Clinical Cases

Erythema Multiforme: A Wound That Doesn’t Heal

erythema multiforme
Written by Shawn Vale

Homeopath Shawn Vale presents a case of an eight year old girl with erythema multiforme.

An 8 year old girl finds support and healing with Ailanthus glandulosa.


Of Caribbean descent, Faith was adopted at 18 months by D, an Italian woman. A grey and cream cashmere jumper contrasts beautifully to her dark skin. At first Faith is reserved, as if sizing me up, but before long her playful spirit prevails. She has a robust appearance, in spite of the dark circles under her eyes. A plastic tiara pushes back her short cropped hair. Faith has an arrangement to see her birth mother every 3 months. Often her mother arrives very late or not at all. Recently her mother gave birth to a baby boy. When she learned the news about her new brother, Faith became very concerned. Her first reaction was, “Will mamma give the baby away like she did with me?”


F: “Do I have to talk a lot? I don’t want to. It’s boring to see the doctor.”

D: She didn’t want to come today. She is afraid of getting shots.


I give Faith a sketch pad and colored pencils inviting her to make some drawings should she become bored.


Since Faith arrived at D’s, she has had one infection after another. According to D, her nose needed blowing 50 times a day. The mucus was white or yellowish and thick. She was treated with at least 6 cycles of antibiotics during a year and a half period. Her right ear was flat. D didn’t know she had hearing problems because Faith was singing and picking up Italian words. At 3 Faith had a myringotomy. From one day to the next she was fine. She understood everything in class. Her nose stopped running.

erythema-multiformeOne month later, Faith had her first outbreak of herpes on her lip. Days later, erythema (Homeopathy for Erythema Nodosum) broke out on her arms, back, legs, and face. Since then, the erythema always appears 10 days after the herpes disappears. Tiny dots appear on her forehead or along the side of her face. Within 24 to 36 hours, the rash explodes into little raised islands with bubbles in the center and brownish crusts on top. It is extremely itchy. Faith tries not to scratch. When the crust falls off, a white or dark scar remains. Sun is a trigger. There has been no repeat of erythema since 2010 after starting Acyclovir.

Once a year, at no particular time, she has a bout of fever, up to 103F. Also, since 2 or 3 years old, she has coughing spells in the fall. Last October she coughed for one month. It is a constant dry cough, worse when she lies down. No fever. A few nights she vomited dinner because she was so convulsed. About ten days later, a herpes sore will appear on her lip. It becomes a huge crust. Now she gets them on the outside and inside of her lips. When younger, her lips were always chapped. On windy days she always wants to wear a hat. She received all her vaccinations and had none of the childhood diseases.


Faith stops twirling in her chair. She shows me two herpes blisters on the right side of her lower lip and two more inside her mouth.


D believes that Faith becomes ‘stressed out’ with excitement. She says, “As soon as we start traveling or visiting family, something always happens.” When she was about to leave for Italy, she cam down with a fever the day before.

Faith: (interrupting) And I was crying on the plane.

D: In the plane? You never showed it to me.

Faith: I was crying because Mama doesn’t yell but Grandma in Italy does and you do when I make mistakes in my homework. Then I get frustrated and cry. I hate it.

D: When we go over the same thing 16 times and it still takes 3 hours to do, I may yell.


Smiling broadly, Faith brings her chair right up to mine. She agrees to speak to me alone.


Faith tells me the visits with her biological mother are sad. She cries when she says goodbye. She would like to stay with her mother and have a new father. Her father left before she was born. [She is crying.] Faith says, “It feels like you don’t have a family but you really do. I love my brother. Before I was an only child and now I’m glad I’m not an only child anymore.” Her skin problem makes her feel sad and uncomfortable. Some kids ask questions and tell her she looks weird. Sometimes she cries.

By the time D returns, Faith is laughing. D tells me she is generally “very bubbly” and “dances and sings like crazy”. When she is sick, she stops being silly and goes to bed. D gives her a hot water bottle, caresses her forehead, and waits until she falls asleep.

Faith sleeps wrapped in her sheets turned towards the wall, “Egyptian style like a mummy”. She is afraid spiders will come in the window and bite her. (She relates this in gales of laughter.)

Sushi is her favorite food. She eats this quickly but otherwise can be a picky eater. At 2 ½ she went to nursery. In 3 days she was potty trained. She is competitive and doesn’t like it when other kids can do something she cannot. She also walked at 2 ½ months and never used the stroller again.


Faith completes 3 drawings. There is a portrait of me with hearts, a self-portrait surrounded by many hearts, and a drawing of a heart divided in two, one side red and the other pink. An arrow with the word ‘mean’ points to one side while another arrow points to the ‘nice’ side.’ The heart has two eyes and a Mona Lisa mouth.


Faith: The nice part is when I help my friend do his math homework. He has trouble and I’m good at it. The mean part is when somebody is mean to me. I get angry. I start not being their friend. I don’t speak anymore. With D, I go in the bathroom, or I go in her room and shut the door. I get over it.


Spontaneously she sings ‘Snowflakes are falling’ in a high clear lilting voice.


When I compliment her she quips, “Born to perform”. I ask if she will come back and see me again. She replies mischievously, “I don’t know. It’s boring.”

