Psoriasis Managed with Classical Homeopathy – A Case Report

Abstract

Psoriasis is a chronic autoimmune disorder that affects millions of people worldwide, causing a range of physical and emotional symptoms. Psoriasis can also have a significant impact on a person’s quality of life, causing social isolation and emotional distress.

This case study demonstrates how a patient with psoriasis was successfully treated using classical homoeopathy, which improved the patient’s overall health and skin clearance. This report also highlights the potential benefits of homeopathy as an alternative treatment option for psoriasis and suggests that further research is needed to fully explore its efficacy.

Homeopathy may offer a personalized and holistic approach to the management of psoriasis, addressing both physical and emotional aspects of the disease.

Keywords:  psoriasis, homeopathy, case report

 Background

Psoriasis is a chronic inflammatory, hyper-proliferative and an autoimmune skin condition characterized by formation of red, scaly patches on the skin. The patches, known as plaques, can be itchy and painful and can develop anywhere on the body, but most commonly occur on the elbows, knees, scalp, and lower back, affecting over 125 million people globally.¹

The etiology is multifaceted and the exact cause of psoriasis is not known. Some common triggers for psoriasis outbreaks include stress, injury to the skin, infections such as chicken pox, certain conventional medications, and changes in the weather.^2,3

Recent research indicates that genes play a significant role in the development of psoriasis^4,5, and that psoriasis has a strong epigenetic component to it, indicating a strong correlation between traumatic life events and disease onset or exacerbation. ^6,7

Besides this, psoriasis shows a clear autoimmune mechanism in its etiology.⁸The pathogenesis of psoriasis involves a complex interplay of genetic, environmental, and immunological factors, leading to the activation of T cells and the production of cytokines that drive the rapid proliferation and build-up of stratum corneum cells causing hyperplasia and plaque formation.²

There are several types of psoriasis, each with its own distinct characteristics and symptoms. Conventionally, there is no cure for psoriasis, but it is managed with a combination of treatments, including topical creams and ointments, phototherapy, and systemic medications.

The use of biologics have revolutionized  the treatment of psoriasis but they can cause massive immune suppression.² Thus,the primary goal of treatment is to reduce the severity of outbreaks, improve the clearance of the skin, and improve the overall quality of life for people with psoriasis.^9,10

Classical homoeopathy has been demonstrated to be effective in the treatment of psoriasis and other advanced pathologies in the past.^6,11,12,13This case report suggests an alternative for treatment of psoriasis with classical homeopathy.

 Case report

A 24-year-old girl developed erythrodermic psoriasis since 2015. The eruptions first appeared over the groin and elbows and spread all over the body. Patient was under allopathic intervention which only alleviated the itching, and she was advised to start cryotherapy. The eruptions progressed to appear on the neck and face (Figure 1). At this juncture patient sought homeopathic help. First consultation took place on 14-09-2020.The symptoms available for prescriptions were:

• MIND-ANIMALS-love for animals (++)
• MIND-CONSOLATION-amel (++)
• MIND-FASTIDIOUS (++++)
• MIND-FEAR-alone, of being (++)
• MIND-FEAR-dark (++)
• MIND-FEAR-high places, of(++)
• MIND-FEAR-thunderstorm of(+)
• MIND-SENSITIVE, oversensitive-reprimands, to (++++)
• SKIN-ERUPTIONS-chickenpox (+)
• SKIN-ERUPTIONS-psoriasis (+)
• GENERALITIES-FOOD AND DRINKS-fat-aversion (++)
• GENERALITIES-FOOD AND DRINKS-smoked food-desire (+++)
• GENERALITIES-SEASHORE, at the –amel (+++)

Figure 1: Photos of psoriasis before treatment (in 2015)

Past medical history:

At the age of 13, she had left ovarian inflammation, which was later discovered to be a cyst and treated with antibiotics. At 18 years, she developed a high fever of 38.8⁰C for 7 days and was treated with antibiotics for the same. In 2015, she contracted chicken pox and took allopathic treatment. Post the treatment, she developed psoriasis.

Family history:

1. Mother – Hypertension.
2. Father- Arrhythmias and Vitiligo.
3. Grandparents – Both maternal and paternal suffered from cardiovascular diseases.
4. Grandfather – Colon cancer.
5. Aunts – Two aunts had breast cancer.

Mental/emotional history:  She seemed to be more mature than her peers. She said she loved her dog the most. She was very tidy and strived for perfection in everything she did. She was very sensitive to criticism. She was most affected by her mother’s criticism, but she didn’t revolt back. She liked to be consoled by her friends. She had fears of high places, dark, thunderstorm, being alone.

Personal history:

1. Desires: smoked meat (+++), dark chocolate (++), fish (++)
2. Aversions: fats (++)
3. Thirst – thirstless (+)
4. Sleep: sleep was good and refreshing. She used to get dreams of diffusing a bomb.
5. Skin: she had dark moles on the body
6. Thermals: chilly (+)

Diagnosis: psoriasis (ICD-10:L40)¹⁴

Case analysis and prescription:

After a thorough investigation, it was obvious that psoriasis started after suppression of chickenpox which appeared with a high fever. The patient was also very sensitive towards mother’s criticism. The study of these symptoms gave rise to a specific totality of symptoms (Figure 2).

