Role of Homoeopathic Constitutional Medicine in Vitiligo- A Case Report

Abstract

A case of vitiligo is being discussed in the following article which was cured by individualised remedy, Sulphur.

Keywords

Vitiligo, Sulphur.

Abbreviations

OPD: outpatient department, No.: number, agg.: aggravation, OD: once a day, BD: twice a day

INTRODUCTION

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.

PRESENTING COMPLAINTS

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.

PAST HISTORY

Nothing significant found.

FAMILY HISTORY

Paternal side- Grandfather- had tuberculosis.

Maternal side- mother suffering from gall stone.

Own side- younger brother suffering from vitiligo.

PERSONAL HISTORY

Occupation- student

Accommodation- pakka house; well ventilated.

Relation with family members- good.

History of vaccination – done at proper age.

GENERALITIES

PHYSICAL GENERALS-

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.

MENTAL GENERALS-

Mild generally; get angry when brother teases her.
Non-communicative2+

GENERAL EXAMINATION-

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

MENTAL GENERALS-

Non-communicative 2+

PHYSICAL GENERALS-

Desire- sweets 3+
Aversion- meat 1+
Thermal reaction- hot 3+

PARTICULARS-

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

MIASMATIC ANALYSIS

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

SYMPTOMS	CHAPTER	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

REPERTORISATION

Working method- computer method

Software used- RADAR

Repertorisation method- synthesis repertory used.

REPERTORIAL ANALYSIS

Sulphur- 15/6

Phosphorus– 9/6

Pulsatilla nigricans– 11/5

Mercurius solubilis– 10/5

REPERTORIAL SELECTION

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.

PRESCRIPTION

1.Sulphur 1M/1dose

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.

FOLLOW UP

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

CONCLUSION

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.

REFERENCES

Davidson, S. Davidson’s Principles & Practice of Medicine. 20^th edition. Elsevier Ltd;2006
Sehgal, VN. Textbook Of Clinical Dermatology. 4^th edition Jaypee brothers medical publishers(P) Ltd.;2004.
Sardana, K. & Ailawadi P. Textbook Of Dermatology & Sexually Transmitted Diseases with HIV Infection. 1^st edition. New Delhi. CBS Publishers & distributers (Pvt.) Ltd.; 2019
Habif, TP. Skin Diseases Diagnosis & Treatment. 3^rd edition. Philadelphia: Reed Elsevier Pvt. Ltd.; 2011.
Maire, K. Vitiligo: clinical aspects, quality of life and the role of melanocortin system in pathogenesis. University of Tartu Press; 2013.
Hahnemann, S. Organon Of Medicine. 6^th edition, New Delhi: B. Jain publishers Pvt. Ltd.; 2008.
Dhawle, M. L. Principles & Practice of Homoeopathy; 3^rd edition. Bombay: institute of clinical research; 2000.
Little, D. The Homoeopathic Compendium. Excerpt from volm V : Constitution, Temperament & Maps of consciousness- chapter 1: constitutional medicine .http://friendsofhealth.com/
Hahnemann, S. The Chronic Diseases Their Peculiar Nature And Their Homoeopathic Cure. 1^st edition. Kolkata: New Central Book Agency(P) Ltd.;2007.
RADAR Homoeopathic software.