Safe and effective treatment of leucoderma with homoeopathy

Dr Chrisel Dsa

ABSTRACT:
Leucoderma, commonly referred to as vitiligo, is a chronic skin condition characterized by the progressive loss of pigmentation, resulting in white patches on the skin. It occurs due to the destruction or malfunction of melanocytes, the cells responsible for producing melanin. In contrast, Homoeopathy provides a holistic and individualized approach, aiming to stimulate the body’s self-healing mechanism. Homoeopathic remedies are selected based on the totality of symptoms, including physical, emotional, and constitutional aspects of the patient. Remedies such as Arsenicum album, Sulphur, and Natrum muriaticum are frequently used depending on the case presentation. This article benefits Homoeopathy in managing leucoderma, particularly in early or stable cases.

KEYWORDS: Homoeopathy, leucoderma, pigmentation, autoimmune

INTRODUCTION
Vitiligo is a chronic skin depigmentation disorder. It occurs when melanocytes cease the production of melanin, leading to the development of pale, asymptomatic patches on the skin. These depigmented areas can appear anywhere on the body, including sensitive areas such as the mucous membranes of the lips and genital region.^[1]

Vitiligo affects approximately 0.5% to 1% of the global population, with prevalence rates in India reaching as high as 8.8%. Vitiligo patches can develop on any part of the skin, but they are most commonly found around the orifices, genitals, and other sun-exposed areas such as the face and hands. Although the hair and, less frequently, the eyes can also be affected, the skin is the primary site of involvement.

Around 50% of vitiligo cases manifest before the age of 20. The visible disfigurement caused by the condition can lead to psychiatric distress, with 16% to 35% of individuals experiencing mental health issues such as depression, sleep disturbances, suicidal thoughts or attempts, relationship difficulties, and avoidance of social situations.

The incidence of vitiligo in individuals with a family history of the condition varies globally. In India, it is reported to range between 6.25% and 18%, with some studies suggesting it may be as high as 40%.^[2]

ETIOLOGY

Genetic predisposition
Inherited disease transmitted as an autosomal dominant characteristic with variable expressivity. About 35% of the patients with a family history of vitiligo develop this disorder.

Nutritional
Defect in copper, proteins, and vitamins in diet, digestive upset like amebiasis, Helminthes, chronic diarrhea, dysentery.

Endocrines
Associated with thyrotoxicosis, diabetes, hypothyroidism, and acromegaly.

Trophoneurosis
Emotional stress and strain.

Infections and toxic products
Enteric fever, ill health, and focal sepsis.

Drugs and chemicals
Quinine’s broad-spectrum antibiotics, amyl phenol.

Other probable factors
Food adulterants, industrial chemicals, and dyes, contamination of water and food. ^[3]

PATHOLOGY
A defect in the enzyme tyrosinase is held responsible for vitiligo. Melatonin, a substance secreted in nerve endings, inhibits tyrosinase, thus interfering with pigment formation. There is a marked absence of melanocytes and melanin in the epidermis. Histopathological studies show a lack of DOPA-positive melanocytes in the basal layer of the epidermis.

Clinical Features

• Vitiligo is marked by patchy discoloration, presenting as typical chalky-white or milky macules.
• These macules are usually round or oval with scalloped edges.
• Their size can range from a few millimeters to several centimeters, affecting both the skin and mucous membranes.
• In most cases, the lesions are asymptomatic, although some patients may experience itching.
• Vitiligo is a slowly progressing condition with periods of remission and flare-ups, often triggered by certain events.
• Although vitiligo can develop anywhere on the skin or mucous membranes, it tends to favor areas of natural hyperpigmentation, such as the face, groin, armpits, areolas, and genital areas. Lesions may also appear on areas like the ankles, elbows, and knees, where repeated trauma or friction can trigger the Koebner phenomenon.
• The lesions are often symmetrically distributed, with a dermatomal pattern or involvement of the mucous membranes.
• Hair within the patch of vitiligo is often depigmented.^[4]
• A variant of vitiligo, known as Lip-tip syndrome, is characterized by depigmentation of the terminal phalanges and the lips ^[5]

CLASSIFICATION OF VITILIGO

1. Focal vitiligo: A solitary macule or a few scattered macules in a localized area, typically found in the distribution of the trigeminal nerve, though the neck and trunk are also frequently affected. This type is more commonly observed in children.
2. Segmental vitiligo: It presents as unilateral macules following a dermatomal or quasi-dermatomal pattern. This type typically manifests at an early age and, unlike other forms, is not associated with thyroid or autoimmune diseases.
3. Acrofacial vitiligo presents as depigmentation of the distal fingers and periorificial areas.
4. Generalized vitiligo is also called vitiligo vulgaris. Depigmented patches are symmetrically distributed.
5. Universal vitiligo presents as depigmented macules and patches, and can be associated with multiple endocrinopathy syndromes.

