Dr Bramarambha K
Abstract:
Tinea corporis, also known as ‘ringworm,’ is a superficial dermatophyte infection of the skin. The incubation period is 1–3 weeks. Tinea corporis typically presents as a well-demarcated, sharply circumscribed, oval or circular, mildly erythematous, scaly patch or plaque with a raised leading edge. In the past few years health care workers have reported increasing cases of Antimicrobial-resistant ringworm, in turn affecting the quality of life of the person. There is a shift from allopathy to homoeopathy for tinea corporis treatment in the recent times. Case of Tinea corporis in a 55-year-old female admitted to In- patient ward in Government Homoeopathic Medical College & Hospital, Bengaluru presented with complaint of itching of circular eruptions with raised edges on the right upper limb & waist region on left side. A detail case taking was done, followed by repertorisation lead to the prescription of Lycopodium. This case treated with individualized homoeopathic medicine showed remarkable improvement in a very short period of time.
Keywords: fungal infection, homoeopathy, lycopodium, tinea, dermatophyte
Introduction: Tinea corporis is a superficial dermatophyte infection characterized by either inflammatory or non-inflammatory lesions on the glabrous skin (i.e., skin, regions other than scalp, groin, palms & soles).1 Tinea corporis occurs worldwide, it is most commonly observed in tropical regions.2 According to WHO the prevalence of superficial mycotic infection globally was 20- 25% in 2015.3 A prevalence of 6.09% to 27.6% has been reported in studies from south India, while a high prevalence of 61.5% has been recorded in north India.4 Superficial fungal infections are caused by dermatophytes -Microsporum, Trichophyton and Epidermophyton genera.5 Predisposing factors include personal history of dermatophytosis (e.g. tinea capitis, tinea pedis, tinea cruris, and tinea unguium), concurrent affected family members, pets in the home, crowding in home, recreational exposure (e.g. wrestling and marital arts), hyperhidrosis, low β-defensin 4 levels, immunodeficiency, diabetes mellitus, genetic predisposition (in particular, tinea imbricata), xerosis, and ichthyosis.
Tinea manuum is the dermatophyte infection of hands, Tinea pedis- dermatophyte infection of feet, Tinea capitis – dermatophyte infection of scalp, Tinea barbae- dermatophyte infection of bearded areas, Tinea faciei- dermatophyte infection of face, Tinea cruris- dermatophyte infection of groin, and Onychomycosis or Tinea unguium- dermatophyte infection of nails.2
Dermatophytes preferentially inhabit the nonliving, cornified layers of the skin, hair, and nail, which is attractive for its warm, moist environment conducive to fungal proliferation. Fungi may release keratinases and other enzymes to invade deeper into the stratum corneum, although typically the depth of infection is limited to the epidermis and, at times, its appendages. They generally do not invade deeply, owing to nonspecific host defense mechanisms that can include the activation of serum inhibitory factor, complement, and polymorphonuclear leukocytes. Elimination of dermatophytes is achieved by cell-mediated immunity. Trichophyton rubrum is a common dermatophyte and, because of its cell wall, is resistant to eradication. This protective barrier contains mannan, which may inhibit cell-mediated immunity, hinder the proliferation of keratinocytes, and enhance the organism’s resistance to the skin’s natural defenses.1
The lesion in Tinea corporis starts off as a flat scaly spot that spreads centrifugally and clears centrally to form a characteristic annular lesion giving rise to the term ‘ringworm’. The central area becomes hypopigmented or brown and less scaly as the active border progresses outward. The border is usually annular and irregular. Occasionally, the border can be papular, vesicular, or pustular. Lesions can be itchy.
Tinea corporis is contagious and therefore may have significant psychological, social, and occupational health effects. Secondary bacterial superinfection may occur as a result of scratching and abrasion of the skin. Post-inflammatory hypopigmentation and hyperpigmentation may occur. Along with physical examination, if necessary, the diagnosis can be confirmed by microscopic examination of potassium hydroxide (KOH) wet-mount preparations of skin scrapings from the active border of the lesion. The KOH dissolves the epithelial tissue, leaving behind easily visualized septate hyphae with or without arthroconidiospores.2 Homoeopathy medicines can be effective in the treatment of Fungal infections.
