KNOW
Homoeopathy Journal Vol–3 & Issue-1, 15 March 2023, Published at https://www.knowhomoeopathyjournal.com/2023/03/volume-3-issue-1,
Pages: 65 to 71 , Title: A Case Of Psoriasis Managed With Homoeopathic
Similimum : An Evidence Based Case Report, Authored By: Dr. Aman Deep Kaushal (M.D.
(Hom) , PhD. Homoeopathic Medical Officer, AYUSH Vibhag, Govt. of Himachal
Pradesh, India, Former Senior Research Fellow (SRF) ,CCRH, New Delhi, Ministry
of AYUSH, Govt. of India.) & Co-Authored By: Dr. Bhavneet Kaur (MD (Hom)
Scholar, Department of Practice Of
Medicine, Dr. M.P.K. Homoeopathic Medical College, Hospital and Research
Centre, Rajasthan, India.)
CASE REPORT
Title: A case of psoriasis managed with homoeopathic similimum : An evidence based case report
Authored By: Dr. Aman Deep Kaushal [1] & Co-Authored By: Dr. Bhavneet Kaur [2]
1 M.D. (Hom) , PhD. Homoeopathic Medical Officer, AYUSH
Vibhag, Govt. of Himachal Pradesh, India, Former Senior Research Fellow (SRF) ,CCRH,
New Delhi, Ministry of AYUSH, Govt. of India
2 MD (Hom) Scholar, Department of Practice Of Medicine, Dr. M.P.K. Homoeopathic
Medical College, Hospital and Research Centre, Rajasthan, India
Received: 19/10/2022 Accepted: 09/12/2022 Published: 15/03/2023
© 2023 KNOW Homoeopathy Journal https://www.knowhomoeopathyjournal.com/p/copyright-policy.html
How to cite this article:
ABSTRACT
INTRODUCTION
Psoriasis is an auto immune disorder of
skin. It is characterized by erythematous
and clearly demarcated papules and
rounded plaques which is covered by silvery scale. Factors such as emotional
stress, trauma and winters aggravates the suffering of the patient.
MATERIALS
AND METHODS
This case report is about a patient who was
suffering from psoriasis from past 7 years. Inspite of taking allopathic treatment
, he got no relief. When he visited the OPD, detailed case taking was done and
after proper repertorization and individualization , Lycopodium Clavatum 200C was
prescribed.
RESULTS
After taking homoeopathic treatment for two
months, marked improvement was seen. Patches of psoriasis were completely clear
with overall improvement in health.
CONCLUSION
This case report shows that Homoeopathy can
aid in managing the cases of psoriasis and more research work should be
encouraged in such cases. Repetition of doses and selection of potency should
be strictly based on homoeopathic principles to achieve good results and avoid
unwanted aggravation.
Keywords: Homoeopathic medicines, Homoeopathy, Individualization,
Lycopodium clavatum, Psoriasis, Repertorisation
Abbreviations:
outdoor patient (OPD)
INTRODUCTION
Psoriasis is defined as immune mediated chronic inflammatory, hyper proliferative disorder which is characterized by erythematous, clearly defined papules and rounded plaques. These skin lesions are covered by silvery scales.It commonly affects extensor surfaces and scalp.[1,2]The prevalence of psoriasis is approximately 2–3% worldwide. On the basis of studies conducted in North India, the prevalence of psoriasis is higher in men with a peak age at onset in the third and fourth decade of life [3]. Monozygotic and dizygoyic twins shows higher prevalence rate which is 60-75% and 15-20 % respectively. If one parent is affected with psoriasis, then the chance of child being affected is 15-20%, if both parents are affected then the risk rises to 50% and it further rises if the sibling is affected. [1]. T-lymphocyte mediated immune response is responsible for psoriasis. There are certain infective agents like bacteria, HIV, drugs, etc. and triggers such as trauma (Koebner phenomenon),winters, stress, upper respiratory tract infections and certain drugs such as beta blockers, chloroquinine and lithium. These induce antigens which are presented to T-lymphocytes by Langerhans cells of skin. It leads to activation of T cells which secrete cytokines and promotes dermal inflammation resulting in hyper proliferation of the epidermis. [4]. The transit time for keratinocyte migration , from basal layer to shedding from stratum corneum , is shortened from approximately 28 days to 5 days. [1]. Various forms of psoriasis are plaque psoriasis, guttae psoriasis, erythrodermic psoriasis, pustular psoriasis and psoriatic arthropathy. Plaque psoriasis is most common presentation [1]
Key Diagnostic Points for psoriasis are : Erythematous scaly plaques with well-defined border, dry
loose and micaceous scales , presence
of Koebner phenomenon , positive Auspitz sign (On skin scraping,
capillaries at the tips of elongated papillae are torn which leads to
multiple bleeding points), Regular
and circular pits on nail plates, Involvement of distal inter phalangeal
joints of toes and fingers and on Histo-pathological examination, Spongiform
pustules of Kogoj are found[4]
CASE STUDY
A 50 year old male patient
reported OPD of Government Homoeopathic Health Centre, Chamba, Himachal Pradesh
on 27.4.2021. He stays in joint family and he is a business man and his socio-economic status is upper middle class. He
complaints of erythematous scaly patches over back and abdomen since 7 years. Itching was worse in
warmth of bed and touch of clothes on affected parts and was ameliorated by
wearing loose fitting clothes.
