Ischemic ulcers (wounds) can occur when there is poor blood flow in the legs. The overlying skin and tissues are then deprived of oxygen, killing these tissues and causing the area to form an open wound. Most ischemic ulcers occur on the feet and legs. Ischemic ulcers are characterized by a punched-out look, usually round in shape, with well-defined, even wound margins.
A number of risk factors may contribute to the development of an ischemic ulcer including the following comorbidities and conditions:
- Diabetes mellitus
- Foot deformity and callus formation resulting in focal areas of high pressure
- Poor footwear that inadequately protects against high pressure and shear
- Absence of protective sensation due to peripheral neuropathy
- Limited joint mobility
A 56 years old female came with complaint ofulcer in the right leg since one month, with gradual onset of complaint. A round, painful, non-oozing ulcer was present over right leg near shin bone. She is known to have uncontrolled diabetes mellitus.
She is also having complaint of sleeplessness since 1 year. Continuous thoughts about her health makes her not to sleep.
Undergone appendicectomy at the age of 24 years. No other significant histories.
Father – 85 years old -known to have diabetes mellitus and hypertension.
Mother – 78 years old – known to have diabetes mellitus
Physical Generals and Personal History:
Appetite – Good
Thirst – 2-3 litres /day
Urine – Frequent. more at night. 3-4 times /night
Stool -1/ day, regular & satisfied
Sleep – Sleeplessness.
Dreams – not specific
Desire – sweets
Aversion – not specific
Perspiration – good
Thermal Relation – chilly patient
Menses – attained menopause at the age of 48 years.
Diet – mixed diet
Habit – 2 cup tea / day
Addiction – nil
She has one son and one daughter. Both were normal full term hospital deliveries. No history of puerperal complication or abortion.
Patient is worried about her health due to uncontrolled diabetes mellitus and leg ulcer. Fear of losing her legs if the ulcer is not cured. Always thinking of it (a physician threatened her like that). Soft in nature. Fears to be alone.
Pulse – 70/min
Temperature – afebrile at the time of examination
Investigation : 10-02-2021
FBS – 273 mg/dl
PPBS – 366 mg/dl
HbA1C – 8.2
Totality of symptoms:
- Worried about her health
- Continuously thinking about her complaints
- Fears to be alone
- Mild in nature
- Desire for sweets
- Family history of diabetes mellitus
Repertorial Totality using synthesis:
Carcinocinum – 7/7
Basis of Prescription:
Considering the repertorial totality and also with reference to Materia Medica, Carcinocinum in 1M potency wasselected.Bbeing a nosode it also covers the fundamental and dominant miasmatic states of the individual.
Carcinocin 1M – 1 dose st
BT 2-2-2 AF * 2 weeks
|23-02-21||Sleep better. Ulcer started to dry||Rx, Placebo – 1 dose BT 2-2-2 *2weeks|
|11-03-21||Sleep better. Ulcer size reduced||Rx, Placebo – 1 dose BT 2-2-2 *2weeks|
|25-03-21||Sleep is Good. Ulcer Completely healed||Rx, Placebo – 1 dose BT 2-2-2 *2weeks|
Homeopathy is a safe option for treating skin diseases as it treats without any side-effects.