1st visit, 8. 1. 2021
A mother comes to me with a boy, 3 years old, whose main problem is eczema of non-specific origin that has developed on 26. 12. 2020 and has been growing worse ever since.
The appearance of the eczema was preceded by fever, during which the boy developed febrile shock (13/12/2020). The boy was hospitalized for 4 days and used ATBs for 10 days. On 26/12/2020, the parents noticed the first signs of eczema in the child and it has been growing steadily worse ever since.
The boy does not scratch during the day but in the evenings and nights he scratches very intensely; when scratching, he weeps. At night, his parents have to give him Dithiaden (an antihistaminic drug) so that he can sleep.
The eruption started on the wrists of both hands, then spread to the forearms and then to the inner thighs, above the elbows, on the trunk, on the palms and between the fingers. In the last few days, it has started to appear even on his face.
Mom says that the doctor suggested that it could be some infection the boy “caught” in the hospital or a reaction to the medication.
Apart from this eczema, the child has no other symptoms in any area, except one, namely that he puts his fingers in his ears. Below are photos of the skin manifestations. The last photo (with arrows in the picture) is a close-up of the left forearm.
Case analysis:
From the homeopath’s perspective, the fact that we have no other symptoms than skin complaints makes this case difficult. In such cases, skin manifestations become the only information we can use to select the remedy. However, to be able to prescribe a remedy on the basis of skin complaints alone, we need to find something peculiar and specific enough to narrow down the pool of possible remedies. In such a case, it is particularly important to know the materia medica and to investigate the skin manifestations very carefully.
If you look at the pictures, you will see that the raised skin bumps are the prominent feature here, see the rubric below:
Similar bumps, together with the beginning of the manifestations on the wrists, nocturnal itching, and subsequent spreading to the palms and between the fingers, are symptoms characteristic of scabies rash.
I asked the mum if the doctors considered this possibility as the condition was worsening and the itching at night was extreme. Mom told me that the doctor expressed the opinion that it could be some form of skin infection that the child caught in the hospital. So we did not know for sure whether or not it was a scabies rash; however, the child’s symptoms were strikingly similar to a scabies rash.
For this reason, Psorinum was the first remedy I considered as all of these symptoms (this type of rash + very severe night itching + crying during itching) are its keynotes, and I began to examine the individual photos even more closely to see if I could find any other characteristics that could confirm Psorinum.
One of the main characteristics of Psorinum is that the affected areas look “dirty” and I noticed several such spots in the picture of the left forearm. In the enlarged image (with arrows) you can see a greyish pigment in certain areas around the individual bumps.
I also knew that children who need Psorinum frequently keep sticking their fingers in their ears (because of itching), see the rubric below:
Similarly, in the rubric corresponding to the “dirty” appearance of the affected areas, Psorinum (along with Sulphur) is the most important remedy, see below:
If you look at these 2 rubrics, you will see that Psorinum is the only remedy that is found in both. Moreover, it also covers the other symptoms of the case (bumps, night itching, localization of the rash). In this case, I did not repertorize the case because there was no totality of symptoms to speak of, just a few specific symptoms that are keynotes of Psorinum.
Selection of the remedy, potency and dosage:
Psorinum is the remedy that best covers the problems in this case and, moreover, most symptoms are its keynotes. In view of the fact that this is a case of solely skin problems and because we do not have the totality of symptoms, it is better (safer) to start with a lower potency of the remedy.
Prescription: Psorinum 30C in a single split dose
1st follow-up 11. 1. 2021 (12 hours after taking the remedy) – a text from the mum:
“I can’t hold until Wednesday – my son’s eruptions are already much better! On the belly and back, they are almost invisible. The night after he got Psorinum, his skin smelled as after hydrogen peroxide.”
This text message was accompanied by a photograph of her son’s belly 12 hours after the last dose of the remedy:
2nd follow-up 8. 2. 2021 – 4 weeks after the remedy
The eruptions are 95 % gone, the boy stopped scratching almost completely. Still, he sometimes puts a finger into his right ear. His sleep is still restless but he does not scratch at night. Photos are below:
Analysis of the 2nd follow-up:
After the boy took the remedy, there was an aggravation in the form of odor (which is a keynote of Psorinum) and subsequently, there was an improvement of the eczema and itching but sleep remains restless. An initial aggravation followed by an improvement of the main problem means that the remedy was probably a good choice but the fact that sleep remains restless indicates that the child will likely need another remedy in the future. At this moment, however, the improvement persists and no new symptoms have appeared – and for this reason, it is necessary to wait.
Prescription: wait
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Thank you Mr. Zacharias for these very instructive cases. They are always worked so logically and following Hahnemannian principles. I’m glad someone still practices classical homeopathy as it was meant to be practiced.