Clinical Cases

Constitutional Treatment of Vitiligo

Constitutional Treatment of Vitiligo 1

Drs. S. Bidwalkar, Yashasvi Shakdvipiya and Noopur Kumari share a case of vitiligo in a 14 year old male. The patient being irritable, obstinate, desiring sweets, having profuse perspiration on the forehead and being a hot patient, led to the simillimum.

Abstract: Vitiligo is an acquired, progressive, common pigmentary disorder which results in depigmented patches appearing on the skin. A case report of a 14 year old male is presented here which was treated with individualized homoeopathic medicine after proper case taking and repertorization.

Keywords:Vitiligo, Autoimmune disease, individualized, homoeopathy, depigmented, patches, reportorial totatility, constitutional medicine

Introduction

Vitiligo is a common chronic skin depigmentation disorder. It is due to stoppage of melanin formation by the melanocytes and presents as asymptomatic depigmented macules anywhere on the body including mucous membranes of lips and genitalia.1 In vitiligo, there is a marked reduction or even absence of melanocytes and melanin in the epidermis.

The exact cause of the vitiligo is not known, but some studies suggested that it is an autoimmune disease in which the body’s immune system attacks its own healthy cells. It sometimes runs in families, suggesting that genetics may play a role.

In some cases, people with vitiligo report some sort of triggering factor like injury, sunburn, illness, emotional stress, pregnancy etc.2

CASE REPORT

A 14 year old male was reported at Sindhi camp campus OPD (211/17) on 17/7/17 with a complaint of hypopigmented spots over his face since 9 months.

HISTORY OF PRESENTING COMPLAINTS

The patient was apparently well 9 months ago when he gradually started complaining of hypopigmented spots first seen above his right eye.

Then the spots gradually started extending to the right temporal region, then towards the right cheek and lastly over the nose. The hairs of eyebrows are also getting white.

PAST MEDICAL HISTORY

Disease/ operation/ injuries etc.Age/year in which occurred Treatment takenOutcome
PneumoniaAfter birthAllopathic treatmentRecurrent cough and Coryza
Meningoencephalitis2015Allopathic treatmentCured

 FAMILY HISTORY

Paternal grandfather – diagnosed with brain tumor, died in 2011

Paternal grandmother- Diabetes Mellitus since 1 year, alive

Mother – allergic to dust since 2 years

SKIN EXAMINATION

Sites of lesionCharacterDescription
 

Right eye, face, forehead

ColorWhite, pinkish
Number of patchesMultiple
Hair in patch (Black/white)White
Margins of patchDefined

 GENERAL EXAMINATION

General build – slightly obese

Pulse – 84 beats/ minute

Respiratory rate – 22 breaths/ min

Blood pressure – 110/ 80 mm/Hg

ANALYSIS OF SYMPTOMS:

MENTAL GENERALS

Gets irritable about almost anything.

Obstinate

Reserved

 PHYSICAL GENERALS

Desire                    : Sweets­+++, rice ++

Perspiration                   : more on forehead++

Thermal reaction : Hot patient

Particulars

Hypopigmented spots over face

Perspiration profuse on forehead

EVALUATION OF SYMPTOMS

  1. Gets irritable easily
  2. Obstinate
  3. Reserved
  4. Desire for sweets
  5. Desire for rice
  6. Hypopigmented spots on face
  7. Profuse perspiration on forehead

MIASMATIC ANALYSIS

S.NoSymptoms PsoraSycosisSyphilis Tubercular
1Gets irritable on every matterü  ü    
2Obstinate ü  ü   
3Reserved ü  ü   
4Desire for sweetsü     
5

 

Desire for riceü     
6Profuse perspiration over forehead   ü  
7Hypopigmented spots on faceü   ü   

Miasmatic predominance- Psora- syco-syphilitic

 REPERTORIAL TOTALITY

S.NoSymptoms Reportorial totality
1Gets irritable easily

 

MIND – IRRITABILITY – trifles, from
2ObstinateMIND – OBSTINATE
3ReservedMIND – RESERVED
4Desire for sweets

 

GENERALS – FOOD and DRINKS – sweets – desire
5Desire for riceGENERALS – FOOD and DRINKS – rice – desire
6Profuse perspiration over foreheadHEAD – PERSPIRATION of scalp – Forehead
7Hypopigmented spots on face

 

SKIN – DISCOLORATION – white – spots

Constitutional Treatment of Vitiligo 2

 Figure 1: Showing repertorization of case from Synthesis Repertory 9.0 (English) using RADAR 10.0

PRESCRIPTION

Sulphur 30/ 1 Dose

Rubrum 30/ TDS/ 14 days

BASIS OF PRESCRIPTION

According to miasmatic analysis the totality of symptoms of the patient covers all the 3 miasms, i.e, Psora, Sycosis and Syphilis. But Psora is the predominant miasm; also the thermal reaction of the patient is Hot, therefore Sulphur was prescribed.

