Tinea corporis -a case report

Dr Padmaja Pawshe

ABSTRACT
Systematic study of superficial fungal infection began more than 150 years ago when Remark described the mycelial nature of the clinical disease favus. In 1841, Gruby isolated the organism of favus in culture and experimentally reproduced the disease with inoculation in normal skin. However, it was not until 1910 that Raymond Saboraud published his seminal treatise, Les Tiegnes, classifying the dermatophytes into four genera based on their microscopic and clinical characteristics. In 1934, Emmons’ critical review of dermatophyte taxonomy resulted in the three genera known today: Epidermophyton, Microsporum, andTrichophyton.1

Dermatophytosis is a common problem, causes disturbances in health and their regular activities.

Here I present a clinical case report with the following objectives.

Back ground and Objectives 

1. To put forth assessment of Tinea corporis case using Dermatology life quality index (DLQI) questionnaire.

2. To lay forward an alternative management of Tinea corporis with homeopathic intervention.

A boy of 18 years old presented with complaints of ringworm over face, Trunk, extremities and groins since 4-5months. Complaints started after taking steroids for weight gaining.  He was on allopathic treatment with episode of relapses.

Methodology Homoeopathic medicine was indicated based on totality of symptoms and assessed with photographs and Dermatology life quality index (DLQI) questionnaire.

Results and Conclusion
This case proves the efficacy of individualized constitutional homoeopathic treatment for the cure of tinea corporis.

Keywords: Tinea corporis, Homoeopathy, Individualized,Constitutional, DLQI.

CASE REPORT

History:
An 18-year-old male individual labor by occupation reported with Tinea corporis at A.M. Shaikh homoeopathic medical college Belagavi, Karnataka, India.

​He presented with skin eruptions over face, trunk,extremities, groin region with intense itching and burning which had troubled him over 4-5 months. eruptions were characterized as red circular scaly that grows outwards with borders and thickened in between with intense itching++ and burning.

​Rash started first on left hand and then gradually spread to all other parts of body, aggravated by exposure to cold, cement dust.  Reddish white scaly circular rash.  The borders appear scaly and there is thickening of area in between. During case taking he informed that he was alright before 6 months but he planned for going to gym and took allopathic medications for weight gain (oral steroids and multivitamins). According to patient he took medicines for around one and half month, meantime he developed increase hunger, weight gain and puffiness of body. And as he belongs to low socioeconomic class had poor hygiene in home and at work place. Patient reported after taking that medicines eruption were increased. As he was doing labor work whenever he uses to work in cement the symptoms get aggravated and terrible burning and itching.

Past treatment taken – Took allopathic treatment from Belgaum civil hospital, treated with antifungal creams and oral antifungal medicines and antihistamines, which did not give any relief, rather aggravated the complaint.  The eruption was diagnosed as ringworm infection.

Treatment history
Took allopathic treatment from Belgaum civil hospital, treated with antifungal creams and oral antifungal medicines and antihistamines.

Past Medical history: H/o Typhoid fever 2 years back was hospitalized and treated.

Antenatal history : No major illness to mother during antenatal period.

Family history:

  • First child of non-consanguineous marriage {both apparently healthy} conceived at first year of marriage.
  • Younger brother 2 years younger than patient and keeping good health
  • Mother had h/o anemia.
  • No h/o DM OR TB in family

Socioeconomic history:

  • Father does labor work on daily wages without any education qualification.
  • Mother is housewife, and works in farms on daily wages
  • Belongs to poor socioeconomic class family

Nutritional history:

  • Poorly built and poorly nourished with normal mid arm circumference.
  • Patient had poor nutritional status.

Immunization history:

  • Received all mandatory vaccines as per schedule till the age of 2 years.
  • No post vaccination events.

Personal history:

  • Prefers warm food and medium spicy food. 
  • Appetite – reduced 
  • Bowels: regular, once a day.
  • Urine passes normally 6-8/0-1 D / N
  • Bath warm water
  • Sleep: sound changes position in sleep.
  • Thirst:  drinks water when needed 2lt/day
  • Thermals: cannot tolerate cold in general.
  • Desires: not specific, prefers spicy than sweets
  • Aversions: not specific
  • Perspiration not specific generalized on exertion

Observations during the Case interview

Mental state: He is active but doesn’t mix up or speaks to others easily. Hyperactive cannot sit in one place. He had insecurity about family especially worried about his mother and brother as his father was a drunker and used to hit his mother so the boy used to get angry on father and felt to hit him but he could not do that as he was elder. he never liked anyone talking about him, his mother and family.

He was worried about his younger brother as he wanted him to study hard and go ahead in his career so he started earning to educate his brother and stability of his family.

Life space: Born and brought up in poor family, Belongs to poor socioeconomic class.

Schooling and education, studied till 9th standard was average in studies, as he was not much interested towards study, he could not complete further studies because of the less interest in study and familial financial problems. 

Father use to be head the of the family, He use to work on daily wages, He is alcoholic and use to always quarrel and beat his mother. Family environment was not happy. Hence, he never liked to see his father hitting and quarreling with his mother. He always worried about his mother and family. Feels insecure about family, at the same time he felt angry towards his father but he did not use to express as he was elder.  And hence he seeks solitude to commence with his thoughts.  With this dissatisfied feeling around his surrounding he leaves the situation and goes to other place for some time.

He likes to be in friendly and caring environment or friends. Has a smaller number of friends, does not likes to be teased or talked bad about him, so likes company with only selected people who care about him, and helping his younger brother in completing his education so now his presently doing labor work on daily wages.

Physical examination: 

  • Built and nourishment: moderately built, poorly nourished.
  • Blood pressure: 120/80mmHg.
  • Pulse rate: 76 beats/min
  • Respiratory rate: 16 cycles/min
  • Temperature: Afebrile.

Local examination of the Skin Lesion:

Inspection:

  • Site: face, trunk, extremities and groins.
  • Shape: round 
  • Border: raised 
  • Color: erythematous 
  • Characteristic of eruption: scaly that grows outwards with borders and thickened in between with intense itching++and burning.

Palpation:

  • Tenderness: Not present
  • Surface texture: Rough
  • Edema: Mild edema at affected site.
  • Associated signs: Nothing significant.

Result
The skin lesions on face, trunk, extremities and groin showed improvement with Calcarea phosphorica 200c. skin eruptions completely disappeared within a period of two months of constitutional Homoeopathic treatment.

DISCUSSION:
This case report describes the importance of single individualized constitutional homoeopathic treatment in obstinate condition called TineaCorporis. The task of treating ringworm by conventional oral medicine, external application was unsatisfactory, and an entire failure that the patient resorted to homoeopathic treatment to get permanent cure.

The remedy Calcarea phos14 200C was selected on basis of mental and physical generals and characteristic particulars, eruptions over face, extremities, trunk and groins completely receded after homoeopathic treatment.

CONCLUSION: A complete disappearing of skin eruptions with complaints without any recurrence is documentary evidence. This case shows positive role of homoeopathy in treating the pathology of Tinea.

Dr. Padmaja Pawshe
Department -Practice of medicine
A. M. Shaikh homeopathic Medical College Belgaum,590019.
padmaja.pawshe7@gmail.com
Phone no:7795175635

Download full report with images 

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