Effect of Homoeopathic constitutional medicine in tinea

Dr Yashasvi Shakdipiya, Dr Yogyata Kashyap

ABSTRACT
Tinea is the superficial fungal pathogens and the fourth commonest cause of any human disease worldwide. It is characterised by itching, dry and scaly eruption. Some lesions have a prominent scaling margin with apparent clearing in the centre, leading to annular or ring- shaped lesions hence the term “ringworm.” This article reports a case of patient with symptoms of Tinea Corporis. After careful case taking, single dose of constitutional Homoeopathic medicine Calcarea carb in 200 potency was prescribed as per homoeopathic principal.

KEYWORD – Tinea corporis, Calcarea Carb, Constitutional medicine, Homoeopathic Medicine.

INTRODUCTION
Superficial fungal pathogens are the fourth commonest cause of any human disease worldwide. Historically, superficial fungal infections have caused minimal disease in temperate climates, with the most severe outbreaks occurring in the tropics and subtropics. Superficial dermatophyte infections are named according to the body site affected; tinea capitis(scalp), tinea corporis (body), tinea cruris(groin) and tinea pedis(feet).1

Tinea corporis is spread by the shedding of fungal spores from infected skin. Transmission is facilitated by a warm, moist environment and the sharing of fomites including bedding, towels, and clothing. The typical morphology of tinea is of an annular lesion which spread centrifugally (away from the centre). The active edge shows papulovesiculation and scaling while the centre is clear.

Sometime the centre may be hyperpigmented; nodulation and even lichenification (chronic lesions) may occur. Itch is common.2There are number of homoeopathic medicine in Materia medica which primarily acts on skin, if prescribed on the basis of symptom similarity it not only relieve symptoms but also improve skin health in general. Treating skin disease is significantly difficult without homoeopathic aid. If we have the proper knowledge of Homoeopathy and its Law we can treat any kind of skin diseases. Constitutional medicine prescription is the classical method in homoeopathy based on the patient’s individual characteristics. This case report shows the power of constitutional medicine Calcarea Carb for superficial fungal disease.

CASE REPORT

PATIENT INFORMATION
A 26-year-old female attended outpatient department (OPD) of Dr. Girendra Pal Homoeopathic Hospital and Research Centre with the complaint of eruption on wrist and waist area since three an half month. She had itching on it that was aggravated when undressing and from heat.

HISTORY OF PRESENTING COMPLAINT
Patient was apparently well three an half month back when she started complaining of macular eruption with raised margin, which was round in shape and clear from centre. Initially eruption was first appeared on waist region then gradually spread in whole area and then appeared on left wrist. Patients did not take any kind of treatment before it.

PERSONAL HISTORY: Patient was housewife from middle class family.

GYNAECOLOGICAL & OBSTETRIC HISTORY

  • Menarche- Sets at the age of 16 year.
  • Regular cycles
  • Duration of menses- it last for 2 days only
  • Flow – Scanty
  • Odour – offensive
  • Concomitant- pain in lower abdomen that starts 10 days before menses.

OBSTETRICS HISTORY :G-1, P-1, A-0, L-1. Mode of delivery was through cessarian section because of the absence of labour pain.

PHYSICAL GENERAL
Patient is towards chilly. She feels coldness of lower extremities in winter and is sensitive to cold. She usually drank two and half litre water per day. Appetite satisfactory, like ice cream and averse sweets. Patient used to sweat profusely on whole body and offensive in odour. She usually had 7-8 hours of sound sleep.

MENTAL GENERAL
Patient was cooperative and easily narrated her complaint of whatever she was enquired about. When she get angry she weeps. She does not like to be alone. Patient had reported fear of height, & of going to high place.

EXAMINATION 

  • On observation patient was fair and endomorphic in appearance.
  • Her tongue was clean and dry.
  • Skin: on examination of skin, macular eruption on both sid9es of waist region and on right wrist, circular in appearance with raised margin.

DIAGNOSIS
Diagnosis was based on clinical history and physical examination- a solitary patch or asymmetrical rash and confirmed on mycology to determine the likely source. Examinations also include the entire skin surface, including the scalp and nails, for other sites of involvement.3

MIASMATIC ANALYSIS
Miasmatic evaluation for the presenting symptoms was done with the help of “The Chronic disease by Dr. Samuel Hahnemann” showed the predominance of Psoric miasm.4

 ANALYSIS AND EVOLUTION OF SYMPTOMS

S.NO Symptoms Type Symptoms Intensity
1. Mental General She has Fear of height and afraid to going in high places. +++
2. Mental General Does not want to be alone. ++
3. Mental General Weep when in angry ++
4. Physical General Perspiration profuse on whole body +++
5. Physical General Perspiration was offensive +
6. Physical General Coldness of lower extremities +++
7. Physical General She had Desire for ice cream ++
8. Physical General Dislike sweets +
9. Physical General Her Menses was scanty +++
10. Physical General Pain in lower abdomen before appearing menses ++
11 Physical General Menses slightly offensive sometime +
12. Particular Macular Eruption on whole body which was round in shape with raised margin and clear from the centre. ++
13. Particular Itching in eruption was present +
14. Particular Itching aggravated when undressing +
15. Particular Burning in eruption after scratching +

TOTALITY OF SYMPTOMS

  1. Fear of height
  2. Desire for company
  3. Weep when in angry
  4. Profuse perspiration on whole body
  5. Coldness of lower extremities
  6. Desire for ice cream
  7. Menses was scanty
  8. Pain in abdomen before menses(10-12days before)
  9. Eruption on whole body
  10. Patient was sensitive to cold.

