Preliminary Data: Name: Mr. PQS | Marital status: Married |
Age: 38yrs | Religion: Hindu |
Sex: Female | Address: DEF |
Education: graduate | Date: 19-11-14 |
Occupation: Housewife |
Chief Complaints: Patient came with complaints of eruption over both ears along with erythema and fine cracks and intense itching since 3-4 years. She also complained of dandruff since many years. She took conventional treatment for more than a year but without major relief. She was also undergoing psychiatric treatment for depression for the last few months.
Location | Sensation | Modality | Concomitant |
Ear
Rt > Lt Since 3-4yrs |
Cracks+/ Erythema
Itching++ Dandruff+ |
< Night+
< summer >cold application++ |
Sleeplessness |
Past History:
No major illness in past
Family History:
Grandfather: Rt side hemiplegic Grandmother: Osteoporosis
Father: IBS Mother: Allergic Rhinitis
Patient as a person:
Appearance: Average build Diet: vegetarian
Appetite: Good Thirst: 4-6 glasses/day
Desire: Pickles++, Spicy food+ Aversion: Potatoes++ agg
Bowel: regular, occasionally constipated Urine: 4-5 times /day
Sleep: Sound, on back Perspiration: scanty on head, face, sour++
Dreams: falling in water Habits: Tea twice daily
Thermals: chilly
Summer | Rainy | Winter | |
Fanning | Slow | Slow | No fan |
Covering | 1 thin | 1 thin | 1 thick |
Bathing (water) | Warm | Warm | Warm |
Life Space Investigation:
The patient gets irritated easily the last few months. Prior to this she used to suppress her feelings. She was very outgoing before but because of the eruptions she had started to avoid public functions or meeting people. She is a very caring mother having one elder daughter and a younger son. She is always worried about their future and about their studies. Her husband is very supportive of her in everything and never shouts or scolds her. She feels lucky to have such a family but she says that sometimes she wishes that people would not disturb her and she avoids company. She has sleepless nights due to anxiety. She always has fear that something bad will happen to her, or to the family. She is interested in handicrafts and cooking.
Observation by Attendants: Very reclusive; talks little and has no contact with friends or relatives. Startles in sleep.
Physical Examination
General Examination: T – 980 F P/R – 78/min RR – 16/min
BP-130/80mmHg Weight – 64kg
No signs of pallor, cyanosis, clubbing, lymphadenopathy and icterus
Systemic Examination:
Respiratory System: Air entry bilaterally equal and clear
CVS: S1S2+, no murmur P/A: Soft, non-tender CNS: Normal
Diagnosis of Disease: Atopic Dermatitis
Miasm: Syco syphilitic
Susceptibility of the case: Moderately susceptible
Analysis of symptoms:
Mental Generals | Physical generals | Particulars |
aversion to company
Anxiety with sleeplessness fear something bad will happen caring and worrying
|
desire pickles
potatoes disagree perspiration sour sleeps on back
|
cracks in ear
ear itching <night cold application amel
|
Repertory used: Complete Repertory
Probable Remedies: Sep, Sulph, Calc, Graph
Constitutional remedy: Sepia Potency: 200
Reason: From the study of the patient and reference to materia medica, Sepia covers the following features –Indifferent nature, avoids company, reclusive nature, fear of evil things, peculiar cravings for pickles and dreams of falling in water. Thus Sepia gets highest marks in the above features and was prescribed.
Prescription: SEPIA 200 (4 pills- 1 dose) S.L. BD x 15 days.
Auxiliary measures: Avoid foodstuffs that may aggravate the eruptions. Start taking lots of citrus fruits and a healthy balanced diet. Wash your hair regularly and avoid using any irritant dyes, shampoos and chemicals.
Follow Up:
DATE | OBSERVATION | PLAN | TREATMENT |
10-12-14 | Constipated since 3 days, rest feeling better, no any change in eruption, itching bit increased | Wait and watch | S.L. BD x 1month |
13-01-15 | No Significant change, itching still same, again had dreams of falling in water. Dandruff+ | Repeat the dose | Sep 200 2 dose
S.L x 1month
|
12-02-15 | Itching reduced by 20%, redness reduced, cracks still persist, bowels regular, feeling better. | Repeat the dose as the remedy action exhausts soon | Sep 200 1 dose
S.L. BD x 1 month |
20-03-15 | Not Much improvement, itching and redness still present, cracks+. | Miasmatic block
Anti-psoric needed |
Psor 200 1 dose f/b Sep 200 1 dose after a week
S.L BD x 1 month |
18-04-15
|
Itching and redness reduced almost 60%, Appetite improving, bowels regular, sleep sound, cracks reduced. | Wait and Watch
|
S.L BD x 1 month
|
24-05-15 | Itching stopped completely, redness and cracks negligible, she started to talk with people, went outside for functions, her anxiety levels decreased. In the mean time her psychiatrist tapered the medicines and stopped after 2 months. Overall she showed great improvement physically as well as mentally. | Wait and Watch | S.L BD x 2 month
and visit if any relapse |
14-07-15 | Eruption over both the ears totally gone, feeling better, no new attacks of depression. | Advised to stop the treatment |
BEFORE TREATMENT
AFTER TREATMENT
Good case.but you have said miasm as syco-syhilitic but psor given as antipsoric
great case! Very clear and systematic presentation .
great case! very systematic presentation.
Nice case presentation.i want to saysame u have given psori for miasmatic block.but miasm is sycosyphilis.
Dr nash explains nicely.as psorinum excellent remedy 4atopic derm. Seborrhic der.it always control recurrance.
In one yr good development.
Wish u all the best
Thanks for your valuable comments.