HISTORY OF PRESENTING
COMPLAINTS
Approximately 7 years back, the
patient noticed small erythematous patch with white scales over his abdomen and
back which was growing gradually and caused intolerable itching. He took
allopathic treatment for about 3 years. He got temporary relief in itching but there
was no change in the size and appearance of patches. So the patient left the
treatment since 6 months.
PAST HISTORY
Patient suffered with Right
Nephrolithiasis and Hydronephrosis in
2016
FAMILY HISTORY
His father is suffering with
ischaemic heart disease, mother is
diabetic, siblings and children are healthy.
PERSONAL
HISTORY
The patient is vegetarian, having no
specific addiction. His milestones were developed at proper time. He had no
complaints after vaccination.
PHYSICAL
GENERALS
Patient is sensitive to hot weather,
thirstless, drinks 2-3 glass of water per day. He had desire for tea and coffee
and aversion to tobacco. He was usually constipated with unsatisfactory stool
and flatulence. Urine was satisfactory, passed urine 4-5 times per day, no
offensive odor. Appetite was good with three meals per day and hunger was
intolerable, he used to have headache if food was delayed. Sleep was disturbed
and unrefreshing. Profuse perspiration during anger.
MENTAL
GENERALS
The patient is intellectual and aggressive.
During anger, he perspires profusely. He is business minded person. He always
thinks about how he can grow his
business. He is very competitive. He spends his money wisely and does a lot of
bargaining while buying goods for his business. He doesn’t let his children and
wife spend money on useless things. He has anxiety about little things. Before
any business meeting, he cannot sleep properly due to anxiousness. He has fear
of height and darkness.
GENERAL
PHYSICAL EXAMINATION
During physical examination, patient was
well oriented with time, place and person. There were no signs of pallor,
cyanosis, clubbing, icterus and lymphadenopathy. His blood pressure was 130/80mm
of Hg, pulse 78 beats per minute, temperature was 98.2°F, respiratory rate was
18 breaths per minute and weight was 67 kg.
LOCAL
EXAMINATION
Examination of skin: on Inspection erythematous scaly lesions were
seen on abdomen and lower back.
DIAGNOSIS
Psoriasis, ICD-10-CM Code is L 40 [5]
DIFFERENTIAL
DIAGNOSIS
1. Pityriasis
Lichenoides Chronica
2. Secondary
Syphilis
3. Lymphomatoid
Papulosis
4. Pityriasis
Rosea [6]
5. Acute
Generalized Exanthematous Pustulosis
6. Seborrheic
Dermatitis
7. Hypertrophic
Lichen Planus
8. Intertrigo
[7]
TOTALITY
OF SYMPTOMS
1. Itching
in eruptions aggravated by touch of clothes and warmth of bed.
2. Itching
ameliorated by wearing loose clothes.
3. Aversion
to tobacco.
4. Perspiration
from anger
5. Unrefreshing
sleep
6. Avarice
7. Anticipation
REPORTORIAL
RESULT:[9]
Figure 1
PRESCRIPTION:
Lycopodium clavatum 200C , 1 dose / stat was prescribed along with placebo for 7 days on first visit i.e. 27.04.2021 on the basis of totality of symptoms and repertorization.
