Abstract:
Plantar psoriasis is a chronic, autoimmune, inflammatory skin condition commonly characterized by hyperkeratosis, fissuring, itching, scaling, etc. Conventional treatment often provides symptomatic relief with frequent recurrences as relapses are common. Homoeopathy, with its principle of individualization and minimum dose, aims at restoring health at a deeper level.
Objective:
To evaluate the role of individualized homoeopathic treatment in the management of plantar psoriasis.
Case summary:
A diagnosed case of plantar psoriasis presented with hyperkeratotic plaques, hard callous cracks, and white scaling from the skin of the sole. A detailed case-taking was carried out emphasizing mental generals, physical generals, and characteristic particulars. The totality of symptoms was constructed, and an individualized constitutional remedy was selected based on classical homoeopathic principles. The patient was treated with a minimum dose and followed up over two months.
Results:
Gradual improvement was observed, followed by reduction in scaling, fissuring, and hyperkeratosis. Photographic evidence before and after treatment demonstrates significant clinical improvement without the use of topical or systemic conventional medications.
Conclusion:
This article highlights the effectiveness of individualized homoeopathic medicine in treatment of plantar psoriasis.
Key-words:
Plantar Psoriasis, Homoeopathy, Individualization
Introduction:
Plantar psoriasis commonly termed palmoplantar psoriasis is a variant of psoriasis that mainly affects the skin of soles (palms in palmar psoriasis). It is chronic relapsing inflammatory condition caused by combination of genetic and environmental factors .It
presents as hyperkeratotic patches with or without itching, or pustular features or typical scaly patches on which a fine silvery scale which can be evoked by scratching, as less well defined plaques resembling lichen simplex or hyperkeratotic eczema. Mixed forms occasionally occur.
Case Report:
A 16 year old male patient came with the complaint of hard, dry rough, and cracked skin over the medial metatarsal surface of the right sole of foot since 6-7 months. There was marked scaling of the skin without itching and bleeding. The skin had tendency to form callosities.
History of presenting complaint:
Patient previously diagnosed with plantar psoriasis by a dermatologist 2 years ago. For which he was treated with allopathic medications and ointments. The treatment gave temporary relief of symptoms but patches came back as soon as he stopped applying the ointment. Lesion started as a small, hard rough surface which used to crack and started scaling after area became large.
Past history:
Recurrent tonsillitis since 5-6 years.
Recurrent Upper respiratory tract infection in childhood.
Family history:
Father: warts, migraine
Mother: hypothyroidism
Patient as a person:
Patient is shy, usually calm but violent anger outburst when provoked. Anticipatory anxiety with profuse perspiration when appearing for tests, before exams. Avoids stage performance due to stage fear and speaking in public. Patient is a good kid, very organized about his things according to his mother.
Physical Generals:
Appetite: adequate, 4 meals a day, cannot tolerate hunger Desires: sour, spicy foods
Thirst: less than usual, 1 L/day, a glass of pot water at a time Urine: no complaints
Stool: No complaints
Perspiration: profuse on hands and palms, no odor, no stain Sleep: 7-8 hr, sound
Thermal state: hot
Local examination:
Skin was dry, hard and cracked with white scaling of skin.
Totality of Symptoms:
∙ Violent anger
∙ Timidity
∙ Anticipation anxiety
∙ Profuse Perspiration in extremities
∙ Desire sour, spicy
∙ Skin cracked, hard, dry
Rubrics:
Prescription:
Graphitis 200/ 2 doses Followed by SL BD for 15 days.
Patient was advised to apply coconut oil for moisturizing the skin. 1st follow up:
Dryness still present,
Scaling decreased than before
Cracks stared to heal
Prescription:
SL bd for 15 days
2nd follow up:
Dryness better than before.
Scaling much reduced almost gone.
Hardness and cracks still present.
New small callous lesion appeared
Prescription:
Graphitis 1M 2 doses
f/b SL BD for 15 days.
3rd follow up:
Skin smooth, cracks healed completely.
Scaling better completely.
Hardness is almost gone.
Conclusion:
The present case shows that individualized homoeopathic treatment can be effective in the management of plantar psoriasis when given in a minimum dose. The improvement seen in this case suggests that following classical homoeopathic principles, especially individualization and patience during treatment, can help achieve lasting relief in chronic skin conditions.
References :
1. Fitzpatrick’s dermatology,9th edition.
2. Miceli A, Schmieder GJ. Palmoplantar Psoriasis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448142/
3. Davidson’s principles and practice of medicine, 23rd edition.
4. Synthesis repertory software
