Evidence Based Case Report on Homoeopathic Treatment of Psoriasis

KNOW Homoeopathy Journal Vol–3 & Issue-2, 18 October 2023, Published at https://www.knowhomoeopathyjournal.com/2023/10/volume-3-issue-2.html, Pages: 33-38 , Title: Evidence based case report on homoeopathic treatment of psoriasis, Authored By: Dr. Devika Chaturvedi & Co-Authored By: Dr. Ram Prasad Yadav , Dr. Zubair Ali khan (PGT, State National Homoeopathic Medical College and Hospital, Lucknow, Uttar Pradesh, India.)

CASE REPORT

Title: Evidence based case report on homoeopathic treatment of psoriasis

Authored By: Dr. Devika Chaturvedi^[1] & Co-Authored By: Dr. Ram Prasad Yadav^[2], Dr. Zubair Ali khan^[3]

^[1][2][3]PGT, State National Homoeopathic Medical College and Hospital, Lucknow, Uttar Pradesh, India.

EDITORIAL BOARD PUBLISHER DETAILS COPYRIGHT POLICY DISCLAIMER

Received: 24/05/2023 Accepted: 13/08/2023 Published: 18/10/2023

How to cite this Case report:

Chaturvedi D, Yadav R, Khan Z. Evidence based case report on homoeopathic treatment of psoriasis, KNOW Homoeopathy Journal, 2023; 3(2):33-38, available at https://www.knowhomoeopathyjournal.com/2023/10/Evidence based-case-report-on-homoeopathic-treatment-of-psoriasis.html

ABSTRACT

Psoriasis is a chronic skin disease resulting in marked scaling and thickened plaques of the skin. There is rapid proliferation of skin cells with dry flakes of the skin. It is a case report on psoriasis. On first visit, the patient was having psoriatic plaques on lower back with much desquamation. Symptomatology was erected after taking the case properly and repertorization was done by synthesis repertory. The medicine was prescribed in LM potency and the patient was better within 3 months.

Keywords: Auto-immune, Desquamation, Erythema, Homoeopathy, Induration, Psoriasis

Abbreviations: Psoriasis area and severity index score (PASI)

INTRODUCTION

The word Psoriasis comes from the word ‘psora’ which is a Greek word meaning itch. Psoriasis is a non-communicable, chronic, inflammatory, disease of the skin^[1]which can have local or generalized symptoms. The sites which are most commonly involved are scalp, toes and tips of the fingers, palms, umbilical area, buttocks, soles, skin under the breast and groin area, shin and sacral region.^[2]

It is a commonly occurring skin ailment with an overall incidence of about 2-3% of population.^[3]

The triggering factors include smoking, physical irritants, repetitive friction or trauma. The commonly affected population are labourers, farmers and homemakers. Seasonal changes, exposure to detergents and an excess of household work are some of the aggravating factors.^[4]

The most common signs and symptoms are scales of desquamation of skin with much itching, which can be sometimes painful. Dry, cracked skin that may bleed with itching, burning and soreness is commonly present.

The extent of skin involvement in psoriasis can be assessed by PASI Score (Psoriasis Area and Severity Index score). Severity of following is noticed-

Induration
Erythema
Desquamation

Area involvement of upper limbs, lower limbs and head and trunk is calculated on a 5-point scale from 0 to 4. The score ranges from 0 to 72. A large score indicates the severity of the disease. This score is also useful for evaluating the prognosis of the disease during the treatment.^[5]

Among modern medicine treatment immunosuppressant drugs like cyclosporine, methotrexate, apremilast etc. are used which have their own contraindications and side effects.^[4]

Topical treatments have their own side effects like dryness and irritation of skin and skin thinning. Various studies have demonstrated the efficacy of homoeopathy in the management of auto-immune disorders like psoriasis.^[6]

One case of plantar psoriasis treated with individualized homoeopathic remedy ^[4]and another case of erythrodermic psoriasis treated with Hepar sulphur and Arsenicum sulphuratum rubrum.^[7]

Another study was conducted on 70 patients in which an excellent prognosis was reported in 64.2% of cases using homoeopathy medicine.^[8]

CASE REPORT

PRESENT COMPLAINT:

Mr. X, 57 years old presented to out outpatient department with thick psoriatic plaques on the lower back with intense itching, redness, and irritation for 12 years. The patches started to appear from right leg and then involved the lower back. The itching aggravated on going to sleep in the evening and on change of weather, the itching was relieved with some moist application.

