KNOW
Homoeopathy Journal Vol–3 & Issue-1, 15 March 2023, Published at https://www.knowhomoeopathyjournal.com/2023/03/volume-3-issue-1.html,
Pages: 75 to 80 , Title: Homoeopathic management of eczema: A case report,
Authored By: Dr. Pragya Sharma (PG Scholar Department of Homoeopathic Materia
Medica, Bakson Homoeopathic Medical College and Hospital, Uttarpradesh, India.)
CASE REPORT
Title: Homoeopathic management of eczema: A case report
Authored By: Dr. Pragya Sharma
PG Scholar – Department of Homoeopathic Materia Medica,
Bakson Homoeopathic Medical College and Hospital, UttarPradesh, India.
Received: 31/12/2022 Accepted: 11/02/2023 Published: 15/03/2023
© 2023 KNOW Homoeopathy Journal https://www.knowhomoeopathyjournal.com/p/copyright-policy.html
How to cite this article:
ABSTRACT
Eczema is an inflammatory skin condition clinically
presents with itchy, dry, rough, scaly and inflamed skin. This is a case report
of a 28 year old female having itchy and dry skin lesions on her both hands,
since past 2 years. In this article, a case of eczema cured with the well
selected homoeopathic remedy after detailed case taking and repertorisation,
which improved physical as well as mental well-being of the patient, is being
explained.
Keywords: Eczema, Dermatitis, Graphites, Homoeopathy
INTRODUCTION
The term Eczema is synonymous
with term Dermatitis. It is an inflammatory response to various agents acting
on the skin such as chemicals, drugs, increased sensitiveness to antigens and
haptens etc. It is clinically characterized by eruptions (papules, vesicles or
blisters) that may present with itching, erythema with oedema, oozing and
scaling.[1] Eczema is also called as
the "itch that rashes" caused due to dry skin that produces
rashes due to scratching. Hydration of skin is most important for treatment of
eczema.[2]
Different types of eczema
are:[3]
·
Atopic eczema – It is due to formation of excessive IgE
antibodies to inhaled, injected or ingested antigens. Mostly occurs in people
having family history of this condition.
·
Seborrhoeic dermatitis – It is presented
by a reddish rash with scales, usually affects the scalp, central face,
nasolabial folds, eyebrows and centre of chest.
·
Discoid eczema – It consists of coin shaped
lesions, which may be infected, commonly seen on the extremities.
·
Allergic contact eczema – It is due to type
IV hypersensitivity reaction after contact with various antigens.
·
Asteatotic eczema – It occurs in dry skin, and
commonly seen on the legs in hospitalized patients.
·
Gravitational eczema – It usually occurs
in legs and associated with insufficiency of veins.
·
Lichen simplex – This is a localised plaque of hard
skin caused due to rubbing or scratching repeatedly. Usually occurs in neck,
lower legs and anogenital area.
·
Pompholyx – It occurs in the form of vesicles and
bullae with itching maily occurring on the palms, palmar surface and sides of
the fingers and soles.
DIFFERENTIAL DIAGNOSIS:
·
Psoriasis – It is a chronic inflammatory disease
which causes rapid proliferation of skin. It is presented by erythema, plaques
with silvery white scales and itching (more scales and less itching as compared
to eczema). The precipitating factors are mental sress, trauma and drugs like
beta-blockers. Complications can be psoriatic arthritis and onycholysis.[3]
·
Tinea manuum – Also known as ringworm of hand. It is
caused by dermatophytes or fungi and risk factors are humid environment,
hypertension, diabetes mellitus, recurrent trauma to hands etc. The lesion is
clinically presented by red scaly rashes on edge with central clearing and
itching.[4]
This case report will help the
clinical practitioners to know the effectiveness of homoeopathic medicines in
the cases of eczema and it will also help in better understanding of the
disease dermatitis or eczema along with its differential diagnosis.
CASE RECORD
A female aged 28 year old reported with complaint of
dry skin lesions on her both hands, since past 2 years.
