PRELIMINARY DATA:
Name: Mr A A
Age: 28 Years Date of Case taking: 22/10/2018
Sex: Male Religion: Islam
Address: Ullal Occupation: Businessman.
CHIEF COMPLAINTS:
| Location | Sensation | Modalities | Concomitants |
| Skin
Head, genitals, scrotum Since 2 years Gradual onset and progression. Allopathic medication |
Dryness
Itching++ Eruptions+, reddish Dandruff Scaling++
|
< touch+ < non veg items+ <cold weather+ |
|
| Skin
Right side Palm , medial side Since 1 year |
Wart
Bleeding occasionally
|
<pressure |
HISTORY OF CHIEF COMPLAINTS:
Patient was apparently well 2 years back, then he started with complaints of itching and dryness of the scalp and scrotum. The complaints were gradual in onset and progression. Itching is aggravated by touch.
Along with the itching he also had eruptions which were reddish in colour, also dandruff from the head and there is also scaling of the skin from the affected part.
The scaling is aggravated by taking non-veg items. Also, the complaints are aggravated in the cold weather. He had taken allopathic medicines for the complaints but was better only for a temporary period.
Patient also complains of a wart in the right palm over the medial side since one year, which is irregular and bleeds; bleeding is more with pressure.
PAST HISTORY: Iron deficiency anaemia
SURGICAL HISTORY: Nothing significant
FAMILY HISTORY:
Mother- HTN
Uncle-DM
PATIENT AS A PERSON:
Appearance: Stocky, moderately build and
nourished.
Appetite: Moderate.
Thirst: 1-2 litters / day, warm water.
Craving- Sweets++
Aversion- Nil
Bowel habits- Normal stool, passes once in a day, no difficulty.
Bladder habits- 3-4 times in day, 1 time at night, no difficulty.
Dreams- Unremembered
Perspiration: Increased, generalised, sticky.
Thermals-towards hot
LIFE SPACE EXAMINATION
Patient hails from a good socio-economic status; his father was a vender in the fish market and was financially sound, and mother is a house wife. He has four siblings, three brothers and one sister.
The patient studied up to Degree BCA, and presently working in a supermarket as manager; also he is a partner. He has a good business and is happy with it.
Patient had one love affair with a girl for many years, then 3 years ago he had to break up the relationship as she was forced to marry someone else by her parents and she agreed to that. Because of this incident he was depressed.
Almost the same time one of his uncles expired with whom he was very close. The uncle used to take care of the patient, who also helped him in the business. The patient was very sad and very depressed about the incident.
As a person – He doesn’t get angry easily. He likes company but prefers to rest when he is tired. He is attached to his family. At work he wants things to be done perfectly.
General physical examination
No signs of pallor, cyanosis, clubbing, icterus, oedema, lymphadenopathy,
Weight- 70 kg
Vital signs-
Pulse-68 beats per min., regular rhythm, moderate volume, vessel wall not palpable.
Blood pressure- 110/80 mm of Hg, left arm supine position.
Temperature- patient was afebrile at the time of examination
Respiratory rate-16 breaths per minute
Systemic examination
CNS – higher mental functions intact, cranial nerves intact, no abnormality detected
CVS- S1S2 heard, no added sounds.
RS – normal vesicular breath sounds heard. No added sounds
Local examination
Scaling and dryness of the skin all over the scalp, redness++, thickness.
Wart on medial side of palm, one in number, irregular.
Provisional diagnosis: psoriasis with verruca vulgaris.
Fundamental Miasm: Sycotic
Dominant Miasm: Sycotic
CHRONIC TOTALITY:
Mental Generals
Mild++
Grief++ from disappointed love.
Likes company+
Likes consolation.
Perfectionist+
Physical Generals
Craving- sweets++
Perspiration: generally increased, sticky.
Thermally- Hot patient
Characteristic Particular
Scaling and dryness of scalp
< Non veg
Itching ++<touch
Wart on palm bleeding+
Provisional Remedy:
Pulsatilla
Differential Remedy:
Causticum
First prescription
DATE: 22/10/2018.
Rx
- Pulsatilla 200 1P HS
- No ii pills 4-4-4 for 15 days
Follow up criteria
- Appetite
- Perspiration
- Itching
- Scaling
- Eruption
- Wart
PHOTOGRAPH OF THE FIRST VISIT- 22/10/2018.
PASI SORING ON FIRST VISIT- 3.5
FOLLOW UPS
| DATE | SYMPTOM CHANGES | PRESCRIPTION | |||||
| FOLLOW–UP CRITERIA | |||||||
|
5/11/18 |
1 | 2 | 3 | 4 | 5 | 6 | 1. PULS 200 2P
1P H.S. Weekly 2.No ii pills(4-4-4) x2 weeks |
| G |
S |
> | S | S | > | ||
|
19/11/18 |
1 | 2 | 3 | 4 | 5 | 6 | 1.SL 2P
1 P HS weekly 2.No ii pills(4-4-4) x 2 weeks |
| G | G | A | > | > | S | ||
|
10/12/18 |
1 | 2 | 3 | 4 | 5 | 6 | 1. PULS 200 2P
1 P HS weekly 2. No ii pills (4-4-4) x 1 month |
| G | G | A | S | < | S | ||
|
31/12/18 |
1 | 2 | 3 | 4 | 5 | 6 | 1. PULS 0 2P
1P HS weekly 2. No ii pills (4-4-4) x 2 weeks |
| G | G | A | >+ | >++ | S | ||
|
14/1/18 |
1 | 2 | 3 | 4 | 5 | 6 | 1. SL 2P
1P HS weekly 2. No ii pills (4-4-4)x 2 WKS |
| G | G | A | >++ | >++ | S | ||
| 28/1/19 | 1 | 2 | 3 | 4 | 5 | 6 | 1. SL 2P
1P HS weekly 2. No ii pills (4-4-4) x 2 wks |
| G | G | A |
>++
|
>++ | S | ||
|
11/2/19
|
G |
G |
A |
>++ |
>++ |
S |
1. SL 2P
1P HS weekly No ii pills (4-4-4) x 2 wks |
| 25/2/19 | G | G | A | >++ | >++ | S | 1. SL 2P
1P HS weekly 2. No ii pills (4-4-4) x 2 wks |
| 18/3/19 | G | G | A | >++ | A | >+ | 1. SL 2P
1P HS weakly 2. No ii pills (4-4-4) x 1 month |
PHOTOGRAPH ON VISIT ON 18/3/19.
PASI SCORING ON 18/3/19 – 0.6.
SUMMMARY
This is a case of scalp psoriasis treated with the constitutional method considering the patients mentals, physical generals and characteristic particular symptoms.
The remedy Pulsatilla was indicated and given in 200th potency, repeated as the case demanded. PASI (psoriasis area and severity index) was checked before and after the treatment and showed significant reduction from 3.5 to 0.6. This shows homoeopathy can be very efficacious in the treatment of psoriasis.
