Dr Archie Shrivastav
Nummular eczema, also known as discoid eczema and nummular dermatitis, features scattered circular, often itchy and sometimes oozing patches. The word “nummular” comes from the Latin word for “coin,” as the spots can look coin-shaped on the skin.
Nummular eczema can occur at any age, and males tend to develop it more often than females. Its causes aren’t clear, but triggers can include very dry or sensitive skin and trauma to the skin from insect bites, scrapes or chemical burns.
- Bacterial infection (for example, Staphylococcus).
- Exposure to rough fabrics (for example, wool).
- Extremely dry skin or dry environments.
- Frequent bathing or showering with hot water.
- Skin trauma or injury, like a burn, scrape or bug bite.
- Use of irritating and drying soaps.
- Name: Mrs. X
- Age: 30 years
- Sex: Female
PRESENTING COMPLAINT:
October 2023: A 32 year complained of red painful eruptions on her right leg accompanied with severe itching since 3 years.
Incontinence of urine while sneezing every single time.
Severe constipation with no desire to pass stool.
HISTORY OF PRESENTING ILLNESS:
She developed this complain at the age of 23 when she was in college and she suffered from jaundice took allopathic medications and recovered. After that these small eruptions appeared on her right leg, and still there with severe dry itching. She has taken many steroids for the same and developed incontinence of urine after that.
TREATMENT HISTORY: No specific treatment started.
PAST HISTORY: Hepatic complaint- jaundice; Urinary complaint, Gastric complaint
FAMILY HISTORY: No significant family history present.
PERSONAL HISTORY: Vegetarian.
PHYSICAL GENERALS:
- Thermal reaction: Chilly patient
- Appetite: Adequate; 2 times a day
- Thirst: Adequate; 5-7L/day
- Desire: Sweets
- Aversion: Coffee
- Stool: Irregular bowel movements, unsatisfactory
- Urine: Irregular, incontinence while sneezing
- Perspiration: Nothing significant.
- Sleep: sound sleep
MENTAL GENERALS:
Depressive in nature, wants to rule over everyone, domination is the key. Her husband told she wants to dominate over everyone but she is only scared of her father. She said I don’t like to be alone. She doesn’t like changes in her life like despite she got many great opportunities, still she chooses to be in the same company for more than 7 years.
GENERAL PHYSICAL EXAMNATION:
- Build: Obese
- Pulse: 80 beats
- Temperature: Afebrile
- Skin – cracks in fingers, dry skin
DIAGNOSIS: Nummular Eczema
Medicine and potency selected: Lycopodium 30
Why Lycopodium – because the patient majorly involved the disease in liver, then gastric and urinary.
If you look in Boericke’s Repertory, under skin, eczema accompanied with gastric, hepatic or urinary troubles – LYCOPODIUM is the single remedy.
BASIS OF PRESCRIPTION: In this case the prescription was done on basis of Constitutional method. The following symptoms of the case were taken into consideration:
- Afraid to be alone
- Anxious about health
- Doesn’t like changes
- Rigid in thoughts
- Obese build
- Desires Sweets
- Aversion coffee
- Cracks in fingers
- Constipation
- Chilly thermal
TREATMENT:
| Follow up | Remarks | Medicine prescribed |
| 1st visit | Lycopodium 30/TDS/10 days | |
| 2nd visit | No symptoms | Lycopodium 30/TDS/10 days |
| 3rd visit | No symptoms. | Lycopodium 30/TDS/10 days |
| 4th visit | No symptoms | Lycopodium clavatum 30/ 2 doses
Sac lac 30/TDS/15 days |
| 5th visit | All symptoms were relieved except belching and constipation, after new case taking. | Calcarea carb.200/3 doses every
Sunday of month |
| 6th visit | All symptoms are relieved | Calcarea carb. 30/2doses
Sac lac 30/TDS/15 days |
| 7th visit | No symptoms | Sac Lac 30/BD/10 days |
Conclusion: In this case the correct medicine was selected based on the pathology of the case. The lower potency (30C) in repeated doses was selected in this case in 1st prescription, considering the gravity of the case.
The medicine was changed because we need to look at the constitution also and potency was raised to 200C, when patient was completely relieved except her constipation. Here comes the use of Cognate in the cases.
REFERENCES:
- Allen H.C. Keynotes and Characteristics with comparison of some of leading remedies of the Material Medica with Bowel Nosodes. 8thedition (15thimpression). New Delhi. B Jain Publishers (P) Ltd. 2016
- Boericke W. Pocket manual of Homoeopathic Materia Medica with Indian Medicine and Repertory. 9thNew Delhi. Indian Book and Periodical publishers, 2002
Dr Archie Shrivastav
drarchieshrivastav@gmail.com
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