Dr. Biswajit Bera [1]*, Dr. Sanjay Sarkar [2]
Abstract: Skin diseases are gradually increasing day by day due to various reasons although maintaining good hygiene. Due to abuse of topical medicines and steroids simple skin diseases are palliated or suppressed and converted into incurable different deep seated skin diseases and other internal diseases. Different bacterial and fungal infections are more common e.g. staphylococal, candidal or dermatophytic infections etc. specially in immune-compromised patients and also in cases of patients with internal or systemic disorder. In homoeopathy there is a greater scope for treating different types of skin diseases following homoeopathic philosophy. This article tries to show indications of different homoeopathic medicines for treatment in better way.
Keywords: Skin diseases, topical medicines, infections, immune-compromised, homoeopathic philosophy.
Abbreviations: Visual analogue scale (VAS), Tuberculosis (TB).
Introduction: Proper history taking is necessary before the start of the treatment to treat the patient judicially. How to take the case specially in case of skin diseases described briefly here beside our standard homoeopathic case taking proforma.
History taking
Very necessary for treating skin diseases accurately and should include special questions in relation to objective symptoms as well as any systemic disorder if present.
Present Complaints-
Patients present to the physician with a variety of symptoms among them few are subjective and few are objective symptoms.
- Subjective symptoms: Symptoms which are felt by the patient only. After collecting the symptoms, it is important to find out the severity of symptom- which is often asked to the Patients whether the symptoms are interfering with his or her daily works or during sleep. Also ask to the patient to grade the severity of symptoms on the basis of VAS.
- Objective symptoms: localization of symptoms by patient or relatives and by the physician, which include cutaneous (e.g. rash and ulcers) and mucosal lesions ( oral, genital, nasal etc.) and changes in the hair, nails, palms and soles.
For each symptoms, following questions should be asked:
- Duration: duration of the particular skin diseases, which help the physician for better understanding of the nosological diagnosis.
- Site of first involvement: sequence or evolution of spread
- Evolution: how the lesions being started and evolved. If subsided whether left any scars or sequelae.
- Diurnal variation: if any.
- Aggravating factors: exercise, season, sun exposure, drugs.
- Relieving factors: if any.
- Associated features: any history of rash, wheals, cyanosis, gangrene, hypopigmented lesions, neuritis and sensory involvement. Also see the nail changes, involvements of palms, soles, scalp and mucosae, excessive growth or loss of hair, etc.
Past history-
Any past illness and treatment took and result. Any medications- topical or systemic or self-medication. Any medical disorders- DM, hypertension etc. skin lesions may be the manifestation of that particular internal disorder. And also history of TB is very important, when cutaneous TB is suspected.
Family history-
It is very important in many of the skin diseases e.g.
- Infections: TB, herpes simplex, varicella zoster etc.
- Infestations: scabies and pediculosis etc.
- Genodermatosis: neurofibromatosis, epidermolisis bullosa, icthyosis etc.
- Environmental: arsenic induced skin diseases in families exposed to same source of water etc.
Other history-
Occupational, social, travel history may help in diagnosis of the cases.
Examination
Skin lesions should be examined according to their morphology, arrangement and distribution. Appropriate environment, natural light and patient’s comfort is very much important. Do not hesitate to ask patient to undress if necessary. Removal of make-up is necessary if needed. An ordinary magnifying glass can provide vast information, etc.
Homoeopathic approach
Homoeopathic materia medica is the collection of sign and symptoms through drug proving from different authentic sources. As homoeopathy treat the patient not the disease, so we have to take detailed history of the patients to cure the patient gently and harmless way. Here indications of few less frequently homoeopathic drugs are described for treating the skin diseases.
Ailanthus grandulosa
Indications: Miliary, livid rash, returns annually. Large blisters filled with dark serum. Irregular, patchy, livid eruption, disappearing on pressure. Cold. Raynaud’s disease. Eruptions scanty with sore throat.