PRESENTING COMPLAINT:
The patient presented with dryness, itching, redness and
cracks on her both hands. There was oozing of watery, sticky and offensive
discharge followed by scratching due to itching. Itching worse at night and
complaints were better by warmth.
HISTORY OF PRESENTING COMPLAINTS:
Patient had history of these complaints since 2 years. Complaints started with minor eruptions on index finger of left hand, from where it spread to both hands. Itching was tolerable at starting but it gradually increased day by day. She took allopathic medication and applied external application on eruptions which relieved for sometime, but as soon as she stopped the treatment, itching appeared severely with eruptions and cracks covering both the hands with oozing of sticky, watery discharge after scratching. She was not taking any treatment for the last 1 month.
GYNAE & OBS HISTORY
Her last menstrual periods occurred on 06/07/2022 and
had no associated complaints. Her menstrual cycle is regular, occurs for 4-5
days, every 26-28 days and without any abnormalities.
PAST HISTORY
H/O Jaundice at 10 years and typhoid in 18 years. She
had taken allopathic treatment for those complaints and was cured.
FAMILY HISTORY
Father – Healthy and alive
Mother – Type II Diabetes mellitus and alive
PHYSICAL GENERALS
Appetite – adequate, 3 meals/ day, 2-3 chapatti/meal
Thirst – adequate, 3-4L/day
Desire – Sweets
Aversion – Spicy food
Stool – Unsatisfactory stool and irregular bowel habits
Urine – Satisfactory, 5-6 times a day
Perspiration – Scanty, generalized, non-offensive,
non-staining
Thermal reaction – Chilly
Sleep – Disturbed due to itching
MENTAL GENERALS
Patient was irritable and anxious due to her illness.
She weeps easily, became lachrymose while telling about her complaints. She had
a fear that some misfortune would happen to her. According to her husband she
does not keep things to herself and she is an extrovert person.
PROVISIONAL DIAGNOSIS
After ruling out all the other possible causes of
eruptions, and according to the history of the disease, it was diagnosed as
Eczema of hands.[3]
TABLE-1 ANALYSIS AND EVALUATION OF SYMPTOMS
|
Symptoms of patient |
Intensity |
Common/ Uncommon symptoms |
Miasm |
|
Mental Generals ·
Irritability ·
Anxious about her health ·
Fear of misfortune ·
Weeping easily |
+ ++ ++ ++ |
Uncommon Uncommon Uncommon Uncommon |
Psora Psora Sycosis Psora |
|
Physical Generals ·
Desire – Sweets ·
Aversion – Spicy ·
Thermal reaction – Chilly ·
Disturbed sleep due to itching |
+ +++ ++ + |
Uncommon Uncommon Uncommon Common |
Psora Psora Psora Psora |
|
Particulars ·
Dry, cracked skin with itching. < night, >
warmth ·
Skin eruptions oozing sticky discharge |
+++
+++ |
Uncommon
Uncommon |
Psora
Psora |
TOTALITY OF SYMPTOMS
·
Irritability
·
Anxious about her health
·
Fear of misfortune
·
Weeping
easily
·
Desire – Sweets
·
Aversion – Spicy
·
Thermal reaction – Chilly
·
Dry, cracked skin with itching. <
night, > warmth
·
Skin eruptions oozing sticky discharge
REPORTORIAL TOTALITY
1. MIND
– IRRITABILITY
2. MIND
– ANXIETY – health; about
3. MIND
– FEAR – misfortune, of
4. MIND
– WEEPING
5. GENERALS
– FOOD AND DRINKS – sweets, desire
6. SKIN
– ERUPTIONS – dry – itching
7. SKIN
– ERUPTIONS – itching – night
8. SKIN
– ERUPTIONS – discharging, glutinous
REPORTORIAL CHART: FIGURE 3
Repertorisation was done using synthesis repertory
using RADAR 10.0 Homoeopathic software.[5]
 |
TREATMENT
SELECTION OF REMEDY AND POTENCY : Graphites was
the remedy selected based on repertorisation and homoeopathic materia medica. Graphites
was the remedy of choice as it covers the mental as well as physical
disposition of the patient. Also, thermally the patient was chilly and Sulphur
is hot, hence Graphites
is selected.[6,7]
On the basis of susceptibility of patient, nature and
duration of disease, 30C potency was selected.