FOLLOW UP SHEET

Date Symptoms Prescription
17/7/17The spots are getting darkerRubrum 30/TDS/ 7days
24/7/172 spots over the right cheek have disappeared

The spot over the right side of nose has reduced

Rubrum 30/TDS/ 21days
14/8/17No further improvement is seen

 

Sulphur 30/1 dose

Rubrum 30/ TDS/ 14 days

28/8/17The pigmentation is seen between the spot over neck and cheek.Rubrum 30/ TDS/ 14 days
11/9/17No further improvement is seen

 

Sulphur 30/1 dose

Rubrum 30/ TDS/ 14 days

25/9/17Pigmentation is seen over the foreheadRubrum 30/ TDS/ 14 days
9/10/17Better than beforeRubrum 30/ TDS/ 14 days
30/10/17The spots are getting betterRubrum 30/ TDS/ 14 days
27/11/17The spots are getting betterRubrum 30/TDS/ 30 days
1/1/18Pigmentation is seen in the spotsRubrum 30/TDS/ 30 days
5/2/18No further improvement is seenSulphur 30/ 1 dose

Rubrum 30/ TDS/14 days

19/2/18The spots over the nose are getting smallerRubrum 30/TDS/30 days
19/3/18The spots are getting betterRubrum 30/TDS/60 days
21/5/18The spots are betterRubrum 30/TDS/60 days
23/7/18No further improvement is seenSulphur 200/ 1 dose

Rubrum 30/ TDS/ 30 days

10/9/18The spots over forehead are getting pigmentedRubrum 30/ TDS/ 60 days
12/11/18The spots are getting betterRubrum 30/ TDS/ 60 days
21/1/119The spots are getting pigmentedRubrum 30/ TDS/ 60 days
18/3/19No further improvement is seenSulphur 200/ 1 dose

Rubrum 30/ TDS/ 60 days

20/5/19The spots are the eyes are getting smaller in sizeRubrum 30/ TDS/ 60 days
8/7/19The spots are getting pigmentedRubrum 30/ TDS/ 60 days
5/9/19The spots are getting pigmentedRubrum 30/ TDS/ 30 days

BEFORE TREATMENT (17/7/17)

Constitutional Treatment of Vitiligo 3

AFTER TREATMENT(5/9/19)

Constitutional Treatment of Vitiligo 4

Discussion and conclusion

Homoeopathic medicines are prescribed on the basis of totality of the symptoms of the patient. Homoeopathy treats the patient as a whole, not just the disease. The constitutional approach was followed in the above mentioned case. The medicine was repeated and potency was also increased as per the need of the case. With the help of constitutional medicine the patient experienced a significant improvement in his general health also

References

  1. Homoeopathic research in vitiligo: Current scenario Dewan … [Internet]. Available from: http://www.ijrh.org/article.asp?issn=0974-7168;year=2017;volume=11;issue=4;spage=226;epage=236;aulast=Dewan
  1. Vitiligo [Internet]. Genetic and Rare Diseases Information Center. U.S. Department of Health and Human Services; [cited 2019Aug18]. Available from: https://rarediseases.info.nih.gov/diseases/10751/vitiligo

About the author

Sameer Bidwalkar

Sameer Bidwalkar

Dr S. Bidwalkar, BHMS, MD(Hom.) Professor & Head of the Department of Repertory, Dr. M.P.K Homeopathic Medical College Hospital & Research Centre, Homoeopathy University, Saipura, Jaipur

About the author

Yashasvi Shakdvipiya

Yashasvi Shakdvipiya

Dr Yashasvi Shakdvipiya, BHMS, MD(Hom.), Assistant Professor,
Department of Repertory, Dr. M.P.K. Homoeopathic Medical College, Hospital & Research Centre, Homoeopathy University, Jaipur.

About the author

Noopur Kumari

Noopur Kumari

Dr. Noopur Kumari, BHMS, MD (Hom.) - Part 2, Department of Repertory
Dr M.P.K Homeopathic Medical College Hospital & Research Centre
Homoeopathy University, Jaipur. Former Senior Research Fellow (SRF)
Central Council for Research in Homoeopathy (CCRH).

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