Clinical Cases

Two Psoriasis Cases

Written by Rahul Vardaan

Dr. Rahul Vardaan shares two psoriasis cases, a 21-year-old male patient, and a woman of 17.  The first case was solved using the sensation method.

CASE-1

Presenting complaints –

A 21-year- old male patient complained of eruptions that are dry, scaly, crusty, thick, blackish on arms, legs, feet ankles since 5years. Pain in eyes, double vision; consulted several doctors without any relief.

Appetite – Capricious, likes non-vegetarian food

Stool – normal

Urine –no complaints

Thirst – decreased

Sleep – normal

Perspiration – offensive

Tongue – moist

LIFE INVESTIGATION:

The patient is studying law in third year of college. He is slow and lazy to get up. Family atmosphere was stressed due to strict nature of his father. He has good friends within his batch but his real friendship was with seniors who were 2-3 years semester senior to him. Six months back they all got passed out of the college and he felt alone and as if some bond is breaking between him and seniors. There is no one left with real connections. He lacks that bond of friendship with his classmates. Since then, his psoriasis has aggravated and wants to get rid of it quickly since unable to wear shorts and half-sleeved shirts.

Other complaints: pain in eyes, difficult reading, computing, mobile, consulted ophthalmologist but no response so far.

 CASE ANALYSIS:

  1. DIAGNOSIS : Psoriasis plaque
  2. MIASM: Psoro- sycotic
  3. PASI: 6

Discussion:-

The case is analyzed according to family / sensation method of  Dr. Rajan Sankaran. The Vital Sensation as experienced by the patient is something deeper to the mind and body. The mental state was the deepest that we could reach but I realized the vital sensation is a step deeper than the mental state :  e.g. if you feel jealous or suspicious but the actual experience is of being attacked and is frightened. This emotional situation is good enough but if you describe the experience of attack then you arrive at the intersection of mind and body. Here the feeling may be burning, twisting , stabbing cutting.

Similarly in our case the patient’s friendship within his own batch was missing and he was friends with his senior batches. The connections and bonds are the words used by the patients reflects his inner experience of the situation in his life.

This sensation is well represented under SCROPHULARIACEAE FAMILY sensation.

 The scrophulariaceae family remedies include Euphrasia and our patient too had pain in eyes and double vision. Therefore, the vital sensation and physical complaints clearly added up to EUPHRASIA.

Response after remedy;

Euphrasia 200 (1) dose was given and immediately after taking the remedy the patient felt aggravation of his eye complaint and got better within a day and never experienced again pain in eyes or double vision and gradually the skin symptoms of psoriasis showed improvement.

HEAD UPPER

EXTREMITI

ES

TRUNK LOWER

EXTREMITI

ES

REDNESS 0 1 0 1
THICKNESS 0 2 0 2
SCALE 0 1 0 2
SUM OF

ROWS 1,2 &3

0 4 0 5
AREA SCORE^ 0 2 0 2
SUM OF

ROW 4 x row

5 x area multiplier

0 1.6 0 4
1.6+4

=5.6

                                                                                   PASI

REMEDY GIVEN -(21.08.22)

1.EUPHRASIA 200 (1) dose

  1. Saclac 30/ tds/15 days

Follow-up:

 

DATE FOLLOW-UP PASI REMEDY GIVEN
21.08.22 First prescription 5.6 1.Euphrasia 200(1dose)

2.saclac 30 tds /15 days

05.09.22 Patient felt Immediate pain in eyes after the remedy and never had any pain , double vision. Eruptions better scaly thickness reduced 5 Saclac 30 tds/ 30 days
05.10.22   Eruption thickness reduced. No pain 3.6 Saclac 30 tds/ 30 days
25.11.22  Eruption further better, no pain in eyes 1.1 Saclac 30 tds/ 30 days
13.12.22 Status same 1.1 Saclac 30 tds/ 30 days
06.01.23  Sataus same 1.1 Saclac 30 tds/ 30 days
12.2.23    Status same 1.1 Saclac 30 tds/ 30 days
03.3.23     Status same 1.1 Saclac 30 tds/ 30 days
26.4.23   Eruptions much better 0.5 Saclac 30 tds/ 30 days
12.5.23 Eruptions clear normal skin 0 Saclac 30 tds/ 30 days

 

PASI(05.10.22)

PASI 3.6

HEAD UPPER

EXTREMITIE

S

TRUNK LOWER

EXTREMITIE

S

1 REDNESS 0 1 0 1
2 THICKNESS 0 1 0 1
3 SCALE 0 1 0 1
4 SUM OF ROWS

1,2 &3

0 3 0 3
5 AREA SCORE^ 0 2 0 3
6 SUM OF ROW 4

x row 5 x area multiplier

0 3*2*0.2=1.2 0 3*2*.4=2.4
7 SUM ROW 6

FOR EACH

COLUMN FOR

 

1.2+2.4=3.6

 25.11.22   PASI 1.1              

HEAD UPPER

EXTREMITIE

S

TRUNK LOWER

EXTREMITIE

S

1 REDNESS 0 1 0 1
2 THICKNESS 0 1 0 1
3 SCALE 0 1 0 1
4 SUM OF ROWS

1,2 &3

0 3 0 2
5 AREA SCORE^ 0 1 0 1
6 SUM OF ROW 4 x row 5 x area multiplier 0 3*1*.1=.3 0 2*1*.4=.8
7 SUM ROW 6