Alumen
Indications: Ulcers, with indurated base. To be thought of in indurated glands, epithelioma etc; veins become varicose and bleed. Indurations resulting from long-continued inflammatory irritations. Alopecia, Scrotal eczema and on back of penis.
Anacardium orientale
Indications: Intense itching, eczema, with mental irritability; vesicular eruption; swelling, urticaria; eruption like that of Poison-Oak Lichen planus; neurotic eczema. Skin not easily excited by irritants.
Anagalis arvensis
Indications: Itching; dry, bran-like eruption, especially on hands and fingers. Palms especially affected. Vesicles in groups. Ulcers and swellings on joints. Promotes expulsion of splinters.
Arbutus andrachne
Indications: Eczema associated with gouty and rheumatic symptoms. Urine rendered more clear. Lumbago. Symptoms shift from skin to joints.
Arsenicum bromatum
Indications: A great anti-psoric and anti-syphilitic remedy. Herpetic eruptions, syphilitic excrescences, glandular tumors and indurations, carcinoma, locomotor ataxia, and obstinate intermittents, and diabetes are all greatly influenced by this preparation. Acne rosacea, with violet papules on nose; worse in the spring.
Arsenicum sulphuratum flavum
Indications: Leucoderma and squamous syphilides. Skin itching, dry, cracked; rhagades. Chafing of the skin about genitals and behind ears of children. Complaints < afternoon and evening > by steam or hot water. Eruption on outer side of left wrist; also on inner side.
Azadirachta indica
Indications: Itching without eruptions; scabies, leprosy.
Bellis perennis
Indications: Ecchymosis, swelling, very sensitive to touch. Venous congestion due to mechanical causes. Varicose veins with bruised sore feeling. Exudations and swellings.
Calcarea fluoricum
Indications: Marked whiteness of skin. Scar tissue; adhesions after operations. Chaps and cracks. Fissures or cracks in the palms of the hands, or hard skin. Hard, elevated edges of ulcer, surrounding skin purple and swollen.
Calc iodatum
Indications: Indolent ulcers, accompanying varicose veins. Copper-colored and papulous eruptions, tinea, favus, crusta lactea, swelling of the glands, skin cracked, falling out of hair. Itching in various parts, disappearing and reappearing in other parts, only better after much scratching.
Calotropis gigantica
Indications: Has been used with marked success in the treatment of syphilis following Mercury; also, in elephantiasis, leprosy, and acute dysentery. In the secondary symptoms of syphilis, where Mercury has been used but cannot be pushed safely any farther, it rapidly recruits the constitution, heals the ulcers and blotches from the skin, and perfects the cure.
Caltha palustris
Indications: Pemphigus. Bullæ are surrounded by a ring. Much itching. Face much swollen, especially around the eyes. Itching eruption on thighs.
Carduus marianus
Indications: Itching on lying down at night. Varicose ulcers. Eruption on lower part of sternum.
Cistus Canadensis
Indications: Itching all over body without eruption. Small, painful pimples; lupus. Glands inflamed and indurated. Mercurio-syphilitic ulcers. Skin of hands hard, thick, dry, fissured; deep cracks. Itching of swollen hands and arms; general itching which presents sleep.
Chelidonium majus
Indications: Dry heat of skin; itches, yellow. Painful red pimples and pustules. Old, spreading, offensive ulcers. Wilted skin.
Chininum sulph
Indications: Itching; erythema, urticaria, icterus, vesication, pustules, purpura. Great sensitiveness. Shriveled skin. Red rash all over body with severe stinging followed by desquamation. Urticaria ab ingestis.
Cobaltum metallicum
Indications: Dry and pimply. Pimples about nates, chin, hairy scalp. Itching all over while getting warm in bed.
