Homoeopathic management of Atopic Dermatitis-Case Report

Dr Kiran Kumar G

ABSTRACT: Atopic dermatitis is a chronic inflammatory skin disease posing a significant burden on health care resources. With reference to the present scenario prevalence of atopic dermatitis in adults is increasing. The following article deals with one such case of atopic dermatitis which has revealed promising results with Staphysagria as a constitutional remedy.

KEYWORDS: Homoeopathy, Atopic dermatitis, SCORAD, Hanifin and Rajka criteria.

CASE REPORT:
A 23 years old female patient reported to outpatient department of Government Homoeopathic Medical College & Hospital on 03/03/2023 with complaint of eruptions over flexural aspect of bilateral upper limbs for 1 year.

The patient was apparently healthy till last year after which she gradually started developing eruptions over bilateral arm (flexor aspect) along with dryness of skin, itching followed by burning. The onset and progress of symptoms were gradual.

Past history: Frequently got cold in childhood

Local Examination of skin:

Calculation of SCORAD Score:

• A= Upper extremities- Front of arm= 4.5+4.5= 9
• B= {Redness- mild, Dryness- severe, Oozing- mild, Thickening- moderate, Swelling- none, Scratch mark- severe} = 10
• C=Pruritis- 10, Insomnia-06 = 16

TOTAL= 52

Rubrics selected:⁷

• MIND- Ailments from- indignation
• MIND- Ailments from- disappointment
• MIND- Ailments from- embarrassment
• SLEEP- SLEEPLESSNESS- sleepiness with
• SKIN- Burning- scratching, after
• SKIN- Eruption- eczema

DISCUSSION:
In Homoeopathic literature, several medicines have been mentioned for the treatment of Atopic Dermatitis. The individualized homeopathic treatment has no side effects on account of the principle of minimal dose of medicine.⁹ In the above case Staphysagria has been used as constitutional remedy which has proved to be effective in the treatment of atopic dermatitis which is evident by the SCORAD Score that has been drastically reduced from the total of 52 at first visit to 2.8 at the end of follow up.

Also, the possible causal attribution of the changes in this case were assessed by using the Modified Naranjo Criteria (Table 4). The total score for the case (+9), as per these criteria, is relatively close to the maximum of +13 and suggests positive causal attribution of the individualized homoeopathic treatment to the clinical outcome.

					Case
	Modified Naranjo Criteria	Yes	No	Not sure
1.	Was there an improvement in the main symptom or condition for which the homoeopathic medicine was prescribed?	+2	-1	0	+2
2.	Did the clinical improvement occur within a plausible timeframe relative to the drug intake?	+1	-1	0	+1
3.	Was there an initial aggravation of symptoms?	0	0	0	0
4.	Did the effect encompass more than the main symptom or condition (i.e., were other symptoms ultimately improved or changed)?	+1	0	0	+1
5.	Did overall well-being improve? (suggest using validated scale)	+1	0	0	+1
6.	Direction of cure: did some symptoms improve in the opposite order of the development of symptoms of the disease?	0       +1	0       0	0       0	0
	Direction of cure: did at least two of the following aspects apply to the order of improvement of symptoms —from organs of more importance to those of less importance—from deeper to more superficial aspects of the individual—from the top downward.				+1
7.	Did old symptoms (defined as nonseasonal and non-cyclical that were previously thought to have resolved) reappear temporarily during the course of improvements?	0	0	0	0
8.	Are there alternate causes (other than the medicine) that—with a high probability—could have caused the improvement? (Consider the known course of the disease, other forms of treatment, and other clinically relevant interventions).	-3	+1	0	+1
9.	Was the health improvement confirmed by any objective evidence? (e.g., lab test, clinical observation, etc.)	+2	0	0	+2
10.	Did repeat dosing, if conducted, create similar clinical improvement?	0	0	0	0
	Total score (Maximum score= +13; Minimum score = -3)				9

CONCLUSION:
In this instance, a single dose of Staphysagria with infrequent repetition has been chosen. This case study highlights the competency of constitutional homoeopathic medicines. Atopic dermatitis is one ailment where homoeopathic treatment might help reverse the skin abnormalities. Since this is only one case report, more research needs to be done that might make this study useful.

CONFLICT OF INTEREST: None

FINANCIAL SUPPORT: Not available

DECLARATION OF PATIENT CONSENT: Patient consent was taken for images to be reported for this article.

REFERENCE:

1. Kanwar A. Adult onset atopic dermatitis: Indian Journal of Dermatology 2016  Nov-Dec; 61 (6):662 cited on 30 August 2022. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122283/
2. Nutten S. Atopic Dermatitis: Global Epidemiology and Risk Factors. Annals of Nutrition and Metabolism. 2015;66(Suppl. 1):8-16. cited on 30 August 2022 . Available from https://www.ncbi.nlm.nih.gov/pubmed/25925336
3. Kumar Sorna, Nayak.S.Chitra, Padhi Tanmay, Rao Gnaneshwar, Rao Ashwin, Sharma.V.K et al Epidemiological pattern of psoriasis, vitiligo and atopic dermatitis in India: Hospital-based point prevalence. IDOJ 2014; 5:6-8 cited on 30 August 2022. Available from http://www.idoj.in/article.asp?issn=2229-5178;year=2014;volume=5;issue=5;spage=6;epage=8;aulast=Kumar
4. Griffiths C, Barker J, Bleiker T, Chalmers R, Creamer D. Rook’s Text book of Dermatology.4e, vol 1 :Wilesy Blackwell(p), London ,1986.p 419
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6. Teut et al. (2021) Case reporting in homeopathy—an overview of guidelines and scientific tools. Available at: https://www.researchgate.net/publication/354589265_Case_Reporting_in_Homeopathy-An_Overview_of_Guidelines_and_Scientific_Tools (Accessed: 09 July 2023).
7. Kent JT. Repertory of the Homoeopathic Materia Medica. Enriched Indian ed. New Delhi. B Jain Publishers(P) Ltd;2017.
8. RADAR homoeopathic software
9. Hahnemann, S., Boericke, W. and Dudgeon, R., 2011. Organon of medicine. New Delhi: B. Jain Publishers.

Dr Kiran Kumar G
MD Part-1, Department of Case Taking and Repertory
Govt. Homoeopathic Medical College and Hospital, Bangalore-79
Email: kirankumarg1998@gmail.com

UGO Dr Munir Ahmed R
Professor Department of Case Taking and Repertory
Govt. Homoeopathic Medical College and Hospital, Bangalore-79

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