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Clinical Cases

Palmo-Plantar Psoriasis in a Man of 42

Dr. Darshan Shah shares a case of palmo-plantar psoriasis in a man of 42. Graphites failed but a second remedy turned out to be the simillimum.

 

Mr. GR, a 42- year- old male presented with complaints of desquamation and itching over bilateral palms and soles. All complaints had started around 4-5 months ago. He doesn’t know what could be the cause of the complaint. He visited a few dermatologists who suggested some creams and oral medicines. The last dermatologist suggested steroid ointment; which also gave very partial relief.

On Observation – Photo 1 : Date 15 March 2023   Over feet -skin has cracks and severe desquamation. Raw surface beneath the lesion. Thickening of the skin

Over palms -Multiple spots of psoriasis over palms. Hardening of the skin underneath the lesions.

Symptoms

Itching < heat < night

Itching leading to bleeding

itching causes sticky discharge from the lesion

Cracks bleed when itched too much

RX = GRAPHITES 30 – one dose per week for 2 weeks

Placebo for 2 weeks.

FOLLOW UP – 29 MARCH 2023

Over feet -almost the same. Yellow colour over feet. On inquiry, patient said he applied turmeric / haldi as a natural home remedy for psoriasis.  I advised not to apply anything over the lesion

Over Palms – Lesions have become worse. The itching has aggravated. The skin has started to crack and bleed on slightest touch. The sticky discharge has become pustular with yellow pus. Hardening of skin

Rx = PETROLEUM 30 – one dose

Placebo for 1 week

FOLLOW UP ON 5 APRIL 2023

Over feet – Itching has reduced.  The lesion has slightly improved

Cracks have started to heal slowly. Bleeding through cracks has reduced but  persist if something brushes over it.

Patient still continues to apply turmeric. Now he has started wearing socks as he is scared that nothing should brush or touch the lesion which might aggravate the itching or cracks.

Over palms – Almost same lesion, pustular discharge is reduced. Itching is better. Lesions are almost the same.

Rx = PETROLEUM 30 – one dose

Placebo for 1 week

FOLLOW UP ON 12 APRIL 2023

Over feet – Itching has reduced significantly.  The desquamation has started to improve. The rawness below lesion is reduced. Pink-colored skin is now visible. Size of the lesion has started to improve. Cracks have started to fill up.  No episode of bleeding from cracks.

Over palms -Itching significantly better – Cracks are less, ize of lesion is almost the same. Pustular discharge is negligible.

 Rx = PETROLEUM 30 – one dose

Placebo for 1 week

FOLLOW UP ON 18 APRIL 2023

Over feet – Photo of feet is unavailable as patient could not visit the clinic. Follow up was done over the phone. But patient has sent picture of his hands.

Over palms -Itching much better, cracks almost gone, thick and hardening of skin is reduced. Size of the lesion has started to improve. Pustular discharge absent.

Rx = PETROLEUM 200 – one dose

Placebo for 4 week

FOLLOW UP ON 18 May 2023

Over feet – Cracks almost negligible. No itching. Thickening and hardening of the skin improving  Normal skin is now visible.

Over palms -Itching almost absent. Post inflammatory hyperpigmentation. Thick and hardening of skin completely resolved.  Lesions are better

Rx = PETROLEUM 200 – one dose per week

Placebo for 2 weeks

FOLLOW UP ON 31 May 2023

Over feet – Itching completely resolved. Thickening and hardening of the skin better, but slightly persists. Normal skin is visible below the lesions. Cracks are better, no bleeding.

Over palms -Itching – zero – Post inflammatory hyperpigmentation has started to improve. Normal skin colour has started to appear

Rx = Placebo for 2 week, No dose given.

FOLLOW UP ON 14 June 2023

Over feet –

Itching occasionally.

Cracks are same. But no bleeding.

Thickening and hardening of skin persists.

Over palms – Itching has returned, lesions have aggravated.  No pustular discharge.

Rx = PETROLEUM 1M – one dose

Placebo for 2 week

FOLLOW UP ON 29 June 2023

Feels better – itching has reduced

Photo unavailable as follow up was done over the phone.

Rx = Placebo for 4 weeks, no doses given.

FOLLOW UP ON 9 August 2023

Over feet –

Complete healing of the cracks

No bleeding, no scratching, no itching

All desquamation has resolved

Feels great, normal skin visible.

Over Palms – Complete resolution of the lesion, no itching, no cracks, no bleeding, no thickening or hardening of skin, no discoloration.

Rx = Placebo for 4 weeks, no doses given.

FOLLOW UP ON 11 September 2023

Complete resolution of the itching, cracks, bleeding, hardening and thickening of the skin. Small spot of psoriatic patch visible over the right palm, which shall be taken care by the vital force itself. It doesn’t need any more repetition of the medicines.

(P.S – The brown black spot inside the red circle is almost some mud which the patient had on his feet, it is not any wart, corn, etc. It went away immediately after washing with water)

Rx = NO MEDICINES GIVEN. STOP MEDICINES.

FOLLOW UP – SOS

Learning from the case:

Sometimes to wait and watch in cases which are improving is best, but when the skin lesion gets aggravated, similar remedy with a higher potency in minimal dose helps.

About the author

Darshan Jayesh Shah

Dr. Darshan Jayesh Shah is a consulting homoeopath, BHMS, MD (Hom) and is fascinated with and has a special interest in the in-depth study of Organon of Medicine and aphorisms and its application in practice. He states that he is very patient and unprejudiced with every case, and thus able to understand the sufferings of the patient and help them get better. Along with his wife, he has turned vegan and has seen exceptional benefits in their mental and physical health! You can contact him on his website www.friendsofhealth.in

2 Comments

  • A good case showing how the old indications are usually sufficient to diagnose the remedy; the old rules for repetition or changes as to remedy and potency are also valid. As you say, patience is essential for the homeopath and the patient.

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