INTERVENTION
First visit (16/07/2022) – Graphites 30/OD/3 days
followed by placebo for 2 weeks.
Patient was advised to apply coconut oil on the skin
throughout the treatment.
TABLE-2 FOLLOW UPS
|
Date |
Symptoms |
Prescription |
|
30/07/2022 |
Skin itching was slightly
reduced. Cracks reduced but no change in dryness and discharge. Irritability slightly better
but anxiety about health and fear of misfortune still persists. Stools – satisfactory, regular |
Sac lac 30/TDS/2 weeks |
|
17/08/2022 |
Skin itching – better. Cracks
and dryness same. Discharge reduced. No irritability. No change in
anxiety about disease and fear of misfortune. Stools – satisfactory, regular |
Graphites 30/OD/3 days Sac lac 30/TDS/2 weeks |
|
1/09/2022 |
Skin itching – better. Cracks
and dryness reduced. Discharge occasionally appears. Sleep – improved. Anxiety slightly reduced. |
Sac lac 30/TDS/2 weeks |
|
14/09/2022 |
No marked improvement seen. |
Graphites 200/1 dose/stat Sac lac 30/TDS/2 weeks |
|
28/09/2022 |
Skin itching – better. Cracks
and dryness markedly reduced. No discharge. Anxiety – negligible, patient
started becoming hopeful. No other new complaints. |
Sac lac 30/TDS/2 weeks |
|
17/10/2022 |
Skin healed up. No itching,
dryness and discharge. Anxiety – negligible. No other new complaints. |
Sac lac 30/TDS/2 weeks (since all the complaints were
relieved, only placebo was given for 2 weeks and treatment was stopped
thereafter) |
DISCUSSION
This case report shows the effectiveness of homoeopathy in
treatment of eczema. It also shows the importance of taking a complete case and
prescription of constitutional medicine over therapeutic prescription. It also
helps to confirm the symptoms written in Homoeopathic materia medica and
Repertory, as the case was repertorised and consulted with Homoeopathic materia
medica.
The lacunae in this case was absence of diagnosis through prick test and serum IgE levels but it was confirmed clinically and with the clinical history of skin lesion.
CONCLUSION
This case report confirms the effectiveness
of Homoeopathic treatment in the cases of Eczema as well as the well
established fact of effectiveness of Homoeopathy in skin diseases has been
confirmed through this case report. It further proves the effectiveness of Graphites
in cases of Eczema. It also shows that homoeopathic medicines can cure patients
in the most rapid and gentle way. Consent of patient was obtained for writing
the manuscript.
REFERENCES
1.
Mohan H. Textbook of Pathology.
Seventh. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2015. p-761.
2.
Nemeth V, Evans J. Eczema -
StatPearls - NCBI Bookshelf. Eczema. 2022. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK538209/
3. Davidson's
principles and practice of medicine, 23rd ed. Elsevier
limited; 2018. p-708-711.
4. Chamorro
MJ, House SA. Tinea manuum - statpearls - NCBI bookshelf. 2022. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK559048/
5. RADAR
10.0 Homoeopathic Software, Schroyens F synthesis repertory.
6. Boericke W. Boericke's new manual of homoeopathic
materia medica with repertory: Including Indian Drugs, Nosodes, Uncommon Rare
Remedies, Mother Tinctures, Relationships, Sides of the Body, Drug Affinities
& List of Abbreviations, 3rd Revised and augmented edition based on 9th
ed. New Delhi: B. Jain Publishers (P) LTD; 2018. p-274-276 & 545-548
7. Kent
JT, Lectures on Homoeopathic Materia Medica, Student edition, New Delhi, B.
Jain Publishers (P) Ltd; 2017. p-553-560 & 951-976.
