Homeopathic management of verruca vulgaris –a case report

Dr Sushmitha

ABSTRACT
Verruca vulgaris, also known as viral warts are common cutaneous lesions are benign epidermal lesions caused by human papillomavirus (HPV) infection .They can appear anywhere on the body in a variety of morphologies.They infect squamous epithelium of skin and mucous membrane causing cell proliferation.Warts are almost universal in the population; they affect all ages but are most common among children and are uncommon among the elderly. Here we present a case of 52 year old male with complaints of multiple warts on palmar aspect of both hands. After detailed case taking and repertorization,  phosphorus was given as similimum. Patient reported complete disappearance of warts within a period of 3 months. The aim of article is to show the scope of homoeopathy in the management of warts.

INTRODUCTION
Verruca vulgaris, also known as viral warts  are common  cutaneous lesions are benign epidermal lesions caused by human papillomavirus infection (HPV). They can appear anywhere on the body in a variety of morphologies. Diagnosis is by examination¹

Warts are almost universal in the population; they affect all ages but are most common among children and are uncommon among the elderly¹. Warts  are classified in ICD-10 diagnostic manual under the code. 2023 ICD-10-CM Diagnosis Code B07.8.² . HPV can exist on fomites, showers and swimming pools with abrasive nonslip surfaces act as high-risk areas for simultaneously harboring the virus and causing an epidermal abrasion. Thirty percent of warts may clear spontaneously, but those that do not are often cosmetically unappealing, painful, and irritating to the patient.Warts are named by their clinical appearance and location; different forms are linked to different HPV types³

Vurruca vulgaris or Common warts: It grows most often on the fingers, around the nails, on the back of the hands and where skin was broken. HPV sub types 2 and 4 are mainly responsible for this. They have black dots that look like seeds, often called “seed” warts and feel like rough bumps.^1,4.

Plantar warts or Foot warts or mosaic warts: It grows most often on soles, plantar surface of the feet in clusters. They grow flat or inward and have black dots and caused by HPV sub types 2, 3, 4, 27, and 57. ^1,4

Flat wart: It usually grow on the face, beard area and legs. They are smaller and smoother and tend to grow in large numbers – 20 to 100 at a time and caused by HPV sub types 3, 10 and 28.^1,4

Filiform wart: It looks like long thread or thin fingers that stick out and grows on the face around the mouth, eyes and nose. It is caused by HPV sub types 2 and 4.^1,4

Verruca vulgaris are easily transmitted by direct or indirect contact, especially if there is disruption of the normal epithelial barrier. In general they are benign but HPV strains 5, 8, 20 and 47 have the malignant potential and sometimes develop into what is known as Verrucous carcinoma. The Verrucous carcinoma is a slow growing tumor and is classified as a well-differentiated squamous cell malignancy that often mistaken for a common wart.⁵

Homoeopathy enjoys a reputation of providing a successful management of wart conservatively which has been validated by various research studies. Individualised homeopathy i.e medicine prescribed on the basis of strict individualisation of the given case,

not only removes the wart but also the disposition to develop this condition. Through this case report we shall discuss how an inveterate case of  V.vulgaris can be managed on the basis of symptoms similarity.⁵

CASE REPORT
52 year old homemaker a Hindu by religion came for treatment in general OPD no 46427 of Government homeopathic medical college bengaluru on 22/11/2022. She was suffering from multiple Verruca vulgaris  on fingers of both hands  since 1 and half year.(figure-1).

she was also having  headache alternate side commencing on change of weather and cold,rainy season since last 4 years.

HISTORY OF PRESENTING COMPLAINT
Patient was apparently well 4 years ago, then she started with complains of headache on alternate sides more frequently  on left. Pain in head was recurrent whenever in change of weather and during rainy season.

Patient started developing small papule black, rough, irregular margins, dot like growth on fingers of both hands.since 1 and half year. Eruptions were gradual in onset and progressing.she would feel sensation of dryness of both hands and pain in index finger while using it.

LOCATION	SENSATION	MODALITY	CONCOMITANT
Extremities on Hands fingers Since  and half year Gradual onset and progressive   Head left side	Dryness of hands Pain in index finger Pain Sensation of wanting to put head in hot water	< on touch with any surface   < change of weather, Rainy season, cold weather,	Nausea Erructation sour Facial pain

Analysis of Case

Mental general	Physical general	Characteristic particular
Loquacity Concentration difficult Discontented Deceived Forgetful Timidity	Vivid dreams Thermals chilly	Warts on hands Headache at left side Headache aggravation  on change of weather

Totality of Symptom

• Loquacious
• Concentration difficult
• Foregtful
• Discontented
• Timid
• Vivid dreams
• Wars on hands

Repertorial Approach – Synthesis Repertory^6.

Repertorial Totality

• Mind- concentration- difficult
• Mind-discontented
• Mind- forgetful
• Mind-loquacity
• Mind-timidity
• Head -pain-weather-change of weather
• Head -pain -sides -left
• Dreams- vivid
• Extremities -warts- hands

Repertorization proper

• Phosphorus 9/20
• Calcarea carb 9/18
• Rhus tox 9/18
• Lachesis 9/17

BASIS OF PRESCRIPTION
Based on analysis of mental generals,physical generals, particulars and reportorial result phosphorus was prescribed. Even though both sulphur and lycopodium  have timidity, concentration difficult, due to thermals others  were ruled out. 1M potency was chosen based on the susceptibility and nature of the disease. Infrequent repetition was chosen based on seat of the disease and its intensity.

CONCLUSION
Homoeopathy is a holistic approach which treats the person as a whole. Most of the warts and headache  complaints stem from affections on mental plane. In this case striking mental features were elicited and used to prescribe. Complete symptomatic relief can be seen within 3 months of prescription.

Conflict Of Interest– Nil

Funding– Nil

Consent For Publication– written informed consent was obtained from the patient for publication of this case report.

BABILIOGHRAPHY

1. Porter, R. S., & Kaplan, J. L. (Eds.). (2011). The Merck manual of diagnosis and therapy (19th ed.);837
2. World Health Organization. (2004). ICD-10 : international statistical classification of diseases and related health problems : tenth revision, 2nd ed. World Health Organization.
3. Sterling JC, Handfield-Jones S, Hudson PM, British Association of Dermatologists.Guidelines for management of cutaneous warts. Br J Dermatol 2001;144(1):4–11.
4. Khanna, N. (2019). In Illustrated synopsis of dermatology & sexually transmitted diseases (4TH ed., pp. 269–272). essay, Elsevier India.
5. Sonny, Dr.R. (2020b) ‘Verruca vulgaris amenable to individualised homeopathy: A case report’, International Journal of Homoeopathic Sciences, 4(3), pp. 87–91. doi:10.33545/26164485.2020.v4.i3b.195.
6. Synthesis repertory

Dr Sushmitha
PG scholar of Government homoeopathic medical college and hospital
Bengaluru

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