A Case of Leucoderma in a Woman of 22

Patient: Miss X, Age: 22, student

Date: 13/1/08

Presenting Complaints:

Leukoderma, white patches over feet, breasts and knees since 12 years of age. First it developed on her right foot as a small spot, then on knees, right ear, left foot, right breast, left breast. Right side more than left.

Past history:

Coryza frequently.

Family history:

Mother: hypertension, Hypothyroidism.

Father: hypertension

Menstrual history:

Menarche: 14 yrs of age –  cycle regular, moderate flow.

Personal history:

Allergy: Nausea due to strong odors

Appetite: Normal. Eats well

Desire: spicy food, warm food, chaat.

Aversion: sweet, oily, bland

Thirst: moderate

Sleep: sound

Dreams: Unsuccessful efforts to talk, wishes to talk but can’t utter words.

In reality patient is very soft spoken and can’t talk loudly or express herself well. Can’t argue..

Makes mistakes while writing and talking… says what she didn’t actually mean to and can’t say what she wanted to.

Dreams of her own death,  Dreams of others’ death.  Dreams of being contented, that she has everything. Dreams of travelling, going into space

Perspiration: not much, on exertion only.

Stools: regular, h/o constipation a year ago.

Urine: normal output

Thermals: Chilly

Can’t tolerate cold weather.

Life space situation:

Since childhood patient lacks confidence.  Timid and fearful.

Financial problems at home which led to lack of confidence, self doubt and inferiority complex. Wants everything perfect but can’t do it, due to weakness.  Timid and makes mistakes while talking due to nervousness. Uses wrong words.  Suppresses her feelings, wishes to speak but can’t express herself well.  Doubts herself, wonders what others think of her. Doesn’t ask anything from her parents.  Financial problems at home till her 12th std and were severe in her childhood.  Very Fastidious, likes cleanliness, perfection.  Shouts and gets irritated at family members when things are not kept clean. Can’t tolerate if her feet are unclean.  Expects food to be perfect, can’t tolerate if chapati’s are thick or burnt or if vegetables are unevenly cut.

Dominates family members and expects perfection from them. Doesn’t help around much though. Can’t tolerate lies.  Shouts at family members, snappish, abrupt, anger towards parents.

“I do so much for my parents, adjust everything, do household work.. but they don’t do what I expect, don’t care for me…”

Feels lonely,  timid outside. Irritability with throwing things, Bangs things. Anger with internal trembling.  Ambitious, knows she can achieve more and that she deserves more.

In the past she taught children for some months but discontinued as the parents demanded more from her and less fees and she felt insulted because of it.  She says “I am not a tuition teacher, I want to be a CA…. My standard is higher. People should talk politely to me. I should get what I deserve.”

Nervousness on speaking with strangers.

Analysis:

Patient is chilly

Feels she deserves more, ambitious but is not getting what she deserves.

Anger expressed at family members only and outside suppresses her feelings. Perfectionist, fastidious.. Awkwardness.

RX On 13/1/08 Staphysagria 30 was prescribed.

17/2/08

After remedy: Mistakes in reading and talking still the same.  On left foot, a dark spot, pigmentation has developed in the centre of the white patch.

Had cold cough in between

Medicine was not repeated

13/4/08

Dark pigmented spot developed on right foot as well, over the white patch.

Left spot same in size. Weakness slight.  Slight vertigo due to profuse menses.

Medicine was not repeated.

Patient was willing to talk about an incident in the past. She was having anger towards a woman since many years.  Few years ago, she had to stay at a friend’s place while her mother used to work late at a factory. But her friend’s mother used to treat her badly and used to ask her to do household work in return of the food she offered her.  She was scolded at times if she did the work slowly.  Once she had got hurt and couldn’t do the work so was sent away.  She got angry and felt insulted at that time and many times such incidents happened till she stopped visiting that friend’s place.

Did not share this with her mother would have felt bad. Suppressed her anger, insult and hurt feelings.  Since then she doesn’t yield much to others.

Ailments from Anger, Indignation.++

6/7/08

Right foot central spot darkened

Left foot white patch size reduced

Patches on breast reducing in size.

She feels bad when she makes mistakes while reading writing and talking. Demands perfection from herself but can’t attain the same.  Indignation towards herself.  Complaints increase when others point out her mistakes.

“I don’t look healthy.  I can’t talk properly. I don’t like sympathy and consolation. My weakness should not be exposed in front of others. “I don’t go out as I don’t get importance outside.”

18/1/09

Weakness reduced

Left leg spot the same

Right leg dark spot developed on white patch.

Irritability but can express to colleagues. Can’t do things fast enough..

Again rubrum was prescribed.

1/2/09

Weakness reduced

Spots same

Confidence level is developing, feeling motivated after counseling sessions

Rubrum was prescribed

And so on…

Gradually  went to Staphysagria 200 and then 1M was prescribed…

Patient is still taking treatment but spots aren’t improving further. However  her confidence level has markedly improved and she resists injustice. Expresses correctly.

Patient got divorced recently, as husband was having an extra marital affair and she could not tolerate his behavior, remembered old days of insult and indignation and ran away from their place.

Patient finds immense peace in meditation and engages a lot in it.