Constitutional Treatment of Vitiligo

Abstract: Vitiligo is an acquired, progressive, common pigmentary disorder which results in depigmented patches appearing on the skin. A case report of a 14 year old male is presented here which was treated with individualized homoeopathic medicine after proper case taking and repertorization.

Keywords:Vitiligo, Autoimmune disease, individualized, homoeopathy, depigmented, patches, reportorial totatility, constitutional medicine

Introduction

Vitiligo is a common chronic skin depigmentation disorder. It is due to stoppage of melanin formation by the melanocytes and presents as asymptomatic depigmented macules anywhere on the body including mucous membranes of lips and genitalia.¹ In vitiligo, there is a marked reduction or even absence of melanocytes and melanin in the epidermis.

The exact cause of the vitiligo (Homeopathy for Vitiligo or Leucoderma) is not known, but some studies suggested that it is an autoimmune disease in which the body’s immune system attacks its own healthy cells. It sometimes runs in families, suggesting that genetics may play a role.

In some cases, people with vitiligo report some sort of triggering factor like injury, sunburn, illness, emotional stress, pregnancy etc.²

CASE REPORT

A 14 year old male was reported at Sindhi camp campus OPD (211/17) on 17/7/17 with a complaint of hypopigmented spots over his face since 9 months.

HISTORY OF PRESENTING COMPLAINTS

The patient was apparently well 9 months ago when he gradually started complaining of hypopigmented spots first seen above his right eye.

Then the spots gradually started extending to the right temporal region, then towards the right cheek and lastly over the nose. The hairs of eyebrows are also getting white.

PAST MEDICAL HISTORY

Disease/ operation/ injuries etc.	Age/year in which occurred	Treatment taken	Outcome
Pneumonia	After birth	Allopathic treatment	Recurrent cough and Coryza
Meningoencephalitis	2015	Allopathic treatment	Cured

FAMILY HISTORY

Paternal grandfather – diagnosed with brain tumor, died in 2011

Paternal grandmother- Diabetes Mellitus since 1 year, alive

Mother – allergic to dust since 2 years

SKIN EXAMINATION

Sites of lesion	Character	Description
Right eye, face, forehead	Color	White, pinkish
	Number of patches	Multiple
	Hair in patch (Black/white)	White
	Margins of patch	Defined

GENERAL EXAMINATION

General build – slightly obese

Pulse – 84 beats/ minute

Respiratory rate – 22 breaths/ min

Blood pressure – 110/ 80 mm/Hg

ANALYSIS OF SYMPTOMS:

MENTAL GENERALS

Gets irritable about almost anything.

Obstinate

Reserved

PHYSICAL GENERALS

Desire : Sweets⁺⁺⁺, rice ⁺⁺

Perspiration : more on forehead⁺⁺

Thermal reaction : Hot patient

Particulars

Hypopigmented spots over face

Perspiration profuse on forehead

EVALUATION OF SYMPTOMS

Gets irritable easily
Obstinate
Reserved
Desire for sweets
Desire for rice
Hypopigmented spots on face
Profuse perspiration on forehead

MIASMATIC ANALYSIS

S.No	Symptoms	Psora	Sycosis	Syphilis	Tubercular
1	Gets irritable on every matter	ü	ü
2	Obstinate		ü	ü
3	Reserved		ü	ü
4	Desire for sweets	ü
5	Desire for rice	ü
6	Profuse perspiration over forehead				ü
7	Hypopigmented spots on face	ü		ü

Miasmatic predominance- Psora- syco-syphilitic

REPERTORIAL TOTALITY

S.No	Symptoms	Reportorial totality
1	Gets irritable easily	MIND – IRRITABILITY – trifles, from
2	Obstinate	MIND – OBSTINATE
3	Reserved	MIND – RESERVED
4	Desire for sweets	GENERALS – FOOD and DRINKS – sweets – desire
5	Desire for rice	GENERALS – FOOD and DRINKS – rice – desire
6	Profuse perspiration over forehead	HEAD – PERSPIRATION of scalp – Forehead
7	Hypopigmented spots on face	SKIN – DISCOLORATION – white – spots