Figure 1- First visit (16/06/2022)

FAMILY HISTORY

Father- Hernia

Mother- Carcinoma breast, stroke

PHYSICAL GENERALS

Appetite – Normal
Thirst – 3-4 liters per day
Desire – Spicy, warm food, sweet, fish
Intolerance- cold things cause hoarseness of the throat
Aversion – nothing specific
Stool - normal
Urine – 5-6 times/day
Sweat – on axilla
Thermals - chilly
Tongue – flabby and moist
Sleep – disturbed due to itching
Addiction- tobacco chewing since 1985
Salivation- normal

MENTAL GENERALS

· The patient was affectionate towards others.

· The patient had delusion that he has neglected his responsibilities as a husband and father.

· Desire to please others.

· The patient used to suppress his anger in every situation and never took a stand for himself.

CLINICAL FINDINGS

Blood pressure was normal. No other abnormality was detected.

DIFFERENTIAL DIAGNOSIS

Following are some of the differential diagnosis of the disease^[9]

Lichen planus
Atopic dermatitis
Contact dermatitis
Secondary syphilis
Mycosis fungoides
Tinea corporis
Pityriasis rosea

DIAGNOSIS

Examination of skin and scalp was done. The patient had well-demarcated, symmetric, and erythematous plaques with silvery scales. The lesion had intense itching with redness.

ANALYSIS OF SYMPTOMS

UNCOMMON SYMPTOMS

· Ailments from suppressed anger.

· Affectionate towards others.

· Delusions neglected his duty.

· Aversion to quarrelling.

· Itching aggravated in the evening.

· Craving for tobacco

COMMON SYMPTOMS Psoriatic eruption with redness and itching

TOTALITY OF SYMPTOMS

· Ailments from suppressed anger.

· Affectionate towards others.

· Delusions neglected his duty.

· Aversion to quarrelling.

· Psoriatic eruption with redness and itching

· Itching aggravated in the evening.

RUBRICS TAKEN^[10]

· MIND- AFFECTIONATE

· MIND-DELUSIONS-NEGLECTED-DUTY;HE HAS NEGLECTED HIS

· MIND-QUARRELLING-AVERSION TO

· MIND-AILMENTS FROM-ANGER SUPPRESSED

· SKIN- ERUPTIONS-PSORIASIS

· SKIN-ERUPTIONS-ITCHING

· SKIN-ERUPTIONS-ITCHING-EVENING

REPERTORIAL ANALYSIS- For repertorization Synthesis repertory,^[10] “Repertorium Homoeopathicum Syntheticum was used.

REPERTORIZATION-

Figure 2- Repertorial chart

MEDICINE PRESCRIBED- Staphysagria 0/1, 1 globule mixed in 100 ml of distilled water. 5 ml from this solution to be taken thrice daily

FOLLOW–UP

S.NO.	DATE	SYMPTOMS	MEDICINE GIVEN
01.	16/06/2022	Psoriatic plaques on lower back with much itching and redness which aggravates in evening	Staphysagria 0/1 tds for 15 days
02.	02/07/2022	Itching and redness reduced; area covered with white scales	Staphysagria 0/1 tds for 15 days
03.	19/07/2022	All the complaints were better, with no itching.	Staphysagria 0/1 tds for 15 days
04.	04/08/2022	Relief in all complaints.	Staphysagria 0/1 tds for 15 days
05.	20/08/2022	Scales started to fell off with relief in itching.	Staphysagria 0/1 tds for 15 days
06.	06/09/2022	Patient felt slight aggravation in itching	Staphysagria 0/2 tds for 15 days
07.	20/09/2022	No scaling with relief in itching and other complaints.	Staphysagria 0/2 tds for 15 days
08.	07/10/2022	Scales disappeared with no itching and redness.	Staphysagria 0/2 tds for 1 month

Table-1 Follow-ups

Upto May 2023 the patient was on Staphysagria 0/2 tds because of occurrence of few symptoms now and then. Now, since 2 months the patient is under Staphysagria 0/2 sos (in case of itching and redness of skin) and there is no reappearance of symptoms.