 

Figure 2: Reportorial result on 14/09/2020 (Vithoulkas compass)

A dose of Carcinosinum 200CH was prescribed on 14/09/2020.

Prof George Vithoulkas describes the use of Carcinosinum remedy in cases where patients are very sensitive to reprimands and have a pleasing nature. The remedy must be thought of when there is a strong tendency in the family to produce cancers. The follow up of the case is listed in Table 1.

Table 1 – Follow up of the case.

DATE	SYMPTOMS	ANALYSIS	PRESCRIPTION
10/12/2020	Psoriasis is better by 50%. The eruptions have started to recede from face, legs and then the trunk. Patient started to develop herpes on upper lip (old complaint). Emotionally: Patient is no longer bothered when other people criticise her. Mother’s criticism still bothers her sometimes. Anger has improved. She doesn’t get angry easily. Energetically better. Generally better.	Herpes was her old complaint. Reappearance of old symptom is a good sign. Since the origin of complaint is related to the mental and emotional level, case needs a higher potency.	Carcinosinum 1 M –one dose-every month, followed by placebo.
26/03/2021	Psoriasis is completely better (Figure 3). The eruptions have receded completely from all parts of the body. Patient developed COVID infection with high fever of 39 0C. She has taken Aspirin and vitamin supplements for the acute. Patient’s grandmother passed away and it affected her a lot. She often cries and feels bothered by consolation. Post COVID infection, she cannot tolerate the smell of cigarette and spices. Menses is very painful compared to before. The repertorisation of the follow up is listed in figure 4.	Patient developed an infection with high fever after 6 years. There was a situational stress that has affected her and gave rise to a specific totality of symptoms. Case needs a change of remedy although her psoriasis is completely better.	Ignatia amara 1M one dose followed by placebo

Figure 3: Photos of psoriasis after treatment (in 2021)

Figure 4: Reportorial result on 26/03/2021 (Vithoulkas compass)

 Discussion

Psoriasis is an autoimmune condition, and it requires an individualized strategy for its treatment. While conventional medicine focuses on skin clearance, classical homeopathy investigates how an individual’s immune system responds to the hereditary and epigenetic triggers.^5,15,16

Once a correct remedy is chosen, it is also important for the homeopath to interpret the effects of the prescribed remedy. Prof. George Vithoulkas classifies the state of health of an individual into twelve levels in the “theory of levels of health” and provides a framework for the treatment of diseases and evaluation of the effect of the prescribed remedies using classical homeopathy.^15,18

The above-presented case belongs to group A (very healthy), with no significant fevers in the recent past. The patient developed an infection after 6 months of homeopathic intervention. The theory also suggests that the appearance of an acute (especially accompanied by high fever) helps the organism to overcome the chronic disease and is considered a good response to the treatment.^19,20

The acute disease is generally allowed to run its course without treatment unless deemed necessary, given the danger of sepsis in Psoriatic cases.^6,20  The patient also developed an older complaint – herpes during the treatment. The appearance of an old symptom yields an encouraging sign that the remedy was correct and the case may be curable.¹⁸

The Modified Naranjo Criteria for Homeopathy (MONARCH) causality assessment provided a score of 11/13, suggesting a significant causal relationship to the treatment (Table 3).²¹ This case study highlights the importance of addressing the underlying cause of the disease which may not only help to cure psoriasis but also improve the overall health of the individual. This case report provides a foundation for additional research to explore the benefits of classical homeopathy in the treatment of psoriasis.

Table 3: Modified Naranjo Criteria for Homeopathy (MONARCH) – for causality assessment

Criteria	Y	N	Not sure/NA	Score in case
1. Was there an improvement in the main symptom or condition for which the homeopathic medicine was prescribed?	2	-1	0	2
2. Did the clinical improvement occur within a plausible time frame relative to the drug intake?	1	-2	0	1
3. Was there an initial aggravation of symptoms?	1	0	0	0
4. Did the effect encompass more than the main symptom or condition, i.e., were other symptoms ultimately improved or changed?	1	0	0	1
5. Did overall well-being improve?	1	0	0	1
6 (A) Direction of cure: did some symptoms improve in the opposite order of the development of symptoms of the disease?	1	0	0	1
6 (B) Direction of cure: did at least two of the following aspects apply to the order of improvement of symptoms:- from organs of more importance to those of less importance, from deeper to more superficial aspects of the individual, from the top downwards	1	0	0	1
7. Did “old symptoms” (defined as non-seasonal and non-cyclical symptoms that were previously thought to have resolved) reappear temporarily during the course of improvement?	1	0	0	1
8. Are there alternate causes (other than the medicine) that with a high probability could have caused the improvement? (consider known course of disease, other forms of treatment, and other clinically relevant interventions)	-3	1	0	1
9. Was the health improvement confirmed by any objective evidence? (photos before and after treatment)	2	0	0	2
10. Did repeat dosing, if conducted, create similar clinical improvement?	1	0	0	0
Total				11

 Conclusion

While this case demonstrates a positive outcome for treatment of psoriasis caused by psychological stress and suppression of infection through individualized classical homeopathy, extensive research is necessary to establish the therapeutic benefits observed here.