Comocladia dentata
Indications: Itches, red and pimples. Redness all over, like scarlatina. Erysipelas. Deep ulcers, with hard edges. Herpes; zona; leprosy. Red stripes on skin. Eczema (papular) of the trunk and extremities; also pustular type. Tormenting itching and burning over whole body.
Copaiva officinalis
Indications: Hives, with fever and constipation. Roseola. Erysipelatous inflammation, especially around abdomen. Circumscribed lenticular patches, with itching; mottled appearance. Chronic urticaria in children. Bullous eruptions.
Condurango
Indications: Fissures form about the muco-cutaneous outlets. Epithelioma of lips or anus. Ulcerative stage of carcinoma cutis when fissures form.
Dolichos pruriens
Indications: Intense itching, with no swelling or rash; worse across shoulders, also about elbows and knees and hairy parts. Jaundice. Yellow in spots; itching excessively at night. Herpes zoster.
Dulcamara
Indications: Pruritus, always worse in cold, wet weather. Herpes zoster, pemphigus. Red spots, urticaria, brought on by exposure, or sour stomach. Humid eruptions on face, genitals, hands, etc. Thick, brown-yellow crusts, bleeding when scratched.
Elaps corallinus
Indications: Glands and skin of axillæ affected; itching with tetter. Tips of fingers peel off. Itching eruption in axillæ.
Eucalyptus globulus
Indications: Glandular enlargements and nodular swelling over joints. Foul and indolent ulcers. Herpetic eruptions.
Fagopyrum esculentum
Indications: Itching; better by bathing in cold water; worse scratching, touch and retiring. Sore red blotches. Blind boils. Itching of knees and elbows and hairy portions. Itching of hands, deep in. Vesicular, pustular, phlegmonous dermatitis. a
Formica rufa
Indications: Red, itching and burning. Nettle-rash. Nodes around joints. Profuse sweat without relief.
Fragaria vesca
Indications: Urticaria; petechial and erysipelatous eruptions. Swelling of whole body.
Gaultheria procumbens
Indications: Smarting and burning. Intense erythema, worse, cold bathing; better, olive oil and cool air blowing on part.
Guarana (paullinia sorbilis)
Indications: Chloasmata on temples and arms. Urticaria. Itching in hands and fingers followed by rawness after scratching.
Hydrocotyle asiatica
Indications: Thickness of epidermoid layer of skin and exfoliations in scales. Erythema on face, neck, back, chest, arm, thigh with much itching with copious sweet. Miliary eruptions. Intolerable itching especially of soles.
Hypericum perforatum
Indications: Hyperidrosis, sweating of scalp, worse in morning after sleep; falling of hair from injury; eczema of hands and face, intense itching, eruption seems to be under the skin. Herpes zoster. Old ulcers or sores in mouth when very sensitive.
Icthyolum
Indications: Heat and irritation; itching. Scaly and itching eczema. Pruritus of pregnancy. Psorisis, erysipelas.
Iris versicolor
Indications: Herpes zoster, associated with gastric derangements. Pustular eruptions. Psoriasis; irregular patches with shining scales. Eczema, with nightly itching. Impetigo figurate. Porrigo.
Juglans cinerea
Indications: Red, like flush of scarlatina. Jaundice, with pain about liver and right scapula. Itching and pricking when heated. Pustules. Eczema, especially on lower extremities, sacrum and hands. Erythema and erysipelatous redness.
Kalium arsenicosum
Indications: Intolerable itching, worse undressing. Dry, scaly, wilted. Pustules worse during menses. Chronic eczema; itching worse from warmth, walking, undressing. Psoriasis, lichen. Phagedænic ulcers. Numerous small nodules under skin.
Kali muriaticum
Indications: Erythema, and eczema, with vesicles containing thick, white contents. Dry, flour-like scales on the skin. Bursitis. Albuminoid eczema, or other skin disease arising after vaccination with bad vaccine lymph.
