Molluscum Contagiosum in a Child of 2.5 Years

Abstract
Molluscum contagiosum is a discrete, pearly, skin colored, smooth, dome-shaped papule varying in size from 1-5 mm. They may be found in clusters on the genitals or in the groin of adolescents and may be associated with other venereal diseases in sexually active individuals.

Homoeopathy has a curative role in the treatment of molluscum contagiosum. A 2.5-year-old girl was presented with eruptions on her face. A complete case history was taken and after repertorization, on the basis of totality and individualization, Causticum was given. The aim of the article is to show the effectiveness of homoeopathy in a case of molluscum contagiosum.

Key Words: Pox virus, Molluscum Contagiosum, Causticum

Introduction
Molluscum contagiosum is caused by a DNA poxvirus skin infection. It is most common in children over the age of 1 year, particularly those with atopic dermatitis. It also occurs frequently in immunocompromised patients, including those with HIV. Spontaneous resolution occurs but can take months. Prior to resolution, they often become inflamed and may leave small, atrophic scars ^[1]. Transmission is by close contact but infectivity is low. They may appear on the face, arms, legs, buttocks, scalp or genitalia but sparing of the palms of the hands and the soles of the feet is a characteristic feature ^[2].

Histology
The epidermis is hyperplastic and hypertrophied, extending into the underlying dermis and projecting above the skin surface. The central plug of material, which is composed of virus-laden cells, may be shelled out from a lesion and examined under the microscope. The rounded cup-shaped mass of homogeneous cells, often with identifiable lobules, is diagnostic ^[3].

Case Record
Baby XYZ, 2.5 years old, was brought to us on 24 July 2018 for molluscum contagiosum on her cheeks for the last 3 months.

Present History
The patient was brought to us by her mother.  She had small eruptions on her cheeks. On close observation, there was central dimpling on the eruptions.

Past History
She had these eruptions for the past 3 months. She took allopathic treatment both orally as well as externally but got no relief.

Family History

• Father : 29 years old, healthy, a teacher
• Mother : 26 years old, healthy, housewife

Constitution
The child was moderately built with average height and weight, wheatish complexion.

Patient as a whole
Desires: meat
Aversions: sweets
Appetite: decreased
Thirst: normal
Stool: constipation
Sweating: normal, no smell
T/R: Chilly

MIND: cannot sleep alone, always wants mother by her side, nail biting, desires company, sympathetic. We determined the child was sympathetic because her mother said that whenever her younger brother cries, she also cries and asks the mother to console him. Also, she said that if ever her brother is being scolded, she starts crying and says “don’t scold him”.

Analysis of case
Mental Generals: Sympathetic, desires company, nail biting.
Physical Generals: Chilly patient, desires meat, sweets aversion, decreased appetite.
Particulars: Constipation, eruptions on cheeks.

Evaluation of symptoms
Sympathetic
Desires company
Nail biting
Desires meat
Sweets aversion
Decreased appetite
Eruptions on cheeks
Constipation
Synthesis repertory was selected due to presence of mental symptoms and marked particulars.

Repertorial totality with Repertorization

Fig 1: Repertory Sheet

Reportorial Analysis
Lycopodium was ruled out based on the thermals of the patient. The patient is chilly whereas lycopodium patient is hot. Also, the patient has aversion to sweets whereas lycopodium patient has desire for sweets.

Causticum was selected as the simillimum because it was found homoeopathically the most specific remedy for this particular case and covered maximum symptoms. It was given in 200 CH potency as STAT dose on tongue along with Phytum 30 for 15 days.

Table 1: Follow-up sheet

Before Treatment                                  After Treatment

References:

1. Ralston H Stuart, Penman D Ian, Strachan WJ Mark, Hobson P Richard. Davidson’s principles and practice of medicine. 23rd ed. Elsevier; 2018. p. 1239.
2. Mclntosh Neil, Helms Peter, Smyth Rosalind, Logan Stuart. Forfar and Arneil’s Textbook of pediatrics. 7th ed. Elsevier; 2008. p. 1301-02.
3. Kliegman M Robert, Stanton F Bonita, St Geme III W Joseph, Schor F Nina. Nelson textbook of pediatrics. First South Asia edition. Elsevier; 2015. vol 3 p. 3222.