Atopic Dermatitis in a Girl of 11

This is a case of atopic dermatitis in an 11-year-old girl. The patient visited me on 10th July 2021. She had been suffering from atopic dermatitis for 3 years. Her skin lesions had been suppressed repeatedly with allopathic steroidal creams, but they resurfaced sooner or later.

She presented with black discoloration of skin associated with itching and scaling in both the thighs, popliteal fossae and both legs. Her mother said that her skin resembled that of an elephant. The girl used to scratch the lesions violently and that would cause repeated episodes of bleeding. The condition of the lesions used to aggravate on every change of season.

CONFLICT

The patient developed atopic dermatitis in 2018. It was found that the patient had shifted with her parents to Bangalore in 2018 as her father had been transferred to Bangalore. She had to leave her school and friends which caused tremendous anger which was seldom expressed in front of her parents.

INTERPRETATION

• Skin- separation conflict (ectoderm)
• Blackness – Blackness is symbolic of suppressed anger just like redness is symbolic of anger that is expressed.
• Lower limbs – performance in day-to-day life
• Popliteal fossa- diseases affecting the popliteal fossa are usually seen in timid and reserved constitutions as they are hidden from the sight of others. As the patient did not express her grudges to her parents the disease developed in the hidden space of popliteal fossa. The same is the case with pathologies developing in the axilla.

ON OBSERVATION 

1. Black discoloration around the mouth
2. Dry and cracked lips
3. Acne on forehead
4. Increased body hair (symbolic of added protection which means that the need of the remedy is support and safety)

PHYSICAL GENERALS
Build – extremely thin girl with very thin neck
Appetite- extremely poor
Thermal reaction – chilly
Thirst – thirstless
Desires- sweets, sour
Sweat – very offensive; mother said that nobody can sit in the room if she has come back from school, as her sweat is extremely offensive
Urine – offensive and dark urine
Sensitivity – tight clothing, sun
Ailments from – riding in cars caused nausea and headache
Tendencies – recurrent aphthae with fetor oris; dental caries

PATIENT AS A PERSON

1. Introvert
2. Taciturn, uncommunicative
3. Indolent and lazy
4. Loves to sleep throughout the day
5. Non diligent; must be pushed to study
6. Seldom expresses her emotions
7. Tired throughout the day with poor energy levels even after a good sleep
8. Slow in execution of tasks given to her
9. Remains absorbed in her own thoughts and sometimes is completely unaware of her surroundings and it is evident from her face that she is thinking about something else

REPERTORIAL ANALYSIS
Based on the characteristic syphilitic symptoms at the level of the mind and body, the Repertorial analysis was as follows: –

1. Mind, abstraction of mind
2. Skin, discoloration, blackish
3. Generals, Emaciation, children in
4. Generals, Odor of body, offensive

MERC – 7/4
KREOS – 6/4
PHOS – 6/4
SEC COR – 6/4
ARNICA – 5/4
CHINA – 5/4
RHUS TOX – 5/4

PRESCRIPTION
We needed a Chilly, Thirstless, Non-diligent, Timid and Introverted remedy whose need is support and security.
Merc – thirsty and rebellious
Phos – extrovert and vivacious
Secale cor- hot and thirsty
Arnica – antagonism with family and soreness in mind and body
China- haughty

When we think of Chilly, introverted, timid and non-diligent remedy groups, we think of Calcareas, Carbons and Kalis.

In the Repertorial analysis we had Kreosotum as the only Carbon which also covered the tendency to dental caries and nausea and headache from carriage riding.

10th July 2021 -KREOSOTUM 200, Unit dose was prescribed in this case

FOLLOW UP   – 26th march 2022 – Lesions have healed completely in accordance with Hering’s Law i.e. above downwards (photos attached).