Figure 1: Showing repertorization of case from Synthesis Repertory 9.0 (English) using RADAR 10.0

PRESCRIPTION

Sulphur 30/ 1 Dose

Rubrum 30/ TDS/ 14 days

BASIS OF PRESCRIPTION

According to miasmatic analysis the totality of symptoms of the patient covers all the 3 miasms, i.e, Psora, Sycosis and Syphilis. But Psora is the predominant miasm; also the thermal reaction of the patient is Hot, therefore Sulphur was prescribed.

FOLLOW UP SHEET

Date	Symptoms	Prescription
17/7/17	The spots are getting darker	Rubrum 30/TDS/ 7days
24/7/17	2 spots over the right cheek have disappeared The spot over the right side of nose has reduced	Rubrum 30/TDS/ 21days
14/8/17	No further improvement is seen	Sulphur 30/1 dose Rubrum 30/ TDS/ 14 days
28/8/17	The pigmentation is seen between the spot over neck and cheek.	Rubrum 30/ TDS/ 14 days
11/9/17	No further improvement is seen	Sulphur 30/1 dose Rubrum 30/ TDS/ 14 days
25/9/17	Pigmentation is seen over the forehead	Rubrum 30/ TDS/ 14 days
9/10/17	Better than before	Rubrum 30/ TDS/ 14 days
30/10/17	The spots are getting better	Rubrum 30/ TDS/ 14 days
27/11/17	The spots are getting better	Rubrum 30/TDS/ 30 days
1/1/18	Pigmentation is seen in the spots	Rubrum 30/TDS/ 30 days
5/2/18	No further improvement is seen	Sulphur 30/ 1 dose Rubrum 30/ TDS/14 days
19/2/18	The spots over the nose are getting smaller	Rubrum 30/TDS/30 days
19/3/18	The spots are getting better	Rubrum 30/TDS/60 days
21/5/18	The spots are better	Rubrum 30/TDS/60 days
23/7/18	No further improvement is seen	Sulphur 200/ 1 dose Rubrum 30/ TDS/ 30 days
10/9/18	The spots over forehead are getting pigmented	Rubrum 30/ TDS/ 60 days
12/11/18	The spots are getting better	Rubrum 30/ TDS/ 60 days
21/1/119	The spots are getting pigmented	Rubrum 30/ TDS/ 60 days
18/3/19	No further improvement is seen	Sulphur 200/ 1 dose Rubrum 30/ TDS/ 60 days
20/5/19	The spots are the eyes are getting smaller in size	Rubrum 30/ TDS/ 60 days
8/7/19	The spots are getting pigmented	Rubrum 30/ TDS/ 60 days
5/9/19	The spots are getting pigmented	Rubrum 30/ TDS/ 30 days

BEFORE TREATMENT (17/7/17)

AFTER TREATMENT(5/9/19)

Discussion and conclusion

Homoeopathic medicines are prescribed on the basis of totality of the symptoms of the patient. Homoeopathy treats the patient as a whole, not just the disease. The constitutional approach was followed in the above mentioned case. The medicine was repeated and potency was also increased as per the need of the case. With the help of constitutional medicine the patient experienced a significant improvement in his general health also

References

Homoeopathic research in vitiligo: Current scenario Dewan … [Internet]. Available from: http://www.ijrh.org/article.asp?issn=0974-7168;year=2017;volume=11;issue=4;spage=226;epage=236;aulast=Dewan

Vitiligo [Internet]. Genetic and Rare Diseases Information Center. U.S. Department of Health and Human Services; [cited 2019Aug18]. Available from: https://rarediseases.info.nih.gov/diseases/10751/vitiligo