Faith impressed me as someone with a strong vital force. Although she has been deprived of mother’s nurture and weakened by medications, Faith’s system always finds an answer, however poor and disorganized its expression. Low fevers of no apparent cause with no accompanying symptoms, the absence of childhood diseases, a stubborn chronicity and strict periodicity, all underline the low and incomplete reactivity of her state. The tenacious aspect of ‘infection after infection’ on the physical level conversely describes her irrepressible good nature and persistence of self expression. ‘Born to perform’. It was interesting how she was able to use our consultation to voice some of her grievances. The drawings suggest a heart ‘torn’ in two, an emotional anguish relating to D, her birth mother, and her brother. Also note worthy is her strategy of not asking for help. She walked at 2 ½ months and never used the stroller again. She was potty trained in 3 days. At night, feeling fearful, she wraps herself in her sheet and turns toward the wall. She doesn’t tell M that she cried on the plane.


The fundamental theme of this case is slow and incomplete reaction related to chronic suppression.

Gen: Eruptions; fail to break out

Skin: Eruptions; General; slow evolution

Skin Eruptions; General; suppressed

Fever, Heat: Low fevers; Eruptive fevers

Gen: Periodicity; Periodicity annually; Chronicity; Children complaints in


Her strategy is not asking for help.

Mind: Stoic

Mind: Indifference, apathy; stoical to what happens

Stomach: Appetite; Capricious, hunger but knows not for what, or refuses things when offered

Mind: Grief; Anguish

Mind: Weeping, tearful mood; tendency, incessantly


Faith’s feeling of vulnerability is represented by her fears.

Mind: Delusions, imaginations; animals, of creeping of; animals of; rats, mice, insects

Ear: Sensibility; wind in the ear, as to ; Wind; sensation of, in


The following symptoms complete the remedy picture.

Gen: Excitement agg.

Gen: Sun, from; exposure to; agg. or ailments from

Mind: Concentration difficult

Mind: Memory; weakness, loss of; done, for what he has just

Skin: Itching, scratch must

Skin: Eruptions, vesicular; Spots, large; Spots, small

Cough: Constant; Dry; Convulsive, spasmodic; Paroxysmal


The remedy is Ailanthus glandulosa, also known as the Tree of heaven. In the book, A Tree Grows in Brooklyn, a variety of the Ailanthus tree represents the tenacity of a neighborhood’s poor residents to overcome difficult circumstances. Ailanthus can grow in cement without water or fertilizer, making it a favorite choice of city planners. In Kent’s time it was better known and employed symptomatically in cases of skin eruptions where there has been suppression or in eruptive diseases that are slow to evolve or resolve. I suggest a test dose of 30C, one dose daily for 3 days.

A few days later, there is a single painless herpes eruption on Faith’s upper lip, a new location. With no further progress 2 weeks later, we repeat the dose.

At the 6 week follow-up, D reports that the second dose produced a herpes eruption on her bottom lip in the usual place. Like clockwork, but in fewer than the usual10 days, she had a mild breakout of erythema on her neck and arm. It itched less and resolved quickly. She believes Faith has been less anxious at night. One month later a single herpes eruption appears on D’s bottom lip, so mild she almost didn’t think about it.

Two months later we meet again. Faith had only a mild cough lasting 3 days. No chapped lips. Old and new erythema scars are more quickly reverting to the original skin color. Because she retains more of her reading, her schoolwork is better than ever.


D: I’ve been thinking about what you said. She was always in a daze with all these anti-systemics they were giving her. And the separation of seeing her birth mother and then being taken away is so traumatic. It’s like a wound that doesn’t heal.


I see Faith again three months later. There had been a recent mild outbreak of erythema. D says she is more calm, less silly, and listening better. Her grades are excellent. Faith confides, “I am proud of myself.” We give an LM01 every 3 days with the intention of continuing but a month later Faith is on vacation and the remedy is left behind. Yet, she passes a fine summer, symptom free. That fall, D and Faith move to Europe. It is presently two and a half years since she took any remedy. There has been no recurrence of erythema and only an occasional herpes eruption that successfully resolves in a day or two. Colds and coughs are infrequent and also resolve quickly.

About the author

Shawn Vale

Shawn Vale, CCH, RSHom (NA) is a Certified Classical Homeopath, author, and lecturer residing in Staten Island. A graduate of The School of Homeopathy New York, Shawn has been in family practice in New York City since 2006. In 2005 Shawn was invited by Abhalight, a charitable organization serving Kenya’s poorest communities, to help establish a network of mobile clinics. Two years later, post graduate studies took Shawn to the Bombay School of Homoeopathy in Mumbai, India. In 2014, he was privileged to collaborate with Master Homeopath Dr. Massimo Mangialavori on his book, The Milks. Shawn continues to write and speak about the energetic principles of health and wellness, and especially about her passion for homeopathy. Her dream is to see this venerable medical art restored to its former good standing in this country. Today, with the advent of Tele-health, Shawn continues to expand her practice and the reach of homeopathy.


  • So much of analysis and finally, a remedy was given that is well known to cure this pathology. 🙂

  • It is not very common to see this disease here; most patients treat it conventionally. Because Ailanthus is only one of many remedies known to treat this pathology, and because I never had occasion to prescribe it,
    I thought it might be interesting to some of my colleagues. More important than being well known to cure this particular pathology, as are many other remedies, is the specific ‘essence’ of this remedy. I hope that others will recognize its totality after reading the case. Nevertheless, thank you for your comment.

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