal
- GIT- NAD
- RS-NAD
- LS- NAD
- Lab investigation – suggested CBC.
- Life space
She comes from a lower middle-class family. Since childhood, the financial condition at home was poor, so there were many restrictions. Even in the heat, they couldn’t switch on the fan. She was not allowed to go out anywhere, and even if she had a strong desire to eat outside food, she was not allowed to eat it. After completing her studies up to the 10th std, she started working in a diamond polishing job. Later, she got married, and life has been better after marriage.
Her mother-in-law has schizophrenia. She often sees someone in white clothes and feels that person has come to steal something from the house, so she hides things. Everything in the house must be placed exactly where her father-in-law wants, otherwise he scolds.
She cannot express her anger openly. When asked why, she said, “One doesn’t speak in front of elders.” When she gets angry, she keeps it inside, but sometimes the anger becomes so intense that she ends up hitting the children and trembles whole body while anger. She said I never cried. Apart from her family, she doesn’t feel much sympathy. If someone else suffers, it doesn’t affect her much.
- Differential diagnosis
- Psoriasis
- Pityriasis rosea
- Chronic cutaneous lupus erythematosus
- Diagnosis– lichen planus
- Diagnosis was primarily clinical through physical examination (PE), observing characteristic violaceous, polygonal plaques and Wickham striae on the skin.
- Prognostic Characteristics: Lichen planus is generally chronic but benign. Prognosis is favorable with appropriate treatment. No malignant potential was observed in this patient.
Totality of symptoms
1) anger suppressed, can’t express it and trembling of extremities and voice broken while anger.
2) never weeps.
3) dreams of dead body is talking with her, afraid from these types of dreams and can’t sleep. Dreams < while sleeping on back.
5) desire for fried and spicy food.
6) Frequent and scanty urination after marriage.
7) profuse menses with dark red clots and lower abdominal pain.calves cramp. weakness and itching in pubic region during menses.
8) leucorrhea profuse, watery, and bland.< before menses.
9)dark, blackish, circular, flat topped patches on forehead and lateral aspect of arm (rt sided) eruptions itch slightly <in summer, threading, waxing.
MIASM: –
Dominant Miasm: – sycosis
Fundamental Miasm: – sycosis
Susceptibility– high
Repertorisation– case was repertories with the help of synthesis repertory.
Prescription- on 19/01/25 staphysagria was selected on the basis of repertorisation
Rx. Staphysagria 30 bd for 1 week followed by sac lac bd for 15 days.
- Remedy: Staphysagria
- Trade Names: Staphysagria
- Manufacturer: SBL
- Potency: 30
- Scale: Centesimal (C)
- Galenic Form: Globules (sucrose-lactose pellets)
Follow up– 12/2/25
– No any Improvement.
– Itching increased.
Rx. STAPHYSAGRIA 30 BD for 3 Days.
Followed by Sac lac 30 for 15 Days
- 21/02/25 – Itching in eruption leg cramps aggravation at night.
clots dark black Bright red.
Urine frequency as it is.
Frightful dreams < on back. Staphysagria
Rx. Staphysagria 200 – 2 Dose (morning – evening)
Sac Lac 30 BD For 21Days.
- 17/03/2025 – itching decreased
no any frightful dreams
now can sleep on back
eruptions become lighter
no eruptions on forehead
Rx. Sac lac 200 -2 Dose (morning – evening)
Sac Lac 30 BD For 21Days.
- 03/04/2025 – complaint of severe leg pain.
weakness.
no frightful dreams.
eruption on arm as it is.
Rx. Thuja 1 M – 1 Dose stat.
Calcarea phos 6x 3 tab. BD for 30 days.
15/05/2025 – Better in lag cramps,
no frightful dreams
urine frequency decreased
no clots in menses eruption lightens
Rx. Sac lac 200 BD for 15 Days.
02/06/2025 – better in leg cramps
no eruption on forehead or arm
general well being
Rx. Sac lac 200 BD for 1 month.
Conclusion
This case demonstrates the efficacy of individualized homeopathic therapy in managing chronic lichen planus. Emotional and psychological aspects were central to remedy selection. Careful consideration of totality of symptoms, miasmatic evaluation, and periodic follow-up can lead to complete resolution without recurrence, highlighting the importance of holistic management in chronic dermatological conditions.
Patient Perspective
“I feel relieved that my skin cleared and I can sleep peacefully now. The treatment helped not just my eruptions, but also my fear and anxiety from repeated dreams.”
Informed Consent
The patient provided written informed consent for the publication of her clinical information and photographs.
Guide– Dr. Rupal Mehta, professor, department of organon of medicine, Anand homoeopathic medical college and research institute, Anand.
