Dr Alsaba R
Psoriasis is a common chronic, inflammatory skin condition, typically characterized by raised, well-defined, erythematous skin lesions of varying size that are surmounted by silvery-white scales. It occurs due to the interaction of both genetic and environmental factors. The prevalence of psoriasis has been increasing in recent years. Plaque psoriasis is a variant of psoriasis which affects skin of face, ears, scalp, trunk and extremities and this type of psoriasis is very common among Indian children. A male child, aged 17years presented with the complaint of scaling of skin of hands and feet, since 3years, increased since 2-3 months. Homoeopathic medicine Arsenicum sulfuratum flavum was selected and administered on the basis of individualised case analysis. It shows the positive effect in the treatment of Plaque psoriasis.
KEYWORDS: Homoeopathy, Plaque psoriasis, Arsenicum sulfuratum flavum
Plaque Psoriasis in children may present in the typical adult form of the classic plaque type of psoriasis. However, lesions are smaller, scales are often finer in children. Areas of distribution are like in the adult form with a predilection to the extensor surfaces, knees, buttocks, elbows, and scalp. The frequency of plaque psoriasis in children varies from 34%‑ 84%. In dark skinned children, the scale may be so subtle that the condition presents as hypopigmentation, and the scale becomes obvious when the lesions are scratched.2
The important diagnostic points for psoriasis includes- Auspitz sign pinpoint bleeding spots following removal of yellowish white scale, pitting of the nail plate, Koebner or Isomorphic response, i.e., appearance of fresh lesions at the site of trauma.3
Homoeopathy is a system of medicine which treats the patient as a whole not a disease. It focuses on the individual as well as the pathological condition.
A male, aged 17 years, brought to the outpatient department of Government
Homoeopathic medical hospital, Bengaluru , by mother on 09/04/2020 , with the complaint of skin eruptions over arm, forearm and leg , since 3years, increased since 2-3 months.
HISTORY OF PRESENTING COMPLAINTS
Informant – Mother
Gradually patient developed skin eruptions since 3years. Probable exciting cause was not known. First it started on ,,,,Course – left arm » Left forearm » left leg .
Itching +++ and burning sensation with soreness , wants to scratch all the time which gives no relief
Skin eruptions – started as red patches on the arm followed by white scales
< cold, washing, sweating >hot application ,after sleep
Negative history – No history of contact with irritants, no history of allergic complaints like urticaria, Asthma, no history of dehydration, no history of any infectious disease, no history of other repeated respiratory complaints, no fever, no climatic variations, no joint pain, no dandruff
|Location (with duration,
extension, radiation etc)
|Aliments from /
|Skin eruptions over arm, forearm and leg since 3years
Mainly on extensor surface
Course: left arm » Left forearm » left leg
|Itching, burning sensation with soreness||< cold, washing, sweating
TREATMENT HISTORY– Previously on Allopathic treatment for presenting complaints ( for 10 months ), at present since 1 month not taking any medications.
PAST HISTORY– No other major illnesses in the past
FAMILY HISTORY– Father- HTN, Mother- DM, MGF- healthy, MGF -DM, PGF- DM , PGM- Psoriasis.
PHYSICAL GENERALS-Appetite was adequate, thirstless, has desire for sweets, thermally he is very chilly, bowel movements were regular. micturition was 6-7 / 0-1 D/N, sleeps on abdomen, generalized perspiration.
LIFE SPACE INVESTIGATION- The boy is from a middle class family. Born and brought up in Bengaluru. He stays with his parents and with elder brother. At home he is very irritable, angered easily, feels anxious, does not want to be alone. He is good in studies mingles with all.He always quarrels with his brother over small things also,behaves good only when he has some need from others
REPERTORIAL ANALYSIS- The following symptoms were taken for the repertorizatin irritability, cunning, anger over trifles, aggravation bathing, eruptions-itching, burning.
Repertorization was done by Complete repertory software. Repertorization chart is presented in the figure
BASIS OF PRESCRIPTION – Repertorial result shows that the Sulphur 27/8 was covering 8 symptoms with marks 27 i.e., 27/8, Ars alb 25/7, Hepar 22/8, Sepia 21/8, Rhus tox 23/7 . By considering patient’s constitution, mentals and thermals Arsenicum sulfuratum flavum was selected as individualized remedy.
RESULT AND DISCUSSION
After the first prescription, there was improvement in the first month of treatment itself. As shown in Figure-3 (Pictures taken on 07/05/21) burning and itching sensation reduced, there was slight increase in the lesion of the feet. In the beginning of 2nd month patient was 50% better scaling, itching, burning was reduced with reduction in the size of the lesions as shown in the figure- 4 (Pictures taken on 25/06/21). In the 6th month visit psoriatic eruptions over the leg and forearm were completely healed with slight discolouration left figure-5 (Pictures taken on 03/09/21). Last follow up there was no discolouration for scaling completely healed eruptions with no recurrence also with normal skin layer as shown in figure- 6 (Pictures taken on 04/02/22). The patient was followed up after nearly one year there was no history of any recurrence of the complaints after the treatment.
Plaque psoriasis can be successfully treated with Homoeopathic medicines based on detailed individual case analysis. Homoeopathic treatment has shown the ability to treat psoriasis internally and remove the predisposition state to the psoriasis.
- Gupta Piyush, Menon PSN, Ramji Siddarth, Lodha Rakesh. PG Textbook of Pediatrics, 2nd/e.Jaypee Brothers Medical Publishers (P) Ltd. New Delhi; 2018; Vol(3)p3109-3110.
- Hiremagalore R, Lokre S. Childhood psoriasis – Clinical manifestations. Indian Journal of Paediatric Dermatology [Internet]. 2012 [cited 15 February 2022];13(1):3. Available from: https://www.ijpd.in/article.asp?issn=2319-7250;year=2012;volume=13;issue=1;spage=3;epage=8;aulast=Lokre
- Gupte Suraj.The short textbook of Pediatrics ,12/e.Jaypee Brothers Medical publishers (p) Ltd.New Delhi 110 002 India. 2016; p721
Dr Alsaba R
MD Part I
Department Of Paediatrics, Government Homoeopathic Medical College And Hospital Bengaluru-560079