Case report on homoeopathic treatment of lichen planus

Dr. Ashok Yadav¹,Dr. Pravishtha Awasthi^2*, Dr. Navita Sharma³, Dr. Nalini Tiwari⁴

1. Head, Department of Practice of Medicine, HOMOEOPATHY UNIVERSITY, JAIPUR
2*. MD scholar, Department of Practice of Medicine, HOMOEOPATHIC UNIVERSITY, JAIPUR
3. MD scholar, Department of Repertory, HOMOEOPATHY UNIVERSITY, JAIPUR
4. Intern, Dr. M.P.K. Homoeopathic Medical College Hospital and Research Centre, HOMOEOPATHY UNIVERSITY, JAIPUR

ABSTRACT
Lichen planus is seen in around 0.2% to 1% of the population affecting mostly adults during the fifth or sixth decade. In general, only 1% to 4% of patients are children. Mucosal involvement is seen in up to 75%. ^[1]Homoeopathy is a system which deals a person individually by its holistic approach. The aim of homeopathy is not only to treat lichen planus but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat lichen planus that can be selected on the basis of cause, sensations and modalities of the complaints. Indicated homeopathic medicines can manage the spread and general health of the person.

KEYWORDS:Lichen planus, Homoeopathy,Complete Repertory, Case Report, Mag carb.

INTRODUCTION
Lichen planus is fundamentally presented as a pruritic rash mainly on the extensor surfaces. It seldom occurs in families and possible HLA associations have been proposed but there is no pattern of inheritance. There are characteristic histological changes with-

(a). Hyperkeratosis

(b). Basal cell degeneration and

(c). Heavy band like T-Lymphocytes infiltration in the papillary dermis.

The junction of dermis and epidermis has a ‘sawtooth’ appearance. ^[2]There is an association seen with viral infections, drugs and contact allergens like dental restorative methods^[1]. 

CASE REPORT
An 8 years old male child with a clinical history of eruptions on bilateral extremities for more than 6 months approached the OPD of homoeopathy university on 7-8-2019. He has eruptions on bilateral extremities along with purple/black discoloration with itching. Itching aggravated by washing and bathing.

He took homoeopathic treatment 2 months back in which he was prescribed Heparsulph 200/ 3 doses, which aggravated number of lesions and itching.

During case taking we came to know that he is affectionate for his mother only, he has difficulty in concentration and does not let us to examine lesion as he has touch aggravation.

PAST HISTORY- Patient has sudden hearing loss after having fever paroxysm 3 years back, which caused bilateral complete hearing loss, got cochlear implant in his right ear,6 months back.

FAMILY HISTORY- Apart from his mother having complaint of bilateral kidney failure all healthy.

PHYSICAL GENERALS- The patient appetite was increased and sleeps within 15 min after having dinner along with marked desire for sweets and aversion from vegetables. His perspiration is sour in odourand thermal is hot. Bowel movements are regular and satisfactory.

CLINICAL FINDINGS- He presents with eruptions on extremities with itching and purple/black discolouration. 

GENERAL EXAMINATION-Tongue was moist and clean. Normally built and nourished with normal general and systemic examination.

REPERTERY USED- Complete repertory was used for the rubric formation, totality, repertorisation and analysis of the case.^[3]

REPERTORISATION DONE ON BASIS OF TOTALITY OF SYMPTOMS

1. Affectionate for mother only.
2. Difficulty in concentration.
3. Aggravation from touch.
4. Desires- sweets.
5. Aversion- vegetables. Thermal reaction hot.
6. Appetite- increased, eats till satiety and sleeps after having dinner.
7. Sour odour in perspiration
8. Sudden, complete hearing loss.
9. Eruptions of lichen planus.
10. Itching < after washing/bathing.

REPERTORIAL ANALYSIS

1. Magnesium carbonicum- 18/10
2. Calcarea carbonica-17/8
3. Lycopodium clavatum-17/6
4. Phosphorus-16/6
5. Sulphur-15/7

FIRST PRESCRIPTION AND BASIS OF PRESCRIPTION

After repertorisation, considering totality and chronicity of case and further referencing from materia medica Mag. carb 200 CH/ 1 dose, single dose was prescribed on 7-8-2019 followed by placebo.

FOLLOW UP 

DATE	FOLLOW UP	PRESCRIPTION
24/8/19	Itching is comparatively better.  Patient is taking more interest in his school work. Appetite is still increased. Perspiration sour Still falling asleep soon after dinner.	Mag-C 200 1 dose stat  Placebo 30/3 for 14 days
7/9/19	SQ.	Placebo 30/3 for 14  days
21/9/19	Slight increase in itching. Concentration improved. Appetite improved, having adequate meal, 3 times a day. Perspiration improved;odour is not so sour.	Placebo 30/3 for 14  days
5/10/19	Itching is comparatively better.  He is taking interest in other activities, and wakes up about one of hour after dinner for school work. Sleep improved.	Mag-C 200 1 dose stat  Placebo 30/3 for 14 day
19/10/19	Size of eruptions and itching decreased. Concentration improved. Appetite improved, having adequate meal, 3 times a day. Pt. is able to awake approx. 1 hr after dinner. Perspiration not so much sour.	Placebo 30/3 for 14 days
2/11/19	Eruptions of hand are much better, patient had relief in itching. Concentration is improved. The sour odour from body is decreased. Appetite is good. Feels sleepy but able to awake for some time after dinner	Mag-C 200 I dose stat Placebo 30/3 for 28 days
30/11/2019	Eruptions of hand are much better, patient had relief in itching. Perspiration is decreased with no odour now. Sleep improved comparatively.	Placebo 30/3 for 28 days
28/12/2019	SQ.	Mag-C 200 I dose stat Placebo 30/3 for 28 days
25/1/2020	No new eruptions appear and the old one are improving. The case is still continuing.	Placebo 30/3 for 28 days

BEFORE

AFTER

REFERENCES

1. API Textbook of Medicine. 9th ed. Mumbai: The Association of Physicians of India and Jaypee Brothers Medical Publishers (P) Ltd.; 2012.
2. Ibbotson S, Dawe R. Davidson’s Principles and Practice of Medicine. 22nd ed. LONDON: CHURCHILL LIVINGSTONE ELSEVIER; 2014.
3. Zandvoort RV. Complete Repertory. [internet]2017[cited 2019 July 28]. Available from: www.homoeobook.com/complete/.