Natrum salicylicum
Indications: Œdema, urticaria, red in circumscribed patches. Tingling and itching. Pemphigoid eruption.
Oleander
Indications: Itching, scurfy pimples; herpes; sensitive and numb. Nocturnal burning. Very sensitive skin; slightest friction causes soreness and chapping. Violent itching eruption, bleeding, oozing; want of perspiration. Pruritus, especially of scalp, which is sensitive.
Osmium
Indications: Eczema, with pruritus. Irritated skin. Itching pimples. Bromidrosis, sweat in axilla smelling of garlic, worse evening and night. Fold remains attached to growing nail.
Primula obconica
Indications: Great itching, worse at night, red and swollen like erysipelas. Tumefied. Small papules on a raised base. Skin symptoms accompanied by febrile symptoms.
Prunus spinosa
Indications: Herpes zoster. Dropsy. Itching on tips of fingers, as if frozen.
Syzygium jambolanum
Indications: Prickly heat in upper part of the body; small red pimples itch violently.
Torula cerevisae
Indications: Itching eczema around ankles. Tinea versicolor. Sycotic remedy Anaphylactic states produced by proteins and enzymes.
Vespa crabro
Indications: Erythema; intense itching; burning. Dry scab over the whole body. Wheals, macules and swellings with burning, stinging and soreness. Erythema multiforme, relieved by bathing with vinegar.
Viola tricolor
Indications: Impetigo. Intolerable itching. Eruptions, particularly over face and head, with burning, itching; worse at night. Thick scabs, which crack and exude a tenacious yellow pus. Eczema impetigonoides of the face.
Xerophyllum
Indications: Erythema, with vesication and intense itching, stinging, and burning. Blisters, little lumps. Skin rough and cracked; feels like leather. Dermatitis, especially around knees. Inflammation resembling poison-oak.
References
- Khanna N. Illustrated synopsis of Dermatology and Sexually Transmitted Diseases. 5th New Delhi: Reed Elsevier India Pvt. Ltd; 2016.
- Ralston SH, Penman ID, Strachan MWJ, Hobson RP. Davidson’s Principles and Practice of Medicine. 23rd ed. Edinburg: Elsevier; 2018.
- Kent JT. Lectures On Homoeopathic Philosophy. New Delhi: Indian Books & Periodicals Publishers; 2012.
- Dudgeon RE, Boericke W. Organon of Medicine by Samuel Hahnemann. 5th and 6th New Delhi: B. Jain publishers (P) Ltd; 2015.
- Sarkar BK. Organon of Medicine. 9th Delhi: Birla Publications (P) Ltd; 2013.
- Kent JT. Lectures on Homoeopathic Materia Medica. New Delhi: Indian Books & Periodicals Publishers; 2012.
- Boericke W. Pocket manual of Homoeopathic Materia Medica: comprising the characteristic and guiding symptoms of all remedies (clinical and pathogenetic). New Delhi: Indian Books & Periodicals Publishers; 2012.
- Allen HC. Keynotes and Characteristics with Comparisons of the some of the Leading Remedies of the Materia Medica. Kolkata: Medical Book Publication; 2002.
- Clarke JH. A Dictionary of Practical Materia Medica. 3 vol set. New Delhi: B. Jain Publishers (P) Ltd; 2010.
- Murphy R. Lotus Materia Medica. 3rd revised edn. New Delhi: B. Jain Publishers (P) Ltd; 2021.
About the Authors
[1] Dr. Biswajit Bera, BHMS (H). PG scholar (Part-II), Department of Practice of Medicine of The Calcutta Homoeopathic Medical College & Hospital. Kolkata-09, WB. Email id. berabiswajit721@gmail.com
[2] Dr. Sanjay Sarkar, BHMS. PG scholar (Part-I), Department of Practice of Medicine of The Calcutta Homoeopathic Medical College & Hospital. Kolkata-09, WB. Email id. Sarkar.sanjay2710@gmail.com