REASON FOR CHOOSING LM POTENCY

Dr. Hahnemann in footnote of aphorism 270 of sixth edition of Organon of medicine ^[11], says about LM potency that, ‘I have found after many laborious experiments and counter-experiments, to be the most powerful and at the same time mildest in action i.e., as the most perfected’ method. As LM potency is mildest and most powerful in its action and can be frequently repeated depending on the severity of case, so this case was started with 0/1 potency so as to not produce unwanted homoeopathic aggravations in the patient as are seen in various dermatological cases.

Figure 3-First visit

Figure 4- First follow up

Figure 5- After treatment

DISCUSSION

The patient had no family history of psoriasis. A Constitutional remedy chosen after proper case taking and totality resulted in improvement of the patient. This case report demonstrates the efficacy of Homoeopathic medicine as well as LM potency in managing auto-immune disorders without any side effects, however modern medicine uses immunosuppressive drugs which has their own cons and are not a permanent solution. In previous studies on psoriasis, medicine was changed depending on the symptomatology of the patient however in this case single medicine in LM potency has shown wonderful results.

RESULT AND CONCLUSION

This case has showed marked improvement within 3 months of administration of constitutional homoeopathic medicine which was chosen on account of proper totality. But, a single case study is not enough scientific researches required in the field for the validation of results.

ACKNOWLEDGEMENTS

We want to thank the whole staff of NHMC, Lucknow for their constant support and we want to thank the patient for giving his consent.

PATIENT CONSENT

Patient consent was taken for publishing photos and case report.

SPONSORSHIP- Nil

CONFLICT OF INTEREST- None declared

REFERENCES

1) Samuel ML, Donald PM, Hurley JH. In Jr. Dermatology, Vol-I. W. B. Philadelphia : Saunders Company, 1986; p:204.

2) Lo KK, Ho LY. In Psoriasis: Handbook of Dermatology and Venereology. 2nd Edn, Hong Kong: Social Hygiene Service, Dept. of Health, 1997

3) Heller MM, Lee SE, Koo YMJ. Stress as an influencing factor in psoriasis. Skin Therapy Letter, 2011; 16(5).

4) Rompicherla GRK, Ponnam HB. Homoeopathy in plantar psoriasis: An evidence-based case report. Indian J Res Homoeopathy 2022;16(4):292-300.

5) Schmitt J, Wozel G. The psoriasis area and severity index is the adequate criterion to define severity in chronic plaque-type psoriasis. Dermatology 2005;210:194-9.

6) Witt CM, Lüdtke R, Willich SN. Homeopathic treatment of patients with psoriasis – a prospective observational study with 2 years follow-up Jeadv. 2009; 23:538-43. 9.

7) Dastagiri P, Muhammed H. Management of erythrodermic psoriasis with individualised homoeopathy: An evidence - based case report. Indian J Res Homoeopathy. 2023;17: 94-102

8) Sharma Bhaskar. Homoeopathy medicine for treatment of psoriasis. International Journal of Homoeopathic Sciences 2018;2(4):17-19

9) Loscalzo J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL et.al. Harrison’s principles of internal medicine.21 st edition. United States of America. McGraw Hill LLC;2022:p-418-419

10) Schroyens F.Synthesis Repertorium Homoeopathicum Syntheticum 9.1ed.B.Jain Publishers Ltd.2008

11) Dudgeon R.E. Organon of medicine by Samuel Hahnemann Translated by William Boericke.5 th ed.New Delhi: B.Jain publishers (P) LTD. Reprint edition:2002.p.135