Alopecia Areata in a Woman of 32

Dr. Nikunj J. Jani shares a case of alopecia areata in a woman of 32. Anxiety about the future, talking in sleep, dreams of water, aversion to cheese and aggravation in winter were symptoms leading to the simillimum.

Alopecia Areata in a Woman of 32

Abstract: This is a case suffering from Alopecia Areata. Through this case we are able to appreciate the role of homoeopathy in managing an autoimmune disorder like Alopecia Areata and also the significance of the law of minimum dose in clinical practice.

Key words: Hair Loss, Alopecia Areata, Auto- Immune Disorders, Homoeopathy.

Patient Case Record:

Preliminary Data:

Name: Mrs. PPS32 yrs/FemaleDate of case taking: 05/2/18
Education – B.ComMarital status: MarriedAddress – Mumbai
Occupation- Office Admin at a Pharmaceutical Firm

Chief complaint:

Patient came with complaints of hairfall in a spot+++ at vertex over the scalp since last 2 months. The progress and spread was fast.  There was thinning of the quality of hair. No H/O of dandruff/ scarring/eruptions. She took some treatment from dermatologists but got no improvement.

Diagnosis: Alopecia Areata.

Understanding Alopecia Areata: Alopecia Areata is an autoimmune disease of hair follicles that affects young adults. Well defined patches of non-scarring, non- inflammatory hair loss are characteristic. Any part of scalp or body (e.g. Beard, moustache) may be affected.

Patient as a person

Perspiration – Foot- Offensive +++

Cravings – Milk+++, Warm Food ++

Aversion: Cheese+++

Thermals:  Winter Agg++. Chilly patient.

Motion Sickness while travelling in car++

Sleep: Talking in sleep++

Dreams: Water++

Menstrual history: Normal.

Noise Agg— brings about a lot of irritability.

Early graying of hair++

Life Space-

Patient is a 32 yr female hailing from an upper middle class family. She stays in Mumbai with her in-laws, husband and her 5 year old daughter. Her husband has his own business.  She has anxiety about the future concerning her husband’s business. She chose to take an administrative job in a small pharmaceutical company so she could have her own career independently. She is very particular about her work and wants everything to be done with utmost dedication and planning.

O/E:

No Pallor/ Icterus/ Cyanosis

T– Afebrile                     P– 82/min                               BP– 120/80 mm of hg

RS– AEBE                CVS– S1S2                             P/A– soft/NT

Wt: 52 kg

Skin:  Scalp; patchy hair loss++, no scars.

 Understanding the Case:

In this case we have a young lady of 32 years with well defined patchy, non- scarring hair loss. This clinical presentation fits into the clinical diagnosis of Alopecia Areata.

In this case we are able to see a classical presentation of the clinical course of the disease. In terms of symptomatology we have all the common symptoms of the disease. We have a characteristic mental symptom, a characteristic dream, physical general symptoms and few physical particulars.

Repertorial Totality:

Materia Medica Differentiation:

We have a young lady who is very particular and sincere in her work. Her relationship pattern is also very balanced. What we see in her shades of anxiety especially about the future (here remedies like Sepia, Kali Carb, Silicea come up strongly). She has a marked sensitivity towards noise which brings about irritability (here again Sepia, Kali Carb, Silicea come up). Sepia does not cover her characteristic dream and Kali Carb does not cover the characteristic cravings and aversions. Now if we look at the overall picture, we see nearly all the characteristic symptoms of the case are covered by Silicea.  Franz Vermulen states in his book Prisma, that Silicea has mental clarity.  The patient has great clarity regarding her career and how she will go about it.  Hence the final remedy selected in the case was Silicea.

Prescription:

On 05/2/18: (Refer Photo Plate No- 1)

Patient was given Silicea 30C 3P (3 consecutive nights) HS and SL pills for 2 weeks.

Follow up Summary:

Criteria:

  1. Anxiety about future
  2. Hair fall – Intensity
  3. New Spots of hair fall
  4. Hair growth in spots

(“S” = Status Quo )

Date1234Action
22/2/18>+>+0Started at some spots+SL pills BD for 2 weeks
09/4/18SS0SSilicea 200 200C  Single dose

SL pills BD for  3 weeks

02/5/18>++>++0>++SL pills BD for 2 weeks

 

22/5/18>+++>+++0>+++SL pills BD for 4 weeks

(Refer Photo Plate No- 2)

 The patient was on treatment from 05/02/18 to 22/05/18. In a short span of nearly three and a half months she was completely better. Also, there was minimum repetition of the homoeopathic medicines. After the initial consecutive 3 doses of Silicea 30C at the start of treatment, she was put on placebo. When the improvement came to a standstill, a single dose of the next higher potency – Silicea 200C was given. After that she was again put on placebo. There was re-growth of hair in the Alopecia Areata patch and also no new patches were noticed.

Patient Photos Plate

Conclusion:

In this case we are able to appreciate the utility of the homoeopathic medicine in management of an autoimmune disorder like Alopecia Areata. Here we are able to appreciate the efficacy of the concept of minimum dose in managing an auto immune disorder and also demonstrate the speed of recovery with homoeopathic medicines.

References:

  1. Khopkar, Uday; (2002), An Illustrated Handbook of Skin Diseases and Sexually Transmitted Infections, Bhalani Book Depot, Mumbai
  2. Phatak, S. R; (2002), Materia Medica of Homoeopathic Medicines, Reprint, B. Jain Publications Pvt Ltd, New Delhi.
  3. Vermulen, Franz; (1997), Prisma- The Arcana of Materia Medica Illuminated, Similars and Parallels between Substance and Remedy. The Netherlands, Avenhorn 8.

About the author

Nikunj Jani

Nikunj Jani

Dr Nikunj Jani – M.D. (Hom) is a homoeopathic physician with over 10 years of clinical experience. He is currently working as Associate Professor, Dept of Repertory, Dr. M. L. Dhawale Memorial Homoeopathic Institute, Palghar, Maharashtra. He is also involved as a Physician in the Dept of Geriatric Medicine at Dr. M. L. Dhawale Memorial Trust’s Rural Homoeopathic Hospital, Palghar. Dr Nikunj Jani has over 35 papers published to date in various peer-reviewed and national journals of Homoeopathy.

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