FOLLOW
–UP OF CASE:
|
Date |
Symptoms |
Prescription |
|
27.4.2021 |
Eruptions same as
before, slight relief in itching |
Placebo 30 tds /7
days |
|
4.5.2021 |
Itching much better,
sleep is more sound and refreshing
than before |
Placebo 30 tds/7
days |
|
11.5.2021 |
patch reduced in
size, itching much better, Stool is satisfactory |
Placebo 30 tds / 7 days |
|
25.5.2021 |
No itching, patch
further reduced in size, anxiety much relieved |
Placebo 30 tds/ 7
days |
|
9.6.2021 |
No further reduction
in size with presence of slight itching |
Lycopodium clavatum 200C 1 dose Placebo 30 tds/7
days |
|
16.6.2021 |
No itching, patch
area much reduced. |
Placebo 30 tds/ 7
days |
|
26.6.2021 |
Skin clear with no
itching , no other complaint |
Placebo 30 tds / 7
days |
|
3.7.2021 |
No new patch
appeared , no complaint |
Placebo 30 tds / 7
days |
Table 2
Figure 2. Before Treatment
Figure 3 : After Treatment
After taking homoeopathic treatment, there
was significant relief to the patient in itching , patch of psoriasis was clear
, stool was normal , sleep was better and his anxiety also reduced.
DISCUSSION
AND CONCLUSION
Homoeopathy believes in treating the
patient as a whole and not just the disease. This case reports shows the
effectiveness of homoeopathic medicine lycopodium
clavatum in managing the case of psoriasis as well improving the mental and
physical generals of the patient.
Lycopodium clavatum is a deep acting remedy which is anti-psoric, anti-
sycotic and anti – syphilitic and has a broad sphere of action. Unnecessary
repetition of deep acting medicines should not be done to avoid aggravation. If
the case is improving then we should wait and prescribe placebo. Repetition
of the deep acting medicine or changing
of the potency should be done if the
case comes to a standstill and shows no further improvement. Every case of any disease should be
individualized and no remedy should be considered specific for any disease and
medicine should be prescribed on the basis of characteristic symptoms of the
case.
DECLARATION
OF PATIENT CONSENT
Patient’s consent was taken for publication
of the study.
FINANCIAL
SUPPORT
None
CONFLICTS
OF INTEREST
None
REFERENCES
1.
Walkar
B.R, Colledge Nicki R., Ralston S.H.
Davidson’s Principles and Practice of Medicine. 22nd ed.
Edinburg: Churchill livingstone/ Elsevier; 2014,p.1286-1288
2. Jameson J.L.,
Kasper D.L. , Longo D.L. , Fauci A.S., Hauser S.L., Localzo J. Harrison’s Principles
of Internal Medicine . 19th ed. New York : Mcgraw – Hill Education ;
2018,p.347-348
3.
Dogra S, Mahajan R.
Psoriasis: Epidemiology, clinical features, co-morbidities, and clinical scoring.
Indian dermatology online journal. [Internet].2016 Nov [cited Apr8]; 7(6):471.
4.
Munjal
Y. API Textbook of Medicine. 9th ed. New Delhi: The Association of Physicians
of India; 2012 p. 494-496
5.
ICD
classification of disease. 2022[Internet].2022[Cited 2022,APR 8].Available from:
https://www.icd10data.com/ICD10CM/Codes/L00-L99/L40-L45/L40-/L40
6.
Lisi P. Differential diagnosis of psoriasis.
Reumatismo. [Internet]2007[cited april8];59(s1):56-60.
7.
Basko-Plluska JL, Petronic-Rosic V. Psoriasis:
epidemiology, natural history, and differential diagnosis. Psoriasis: Targets
and Therapy. [Internet] 2012 Sep 11[cited Apr 8];2:67-76.
8.
Patel
RP. Chronic miasms in homoeopathy and
their cure with classification of their rubrics/symptoms in Dr. Kent’ repertory(repertory
of miasms), 1st ed. Hahnemann House,college road, kottayam, kerala :
Dr.Ramanlal P. Patel;1996 , p. 3, 7, 43,
437, 439, 441, 1168, 1198, 1212, 1221
9.
RADAR [computer
program].Version 10.0.028.
Archibel.2007.