 References

1. Griffiths CEM, van der Walt JM, Ashcroft DM, et al. The global state of psoriasis disease epidemiology: a workshop report. In: British Journal of Dermatology. Vol 177. Blackwell Publishing Ltd; 2017:e4-e7. doi:10.1111/bjd.15610
2. Rendon A, Schäkel K. Psoriasis pathogenesis and treatment. Int J Mol Sci. 2019;20(6). doi:10.3390/ijms20061475
3. Oji V, Luger TA. The skin in psoriasis: assessment and challenges. Clin Exp Rheumatol. 2015;33(5 Suppl 93):14-19. Accessed February 12, 2023. https://pubmed.ncbi.nlm.nih.gov/26472560/
4. Chandra A, Lahiri A, Senapati S, et al. Increased Risk of Psoriasis due to combined effect of HLA-Cw6 and LCE3 risk alleles in Indian population. Sci Rep. 2016;6. doi:10.1038/srep24059
5. Woo YR, Cho DH, Park HJ. Molecular mechanisms and management of a cutaneous inflammatory disorder: Psoriasis. Int J Mol Sci. 2017;18(12). doi:10.3390/ijms18122684
6. Mahesh S, Shah V, Mallappa M, Vithoulkas G. Psoriasis cases of same diagnosis but different phenotypes—Management through individualized homeopathic therapy. Clin Case Reports. 2019;7(8):1499-1507. doi:10.1002/ccr3.2197
7. Martins AM, Ascenso A, Ribeiro HM, Marto J. The Brain-Skin Connection and the Pathogenesis of Psoriasis: A Review with a Focus on the Serotonergic System. Cells. 2020;9(4). doi:10.3390/cells9040796
8. Herster F, Bittner Z, Archer NK, et al. Neutrophil extracellular trap-associated RNA and LL37 enable self-amplifying inflammation in psoriasis. Nat Commun. 2020;11(1). doi:10.1038/s41467-019-13756-4
9. Timis TL, Florian IA, Mitrea DR, Orasan R. Mind‐body interventions as alternative and complementary therapies for psoriasis: A systematic review of the English literature. Med. 2021;57(5). doi:10.3390/medicina57050410
10. Tenzera L, Djindjic B, Mihajlovic-Elez O, Pulparampil BJ, Mahesh S, Vithoulkas G. Improvements in long standing cardiac pathologies by individualized homeopathic remedies: A case series. SAGE Open Med Case Reports. 2018;6:2050313X1879281. doi:10.1177/2050313×18792813
11. Witt CM, Lüdtke R, Willich SN. Homeopathic treatment of patients with psoriasis – A prospective observational study with 2 years follow-up. J Eur Acad Dermatology Venereol. 2009;23(5):538-543. doi:10.1111/j.1468-3083.2009.03116.x
12. Jalodia DK. A Case of Psoriasis Vulgaris Managed With Classical Homeopathy. hpathy.com. Published 2021. https://hpathy.com/clinical-cases/a-case-of-psoriasis-vulgaris-managed-with-classical-homeopathy/
13. Mahesh S, Habchi O, Vithoulkas G. Cervical Intraepithelial Neoplasia Managed With Classical Homeopathy: A Case Report. Authorea Prepr. Published online October 18, 2021. doi:10.22541/AU.163454667.71016864/V1
14. 2021 ICD-10-CM Codes L40*: Psoriasis. Accessed June 20, 2021. https://www.icd10data.com/ICD10CM/Codes/L00-L99/L40-L45/L40-
15. Vithoulkas G and Tiller.w. The Science of Homeopathy. 7th Edition.; 2014.
16. Kent JT. Kent’S Lectures on Homoeopathic Philosophy. B.Jain publishers; 2002. https://www.naturopathicmedicineinstitute.org/wp-content/uploads/2016/09/Lectures-on-Homeopathic-Philosophy.pdf
17. Vithoulkas G, Carlino S. The “continuum” of a unified theory of diseases. Med Sci Monit. 2010;16(2).
18. Vithoulkas G. Levels of Health.; 2017.
19. Mahesh S, Mallappa M, Habchi O, et al. Appearance of Acute Inflammatory State Indicates Improvement in Atopic Dermatitis Cases Under Classical Homeopathic Treatment: A Case Series. Clin Med Insights Case Rep. 2021;14:1179547621994103. doi:10.1177/1179547621994103
20. Mahesh S, Mallappa M, Vacaras V, et al. A Novel Outlook on the Correlation Between Acute and Chronic Inflammatory States, a Retrospective Observational Study. Authorea Prepr. Published online October 14, 2020. doi:10.22541/AU.160269741.18547290/V1
21. Lamba CD, Gupta VK, Van Haselen R, et al. Evaluation of the Modified Naranjo Criteria for Assessing Causal Attribution of Clinical Outcome to Homeopathic Intervention as Presented in Case Reports. Homeopathy. 2020;109(4):191-197. doi:10.1055/s-0040-1701251