A case of vitiligo is being discussed in the following article which was cured by individualised remedy, Sulphur.
OPD: outpatient department, No.: number, agg.: aggravation, OD: once a day, BD: twice a day
Vitiligo is common dermatological disorder of chronic depigmentatation which phenotypically characterised by white macules on the skin caused as a result of a systemic destruction of functional melanocytes. Though it affects 1% of population worldwide but having a significant psychosocial impact on the quality of patient’s lives since their symptoms are visible. Vitiligo doesn’t cause notable physical impairment but affects human self-esteem in various ways: predisposes social isolation, depression, difficulties in sexual relationship and suitability for marriage. Some studies have stressed psychiatric comorbidity in patients with vitiligo with the prevalence of 25-35% in Europe and India.
However, treatment and control of vitiligo remain major challenges worldwide and currently, the available treatment options for patients with vitiligo have limited effectiveness but homoeopathic constitutional medicine is said to be effective in treating vitiligo. A constitutional prescription should be based on the totality of the mental and physical reactions which should also be able to cover the level of susceptibility, the tendencies, the behavioural pattern and underlying miasm.
IDENTIFICATION OF THE PATIENT
Miss ABC, 13-year old girl, OPD registration No.: C00956/ 5238, of Sakara, Muzaffarpur, visited in R.B.T.S. OPD on 02/08/19.
Extensive and generalised white discoloration of skin all over body except few regions for 5 years.
Location- all over body except some areas in the body.
Sensation- itching and burning when exposed to heat.
Modalities- <heat in any form, scratching, sunlight, cosmetics, mustard oil
HISTORY OF PRESENTING COMPLAINTS
Duration- since 5 years.
Mode of onset- gradual
Probable cause- not known
Treatment taken- homoeopathic medicine taken followed by some relief.
Nothing significant found.
Paternal side- Grandfather- had tuberculosis.
Maternal side- mother suffering from gall stone.
Own side- younger brother suffering from vitiligo.
Accommodation- pakka house; well ventilated.
Relation with family members- good.
History of vaccination – done at proper age.
- General modalities- most of the complaints aggravated by heat in any form, cosmetics, mustard oil.
- Thermal reaction- extremely hot patient.3+
- Appetite- good, rumbling in abdomen if not taken meal at proper time.
- Thirst- moderate; 3-4 litres/day
- Desire/Craving- sweet 3+ (craves)
- Aversion- meat 1+
- Intolerance- mustard oil 3+, heat in any form 3+, cosmetics 3+, color 3+
- Tongue- moist, posteriorly slight coated.
- Salivation- moderate
- Taste of mouth- no perverted taste of mouth.
- Bowel/ stool- regular, clear stool. Sometimes loose.
- Urine- clear, sometimes burning if less water is consumed.
- Perspiration- more on head; palm moist & hot.
- Sleep- sound, 8-9 hours.
- Dream- not remembered; sometimes of ghost.
- Abnormal discharge (if any)- nothing.
- Menstrual history- menarche not ye.t
- Others- burning palm and sole.
-On examination, thin nails.
- Mild generally; get angry when brother teases her.
- Built- thin
- Appearance- normal, broad forehead and increased space between two eyes.
- Pulse rate-74/minute
- Pallor- mild present
- Respiratory rate- 18/minute
ANALYSIS AND EVALUATION OF SYMPTOMS
- Non-communicative 2+
- Desire- sweets 3+
- Aversion- meat 1+
- Thermal reaction- hot 3+
- Allergic to mustard oil, colour, and cosmetics. 3+
- Burning palm and sole.
- Extensive and generalised white discolouration of skin. 3+
- Itching all over body; <scratching 3+, heated when 3+
- Broad forehead and increased space between two eyes.
- On examination, thin nails
From presenting symptoms, characteristic mental generals, physical generals and characteristic particulars along with family history, it was evident that the case is multi-miasmatic with syphilitic predominance.
TOTALITY OF SYMPTOMS
- Craving –sweet.
- Allergic to mustard oil, colour and cosmetics.
- Thermal reaction- hot patient.
- Itching <heat, scratching.
- Extensive white discoloration of skin.
CONVERSION OF SYMPTOMS INTO RUBRICS
|Desire- sweets||Generalities||Food and drinks-sweet- desire|
|Allergic to colour, mustard oil, cosmetic products||Generalities||Allergic constitution|
|Thermal – hot||Generalities||Heat- sensation of|
|Itching of skin <heated when||Skin||Itching-warm becoming on|
|Itching of skin< scratching||Skin||Itching-scratching –agg.|
|Extensive white discoloration of skin||Skin||Discoloration- white spots|
Working method- computer method
Software used- RADAR
Repertorisation method- synthesis repertory used.
Pulsatilla nigricans– 11/5
Mercurius solubilis– 10/5
As Sulphur covers maximum numbers of rubrics and scored maximum points, therefore Sulphur was the repertorial selection.
FINAL SELECTION OF THE MEDICINE
After considering the whole case and consulting with materia Medica, Sulphur was found to be the final selection for prescription.
1 globule no. 30; aqua dist. 10 ml; 1 dose.
To be taken in the morning empty stomach
2. Rubrum 30/ 1 dram
BD for 15 days.
GENERAL MANAGEMENT ADVISED
- Do not use any cosmetics and cream.
- Do not get exposed much into sun.
|DATE||CHANGE IN SYMPTOMS||MEDICINE PRESCRIBED||ASSESSMENT||REMARKS|
|21/8/19||Slight brown pigmentation appeared in forehead region.||Rubrum 30/1 dram;OD(M) Saclac 30/ 1 dram;OD(N)||2||Slight Improvement.|
|09/09/19||Marked brown pigmentation appeared; itching reduced .||Rubrum 30/1 dram; BD||2||Improving.|
|18/09/19||Improvement still going on; itching lessened||Saclac30/1 dram;OD(M) Phytum 30/1 dram; OD(N)||2||Improving.|
|10/1/20||Skin of forehead regained its normal colour; normal skin colour appeared in palm and face.||Rubrum 30/ 1dram BD||4||Improving.|
|24/1/20||Normal skin colour appeared in shoulder and forearm and neck.||Rubrum 30/1 dram;BD||3||Improving.|
|07/02/20||No significant change||Rubrum 30/1 dram; BD||0||Standstill.|
|26/02/20||Normal skin colour appeared in feet and face region. No marked amelioration.||Sulphur 1M/1 dose;OD(M) Rubrum 30/1dram;BD||2||Slow improvement.|
|13/06/20||Medicine discontinued. Condition stand still.||Sulphur 1M/1 dose; OD(M) Rubrum 30/1 dram;BD||0||Standstill|
Patients suffering much ameliorated after taking homoeopathic constitutional medicine prescribed maintaining strict individuality which has shown the efficacy of homoeopathic constitutional medicine in case of vitiligo. The case is still under treatment and is doing well.
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FIGURE- BEFORE TREATMENT
FIGURE- AFTER TREATMENT
By Dr Priyanka Bharti
PGT, 2017 Batch
RBTS Govt. Homoeopathic Medical College Hospital,