CLINICAL CRITERIA FOR CLASSIFICATION OF VITILIGO

Active (V)

• New lesions are forming
• The size of the lesion is expanding
• Border poorly defined

 Quiescent/stable (V2)

• No new lesions appearing
• lesion stationary in size

Improving

• Lesion shrinking
• No new lesions appearing.
• Border well defined, spontaneous repigmentation.

Segmental

• Unilateral distribution of the lesion
• Preferably along the course of the nerve
• With a border that is clearly defined
• Showing symptoms of spontaneous repigmentation.^[6]

DIAGNOSIS
A unique device known as a Wood’s lamp may be applied to those with fair skin. To illuminate areas of damaged skin that would be difficult to notice with the naked eye, this lamp emits ultraviolet light into a pitch-black space.

HOMOEOPATHIC APPROACH
In homeopathy, the focus is on treating the patient as an individual, rather than merely addressing the disease. We consider both physical and mental symptoms of the patient and then decide on the treatment plan.

Miasmatically, vitiligo of primary origin is basically Tubercular miasm, whereas post-primary vitiligo is due to destruction of melanocytes secondary to eczema or dermatitis or burns or chemical injury, indicating syphilitic miasm.

Homeopathic remedies work at the cellular level, particularly influencing immune cells to prevent further harm and, where possible, to reverse existing damage. This approach is in line with homeopathic principles of restoring balance and vitality.

The absence of symptoms in primary vitiligo often makes it resemble a one-sided condition, as Dr. Samuel Hahnemann described in aphorisms 172–184 of the Organon of Medicine. These aphorisms discuss the nature of diseases, including their symptoms, and guide the homeopathic practitioner in choosing the most appropriate remedy for a patient based on their individual state and the root causes of their illness.^[7]

RUBRICS OF VITILIGO – KENT’S REPERTORY

DISCOLORATION
pale : Acet-ac., anan., apis., ars., bar-c., Bell., benz-ac., calc-s., Calc., carb-ac., carb-an., carb-v., caust., chin-a., chin., Cocc., con., cupr., dig., ferr-ar., ferr-p., Ferr., fl-ac., graph., hell., helon., ign., kali-ar., kali-c., kreos., Lyc., mang., merc-c., merc., nat-m., nat-s., Nit-ac., nux-v., olnd.,op.,ph-ac., phos., Plat., plb., podo., Puls.,sabin., sang., Sec., sep., sil.,  spig., staph., sul-ac., Sulph., sumb., tab., valer., Verat., zinc.

red : Acon., Agar., agn., am-c., ant-c., Apis., arn., Bell., bov., bry., calc., camph., canth., carb-v., chin., coc-c., cocc., coll., com., con., cop., crot-c., crot-h., crot-t., cur., cycl., dulc., eupho., ferr-p., Graph., hyos.,ign.,kreos.,lach.,led., lyc., manc., Merc., nat-m., nit-ac., nux-v., olnd., op., petr., ph-ac., phos., phyt., plb., puls., Rhus-t., ruta., sabad., sec., sep., sil., spong., squil., stann., Stram., sul-ac., sulph., tarax., tell., teucr., til., zinc.

spots : Acon., aeth., agn., alum., Am-c., am-m., ambr., ant-c., ant-t., apis., arn., ars-i., Ars., aur., bar-c., Bell., benz-ac., berb., brom., bry., calad., Calc., canth., caps., carb-an., carb-v., caust., cham., chel., chin., chlol., cinnb., cist., clem., coc-c., Cocc., coff., con., cor-r., croc., crot-h., crot-t., cupr., cycl., dros., dulc., elaps., ferr-ar., ferr-i., ferr., graph., hep., hyos., iod., ip., jug-c., kali-ar., kali-c., kali-i., kali-n., kali-s., Lach., led., lyc., mag-c., mag-m., mang., Merc., mez., nat-a., nat-c., nat-m., nat-p., Nit-ac., nux-v., oena., ol-j., op., par., petr., ph-ac., Phos., phyt., plb., puls., rhod., rhus-t., Sabad., samb., sars., sec., Sep., sil., spong., squil., stann., stram., Sul-ac., Sulph., sumb., tab., teucr., thuj., verat., vip., zinc.

white: Apis., Ars., calc., carb-v., fl-ac., Kali-c., lac-c., sumb.