FOR EACH

COLUMN FOR SCORE

1.1

 

                                                                   CASE-2

 

 Presenting complaints – A female of 17 years complaining of eruptions that were dry, scaly, thick reddish black scaly, cracked, adherent painful, all over body with hairfall since 3 years. Took treatment from various allopathic hospitals but got not much relief. (pic before treatment)

 

LIFE INVESTIGATION:

 The patient is studying in 12 std. and had earlier taken homoepathic treatment from us and had improved dramatically with Nitric acid 30 but it relapsed quickly after she had an episode of urticaria which was treated with injectables and medicines. The spread is far and wide with erythema, cracks, crusts pain. Due to which she doesn’t like going out and almost confined herself to her room since everybody was asking about her illness which she didn’t like at all. She locks herself in the room and weeps profusely due to this severe aggravation. She was repeatedly asking when it will get well, and why this has happened to her and crying continuously.  In school she confined herself to classroom and covered her lesions.

CASE ANALYSIS

  1. DIAGNOSIS: PSORIASIS ERYTHRODERMIC

2 Miasm :  Syphillis- psora

3.Rubrics selected

(A) Impatience, pain from

(B) Weeping

(C) Delusion Unfortunate feels

(D )Delusion despised is

Repertorisation

 

 Remedy

  1. Hura Brasiliensis 200 (1)dose
  2. Saclac 200/tds/15 days

Confirmed with adherent patches on elbow (Boericke)

Mind confirmed with T.F. Allen Encyclopedia of pure Materia  Medica

 

 

                                                                     PASI 01.09.22

HEAD UPPER

EXTREMITIE

S

TRUNK LOWER

EXTREMITIE

S

1 REDNESS 1 3 2 2
2 THICKNESS 2 2 3 2
3 SCALE 2 3 3 3
4 SUM OF ROWS

1,2 &3

5 8 8 7
5 AREA SCORE^ 3 4 4 2
6 SUM OF ROW

4 x row 5 x area multiplier

1.5 6.4 9.6 5.6
7 SUM ROW 6

FOR EACH

COLUMN FOR

PASI SCORE

23.1

 

Discussion:

After the first remedy patient felt much relief in all her complaints but her questions about when it will be cured remained and I continued her on sa clac as shown in the follow-up  chart below:

Date Follow-up PASI REMEDY GIVEN
01.09.22 First prescription 23.1 Euphrasia 200(1)dose
07.09.22 Eruption better with redness and thickness reduced 22 Saclac 30 / 7 days
14.09.22 Redness thickness better 20 Saclac 30 / 15 days
28.09.22 Eruption better 20 Saclac 30/ 15 days
19.10.22 Eruption better 18.7 Saclac 30 /15 days
02.11.22 Eruption better 15 Saclac 30 / 15 days
16.11.22 Redness thickness better 10 Saclac 30 / 30 days
11.12.22 Much better 2.3 Saclac 30 / 30 days
09.01.23 Improving 2.3 Saclac 30 / 30 days
25.01.23 Much better 1.5 Saclac 30 / 30 days
08.02.23 Patient improving 1.5 Saclac 30 /30 days
11.03.23 Better 1 Saclac 30 / 15 days
09.04.23 Eruption are getting better 1 Saclac 30 /15 days
24.04.23 Eruption almost better 1 Saclac 30 / 15 days
07.05.23 Normal Skin 0    Saclac 30 / 15 days
25.05.23 Patient is satisfied with improvement   Saclac 30 / 15 days

 

19.10.22-PASI

Eruption : Psoriasis >>>

HEAD UPPER

EXTREMI

TIES

TRUNK LOWER

EXTREMI

TIES

REDNESS 1 2 2 2
THICKNESS 2 1 3 2
SCALE 2 2 2 2
SUM OF

ROWS 1,2

&3

5 5 7 6
AREA SCORE^ 3 4 4 2
SUM OF

ROW 4 x row

5 x area multiplier

1.5 4.0 8.4 4.8

                                                  

SUM ROW 6

FOR EACH

COLUMN FOR PASI SCORE

18.7

 

(In between treatment pictures)

HEAD UPPER

EXTREMITI

ES

TRUNK
1 REDNESS 0 1 1
2 THICKNESS 0 1 1
3 SCALE 0 1 1
4 SUM OF

ROWS 1,2 &3

0 3 3
5 AREA

SCORE^

0 1 2
6 SUM OF

ROW 4 x row 5 x area multiplier

0 0.3 1.2
7 SUM ROW 6

FOR EACH

COLUMN

FOR PASI

SCORE

2.3

 11.12.22

PASI-2.3

 (After treatment pictures)

About the author

Rahul Vardaan

Dr. Rahul Vardaan BHMS, is Chief Medical Officer (Homoeopathy) Delhi Government. He is a classical homoeopath and in charge of the homeopathy unit at Dte. Of Ayush Guru Gobind Singh Hospital New Delhi. He has been practicing homeopathy for 20 years.

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