REPERTORISATION
After case taking and analysis, the characteristic symptoms were taken and converted into rubrics for repertorisation as follow:-

  • Mind- Fear- High places
  • Mind- Company- Desire for
  • Mind- Weeping, tearful mood, etc ,-Anger  after
  • Perspiration- profuse
  • Extremeties- Coldness- Lower limbs
  • Stomach-Desires- Ice Cream
  • Genitalia female- Menses- Scanty
  • Abdomen- pain- Aching, dull pain, Menses before
  • Skin- Eruptions- Herpetic-Circinate
  • Generalities- Heat- Vital, lack of

Repertorisation was done following kent repertory5 in Hompath software6. On the basis of 10 symptoms following medicine appear as given in the repertorisation chart (figure-1). In the repertorisation chart Phosphorus appear as the topmost medicine but Calcarea Carb was prescribed considering totality of patient and referring to various books of Materia  medica.7,8

JUSTIFICATION OF REMEDY
After taking a detailed case taking, repertorisation Calcarea Carb 200/1dose/stat was chosen9 followed by placebo for 14 days in first visit. Calcarea Carb given constitutionally and on the basis of her general symptoms; like Profuse perspiration on whole body, Coldness of lower extremities, scanty menses with prominent mental symptoms fear of height, desire for company.  After comparison of symptoms from various book of materia medica, Calcarea Carb has been selected.

INTERVENTION
CALCAREA CARBONICA 200 single dose was prescribed along with placebo 30 for 14 days based on the totality of symptoms.

FOLLOW UP

DATE

 

SYMPTOMS MEDICINE JUSTIFICATION
3-12-2020
  • Macular eruption on whole body especially in waist area b /l and on the left wrist.
  • Itching present on these eruptions.
  1. Calcarea carbonica/200/1 dose/ stat
  2. Placebo/30/tds/14days
After considering the totality of symptoms medicine was prescribed constitutionally.
19-12-2020
  • Eruption on waist region was better from before.
  • Eruption on left wrist was slightly better.
  • Itching on and off
  1. Placebo/30/tds/14days
General condition was stable, no new complaint.
01-01-2021
  • Eruption on waist area was not present.
  • Eruption on wrist was better.
  • Itching on wrist region was slightly present.
  • No new complaint was recorded.
  1. Placebo/30/tds/14days
Patient was better.
21-01-2021
  • Eruption on waist area has been cured.
  • Eruption on wrist region small in size still present.
  • Slight Itching was present in eruption.
  •   No other new complaint or eruption was recorded.
  1. Calcarea Carbonica/200/1 dose/stat
  2. Placebo/30/tds/14 days
Slight itching was present there. Condition was stand still.
4-01-2021
  • Eruption on waist area has been completely cured.
  • Eruption on wrist area better from before.

 

  1. Placebo/30/tds/14days
Itching was not present.

No other new complaint was recorded.

General condition of patient was stable.

 

DISCUSSION
After analysis of a case the constitution of patient was fair and fatty, coldness of extremities, profuse perspiration, and scanty menses, pain in lower abdomen before appearing of menses. Patient was sensitive to cold, Calcarea Carb cover all these symptoms, mentally she had fear of height, does not want to be like in alone. Phosphorus patient is also sensitive from cold but the constitution of phosphorus is emaciated, slender, grown up, delicate waxy, anaemic person. After considering the totality of symptoms of patients and various books of materia medica7,8 , Calcarea Carb 200 single dose stat9 was given followed by placebo for 14 days.  In this case Photographic evidence suggests curative action of Calcarea Carb.

CONCLUSION
From the above case, it is evidenced that the constitutional medicine selected with the help of totality of symptoms and matches with the patient’s picture, will surely give the result.

DECLARATION OF PATIENT CONSENT
The author certifies that they have obtained written consent, duly signed by the patient and she has given consent  for the photographs  and other clinical information  to e reported in the journal.

REFERENCES

  1. Wiley j. ABC of Dermatology. 6th. UK. BMJ publishing group ltd; 2014.
  2. Dermnetnz.org. 2021. Tinea corporis | DermNet NZ. [online] Available at https://dermnetnz.org/topics/tinea-corporis/ [Accessed 4 June 2021].
  3. Khanna N. Dermatology and Sexually Transmitted Disease.1st New Delhi: Modern Publisher; 2002.Hahnemann S. The chronic diseases their peculiar nature and their homoeopathic cure. Low Price Edition. New Delhi: Jain Pulishers Pvt. Ltd.; 2002
  4. Kent JT. Repertory of the Homoeopathic Materia Medica. 27 impressions. New Delhi: B. Jain Publishers (P) Ltd; 2013.
  5. HOMPATH [computer program]. Hompath Wildfire Ultimate Lan Version. Mumbai: 2016
  6. Kent JT. Lecture on Homoeopathic Materia Medica. Reprint edition. New Delhi: B. Jain Publishers (P) Ltd;1988
  7. Boericke W. New manual of Homoeopathic Materia Medica and repertory. 9th New Delhi: B. Jain Publishers (P) Ltd; 2011.
  8. Mandal PP, Mandal BA. Textbook of Homoeopathic Pharmacy.2nd ed. Kolkata: New Central Book Agency(P)Ltd 20
  1.  Dr. Yashasvi Shakdipiya, Associate Professor Department of Repertory, Dr. M.P.K. Homoeopathic Medical College, a constituent college of Homoeopathy University, Jaipur Email- yashasvi119@gmail.com
  1. Dr.Yogyata Kashyap, MD Scholar, Department of Repertory, Dr. M.P.K Homoeopathic Medical College, a constituent college of Homoeopathy University, Jaipur Email- Yogyata.kashyap@gmail.com

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