Clinical Cases

Treating The Almost Untreatable!!

Aanchal Parmar
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Dr. Aanchal Parmar presents a case of molluscum contagiosum in woman of 23.

It’s very commonly said, “The scope of homoeopathy begins where that of other pathies end.”  Today, I would like to share with you how this thought got etched into my life through my experience in a very simple yet commonly seen disease of the skin and how homoeopathy can do wonders in such cases.

INTRODUCTION:

Molluscum contagiosum –is a viral disease caused by a DNA poxvirus that is largely (if not exclusively) a disease of humans. Molluscum contagiosum virus causes characteristic skin lesions consisting of single or, more often, multiple, rounded, dome-shaped, pink, waxy papules that are 2-5 mm (rarely up to 1.5 cm in the case of a giant molluscus) in diameter.  The central umbilication of the papules containing a caseous plug forms the hallmark for diagnosis.

Histology-

The epidermis appears thickened (acanthosis) within the region of indentation, up to 6 times the thickness of the surrounding, uninvolved skin, and the cornified layer typically is disintegrated. The striking feature is the presence of intracytoplasmic, eosinophilic, granular inclusions called the Henderson-Paterson bodies within the keratinocytes of the basal, spinous, and granular layers of the epidermis can measure 35µm in diameter.

Infection

It follows after contact with infected persons or contaminated objects. Lesions may spread by autoinoculation. The initial infection seems to occur in the basal layer, and the incubation period is usually 2-7 weeks.

Clinical features

It is most common in children but may be found in persons of all ages. The virus is transmitted by direct skin-to-skin contact, through minor abrasions or indirect skin contact with fomites, such as bath towels, sponges, and gymnasium equipment, transmits the virus. Among young adults, it is usually a sexually transmitted disease. Lesions typically occur on the chest, arms, trunk, legs, and face but rarely on palms and soles. These lesions are usually painless. It is generally self-limiting in healthy patients and heals spontaneously within 6-9months, some persist for 3-4years.

Treatment-

The mainstay of taking treatment is most often for cosmetic reasons and spontaneous recurrence.

Conventional treatment includes surgical removal by scraping, de-coring, freezing, or through needle electrosurgery. This may result in scarring or post inflammatory pigmentary changes. Frequently, multiple treatment sessions are necessary because of the recurrence of treated lesions and/or the appearance of new lesions.

Homoeopathic treatment involves the administration of a well-selected constitutional remedy in each individual case.

A case of a 23-year-old female who visited me on 29th of March 2016.

CHIEF COMPLAINT:

  1. Molluscum contagiousum since 8 months.

L: On face and neck.

Started on forehead and then spread all across the face and neck.

No form of medication or external application was used for the same.

ASSOCIATED COMPLAINTS:

  1. Acne on face- comes and goes, no relation with menses

No treatment taken for it

  1. PCOD, diagnosed in 2009

USG dated 22/12/09 suggests- Normal sized uterus

Cervical fibroid (1.3cmx1.5cm)

Both ovaries are enlarged in size with presence of multiple small follicles at periphery suggestive of polycystic ovaries.

Rt ovary measures 2.4cm x 2.8cm x 3.8cm, volume 13.32cc

Lt ovary measures 2.0cm x 2.9cm x 3.6cm, volume 10.94cc

Menses are irregular, dark red, profuse lasting for 5-6 days.

Complaints before and during menses- severe cramping pain in lower abdomen

Takes Tab. Dymen for this pain.

No complaints after menses

LMP- 5/2/16

  1. Tendency to catch cold easily

<change of weather, <winters, <cold drinks/cold food

Suffers from breathlessness in winters and takes Asthalin pump (SOS).

FAMILY HISTORY:

Paternal Grandfather- DM, expired from brain hemorrhage

Paternal Grandmother- 80yr -DM

Maternal Grandfather-HTN, expired from MI

Maternal Grandmother-HTN, expired from MI

Mother- 57yr- HTN

Father – 64yr – Chronic Kidney Disease, Hypertension, DM, IHD

Sisters (identical twins)- 28yr old- PCOD, Primary infertility

– 28yr old- PCOD

PAST HISTORY:

No significant surgical history

Admitted in 2014 for Acute Gastroenteritis with Intestinal Obstruction- Managed medically.

GENERALS:

App- Good

Thirst -1litre/day; room temperature

Likes- cheese+, chocolates, carbonated drinks, potatoes

Dislikes – nothing specific

Perspiration – upper lip, forehead

Sleep – position- back

eyes- half open during sleep

disturbed by slightest noise

cannot sleep in darkness

Thermals- Chilly patient

Likes winter

Can tolerate summer better

Fan-Seasonal

Bath- seasonal

Covering – throughout the year.

MENTALS/LIFE SPACE SITUATION:

Patient is the third child, born and brought up in Mumbai.