HOMOEOPATHIC REMEDY

Arsenicum sulphuratum flavum: leucoderma near the genitalia, skin itched. Skin darkening that appears in regions of light or white skin.

Tuberculinum: Especially made for persons with fair skin and small chests. weak fiber, weak recuperative abilities, and highly weather-sensitive. when colds are taken from even the slightest exposure, well-chosen remedies fail to help, and symptoms are continually changing. vitiligo and skin conditions.^[10]

Arsenicum album: The skin shows whitish spots, and the skin is dry, dirty, and rough. The skin complaint alternating with respiratory complaints like asthma is a strong pointer for using Arsenic Album. Warm applications to the skin and warm drinks are highly desirable. Burning sensations in varying body parts may also be noticed.^[11]

Phosphorus: Tall, skinny individuals with narrow chests, thin, transparent skin, severe nervous debility, and emaciation are weakened by animal fluid loss. High receptivity to outside stimuli, including light, sound, smells, touch, electrical changes, and thunderstruck. Symptoms that appear suddenly include prostration, fainting, sweating, shooting sensations, etc., vitiligo, fungous, excrescences, and skin lesions.^[10]

CONCLUSION:
Leucoderma is a complex skin disorder with significant psychological and social implications. While modern medicine offers symptomatic relief, it often falls short in delivering long-term or holistic healing. Homeopathy presents an alternative, individualized approach that seeks to address the root cause of the condition by considering the patient’s overall constitution and mental-emotional state. Although scientific validation of homeopathy in treating leucoderma is still evolving, many patients report improvements in pigmentation and general well-being. Further research is needed to establish its efficacy through rigorous, evidence-based trials.

REFERENCE

1. Gupta R, Manchanda RK. Textbook of Dermatology for Homeopaths. 3rd ed. Delhi: B.Jain Publisher; 2009.
2. Dewan D, Taneja D, Singh U, Mittal R, Khurana A. Homoeopathic research in vitiligo: Current scenario. Indian J Res Homoeopathy 2017;11:226-36.
3. Skin: Homeopathic Approach to Dermatology: 2nd Revised Edition Author Farokh J Master Edition. 2010
4. Mendiratta V. Text book of Pediatric Dermatology. Indian J Dermatol Venereol Leprol 2014
5. Sehgal VN, Srivastava G. Vitiligo: Compendium of clinico-epidemiological features. Indian J Dermatol Venereol Leprol 2007;73:149-156
6. Sreevidhya JS. Homoeopathic Approach in Treating Vitiligo: Review Article. International Journal of Research and Review. 2023; 10(7): 779-782.
7. Samuel Hahnemann, Organon of medicine, sixth Edition B. Jain Publishers
8. Ronald Marks and Richard Motley. Roxburgh’s Common Skin Diseases.18th Edition, CRC Press, Taylor & Francis Group, London, New York.2011
9. Kent J.T., Lectures on Homoeopathic Philosophy; Reprint, 1979, B. Jain publishers(P) Ltd.

1. Boericke W. Boericke’s New Manual of Homeopathic Materia Medica with Repertory: including Indian drugs, nosodes, uncommon, rare remedies, mother Tinctures, relationship, sides of the body, drug affinities, and list of abbreviations.New Delhi: B. Jain Publisher;2007.

11. Allen HC. &Classified with leading remedies of the Materia Keynotes Rearranged Medica with Bowel Nosodes. 13th Reprint edition Jain Publishers (P) LTD, New Delhi; 2015, 372-374.

Dr Chrisel Jenicia Dsa
PG, Scholar, Department of Paediatrics
Father Muller Homoeopathic Medical College, Mangalore
Under the Guidance of Dr Jyoshna Shivprasad
Professor, Head of the Department, Department of Paediatrics
Email: chriseljeniciadsa@gmail.com