A Case of Atopic Dermatitis with Depression

Dr. Satyakaam Trigunait presents a case of atopic dermatitis and depression.

 

Preliminary Data: Name: Mr. PQSMarital status: Married
Age: 38yrsReligion: Hindu
Sex: FemaleAddress: DEF
Education: graduateDate: 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.

LocationSensationModalityConcomitant
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 GeneralsPhysical generalsParticulars
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

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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:

DATEOBSERVATIONPLAN   TREATMENT
10-12-14Constipated since 3 days, rest feeling better, no any change in eruption, itching bit increasedWait and watchS.L. BD x 1month
13-01-15No Significant change, itching still same, again had dreams of falling in water. Dandruff+Repeat the doseSep 200 2 dose

S.L x 1month

 

12-02-15Itching reduced by 20%, redness reduced, cracks still persist, bowels regular, feeling better.Repeat the dose as the remedy action exhausts soonSep 200 1 dose

S.L. BD x 1 month

20-03-15Not 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

 

 

24-05-15Itching 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 WatchS.L BD x 2 month

and visit if any relapse

14-07-15Eruption over both the ears totally gone, feeling better, no new attacks of depression.Advised to stop the treatment

BEFORE TREATMENT

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AFTER TREATMENT

Satyakaam Trigunait jan2016Satyakaam Trigunait jan 2016

About the author

Satyakaam Trigunait

Satyakaam Trigunait

Dr. Satyakaam Trigunait has been practicing in Chinchwad Pune for one year. He completed his MD Degree in Practice of Medicine from Shri Bhagwan Homoeopathic Medical college, Aurangabad. He specializes in treating Gastrointestinal disorders, skin diseases and musculoskeletal disorders. He enjoys reading medical books, playing chess and participating in debates. His approach is deeply influenced by the work of Drs. Kent, Hering and Sankaran.

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