She has completed her graduation B.A Economics, in 2003. She was working as a content writer but recently quit her job due to her father’s ill health. Loves to read, travel. Says she gets angry when people don’t listen or do as she says. Family is very career oriented. Sisters- twins- elder is chartered accountant.  Younger twin is a doctor. Expectations are high that she also should do something big in education. But she never felt inclined towards making her career in such a field. She is very creative and loves drawing, writing poems and even acting in plays.

She is very close to her family members. A constant worry is her father’s ill health. Father was diagnosed with CKD in 2008 and has been on dialysis since 2011. He is on dialysis and not improving much. Her eldest sister is married and staying in Chennai. And the other sister is a doctor but does full time duty at a hospital in Andheri so then it’s only her mom who has to handle everything for her father. Hence she quit her job to help out at home and to take care of any medical needs for her father.

There is a marked fear of darkness. She is very particular about her work (perfectionist). Wants that things should be kept in order, in their place.

REPERTORIAL TOTALITY:

 

PRESCRIPTION:  Carcinosin 30 tds

DISCUSSION:

My understanding of Carcinosin comes from what I have seen while working with Dr. Farokh Master. Here is a brief explanation of why I chose Carcinosin in this case. The Carcinosin child comes from a family where the parents are very pushy / demanding of the child to do well in studies, to excel in life. They expect a lot from the child. These children have never been able to express their own individuality. They cannot ‘be themselves’ for fear that they will not be accepted, they will not be appreciated, they will not be loved, and thus they are in a state of constant insecurity. They appear as accepting, submissive or even repressed persons. They are artistic, love – reading, dancing. Carcinosin patients are very sympathetic and compassionate people. They are extremely sensitive to the sufferings of others. They are the ones who sacrifice their comfort for others.  A strong sense of responsibility is usually seen. Children feel overly responsible from an early age on, taking on responsibility for the whole family. They are very reliable in looking after their pets, taking care of the household, and so on. Their exaggerated sense of responsibility for the well-being of their relations and loved ones may lead to feelings of guilt, anxiety fits and eventually depressive states.

All carcinosin patients tend to be anxious and fears form an integral part of the picture.  Another strong characteristic is an inherent need to establish order, to remove the disorder around them (or so they feel) and in response to this need they can become fastidious. It is as if they feel the threat from the oncoming internal disorder.

Strong craving for cheese.

Desire to travel.

Strong family history of Diabetes Mellitus in the family.

FOLLOW UP:

Date Rx
13/4/16Molluscum – decreased in size over cheeks and jaw line.

No new eruptions

Had an episode of cold, which settled on its own.

Acne – SQ-

Menses not yet got

 

Carc 30 tds x 15 days
29/4/16Molluscum – > –

No new eruptions

Nose obstruction <night

Coryza- greenish, mucoid

Mild cough from throat irritation

Expectoration- green

Acne – >  –

Menses- not got as yet

 

Carc 30 tds x 15days

+ Home remedies for cold and cough

15/5/16Molluscum – SQ-

New eruptions on chin

Coryza/cough -0-

Acne –SQ-

Menses- not got as yet

 

Carc 30 tds x 15days

 

17/6/16

 

All complaints –SQ-Carc 200 bd x 15days
4/7/16Molluscum >>

No new eruptions

Sneezing -0-

Acne >

Menses- 26/6/16, Normal flow which lasted for 7 days, NO PAIN.

 

Carc 200 bd x 15days
2/8/16

 

 

Molluscum >

Menses – 25/7/16; normal flow, lasted for 5 days, no pain

Carc 200 bd x 15days
6/9/16Father’s health deteriorated, was hospitalized and that was very stressful period for her

Molluscum – SQ- only on forehead

New eruptions appeared on chin, nasolabial folds

Acne >

Menses – late by 6 days, profuse, mild cramps in abdomen

 

Carc 200 tds x 15days
15/10/16Molluscum – only on forehead

Acne >>

Had an episode of anxiety attack in the hospital when father was admitted again.

Confidence low, feeling very helpless

Menses – 11/10/16, normal flow, lasted for 5 days, no pain

 

Carc 1M bd x 15days
14/11/16Molluscum cleared

No episodes of cold/cough

Acne >>

Menses – delayed

Confidence much better, taken up a job and also pursuing Masters in Economics.

Carc 1M bd x 15days


BEFORE TREATMENT:

About the author

Aanchal Parmar

Aanchal Parmar

Dr. Aanchal Bharat Parmar is a young homoeopathic physician practicing in Mumbai for two years after having acquired her .D. (homoeopathy) in the subject of Repertory. She is a Consulting Homeopathic Physician at: Bai Jerbai Wadia Children Hospital-Parel, Nowrosjee Wadia Maternity Hospital- Parel, Medichek Total Health Care – Opera House Dawood Nursing Home – Mumbai Central, Om Shanti (JDF & Lions Club of Churchgate) Medical Centre - Lalbaug, Bhai Joga Singh Charitable Homoeopathic Clinic – Sion and Senior Associate with Dr. Farokh Master at - K.E.M Hospital - Homoeopathic Health Centre.

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