CASE PRESENTATION
Preliminary Data
- Name – Ms. SDP
- Age – 55 yrs
- Date of IPD Admission – 13/03/2023
- Sex – Female
- Address – Byatarayanapura,Bengaluru
- Marital Status – Widow
- Occupation – Works in Garment factory Religion – Hindu
- Nationality – Indian
Presenting Complaint
- C/O Itching circular Skin Eruptions on right upper limb & left waist region since 2-3
History of Presenting Complaint
- C/O Itching circular Skin Eruptions on right upper limb & left waist region since 2-3
Sometimes itching all over the body is present. Itching starts without eruptions, has the patient starts scratching – the eruption starts to appear as a small circular eruption & later turn into a big circle. Eruptions look dry & scaly
Location – Right side upper limb & left side waist region.
Sensation –burning & itching is present. Modalities < Non veg, Brinjal, evening, night
> Bathing
Past History
- History of Surgery – Myomectomy 35yrs back & Tubectomy 36yrs
- No history of
- No allergic
Family History
- Father – Died due to natural
- Mother – Died due to natural
- Siblings – 2 elder sister – apparently healthy 1 elder brother – apparently healthy
1 younger brother – apparently healthy
Personal History
- Diet – Mixed
- Habit – S
- Appetite – good
- Hunger – Reduce
- Thirst – Thirsty
- Desire – Sweets
- Aversion – Nothing specific
- Stool – 1-2 times/day
- Urine – Regular, no itching or burning while urinating
- Perspiration – Scanty, on much exertion – face
- Sleep – good, but if I have to go somewhere next day I can’t sleep
- Dreams – nothing specific
- Thermals – towards Hot
Gynecology & Obstetrics History
- Menarche- at the age of 14 yrs
- Attained menopause 13yrs back
- G4P4L3A0
- G1 = Girl = Home delivery
- G2 = Girl = Hospital delivery
- G3 = Girl = Home delivery = 18 yrs back died due to suicide
- G4 = Boy = Hospital delivery
Life Space Of Investigation & Mind
B/B in Mandya. Didn’t go to school. Married at the age of 16 yrs. Faced lot of difficulties in the in-law’s house. Husband was alcoholic. Daily he used to come home drinking & was shouting at me. Patient was
not ready to tell anymore details regarding her husband & in laws. I have never been happy in my life.
Husband expired 20 yrs back. After my husband’s death I started to take care of the family.
I am feeling very bad that I couldn’t do properties like others did to their children. I felt neighbors earned money better than me. I also want to earn money & do something for my children. I don’t like to depend on my son for money. I want everything to be kept neatly in the home or else I get irritated. Hurried in walking. When I have to go anywhere, I can’t sleep the previous day I will be very anxious. I will always be anxious for some or the other reasons. I shouldn’t hear anyone tell anything about me or my work. In the work place also, I will finish my work fast because they shouldn’t tell anything. Till I finish my work I will be anxious. Memory is good. Weeping tendency present. Anticipatory anxiety is much marked. Anger – before she used to get angry easily, since 5-6 yrs anger has reduced. Always wants to be occupied or else she will feel she is wasting time & sitting simply. Her children don’t know that she is working now also, as she doesn’t want to ask money to her children. She doesn’t want to ask help or anything to anyone – she feels why I should ask them.
Repertorisation Proper
- Mind- Anxiety– Anticipating
- Mind – industrious – mania for work
- Generalities – food & drinks – sweets- desire
- Skin – eruption- itching
Repertorial Result
- Lycopodium – 9/4
- Arsenicum album – 8/4
- Sepia – 7/3
- Sulphur – 7/3
- Natrum muraticum – 6/4
Basis of Prescription
Based on the analysis of mental generals, physical generals, particulars & reportorial result Lycopodium was prescribed. Lycopodium & Arsenicum album has marked anticipating anxiety, considering the thermals arsenicum album will be ruled out.6 Lycopodium is very ambitious & hurried.7
Lycopodium has more self – esteem.6-8 In lycopodium complaints start from right & goes to left side, desire for sweets.8 Itching of skin < evening & night in Lycopodium with burning sensation.9
Potency 200C was selected based on the susceptibility & condition of the disease. As the subject was an In-patient in Government Homoeopathic Medical College & Hospital Bengaluru for 3 days, 1dose was prescribed on the day of admission. Patient showed remarkable changes in 2 days after the medicine.
Dr Bramarambha K
PG Scholar, Department Of Materia Medica
Government Homoeopathic Medical College & Hospital Bengaluru – 560079
vaishnavikshetty@gmail.com
Under The Guidance Of; Dr. Ashok Kumar Dantakale
PROFESSOR, Department Of Materia Medica
Government Homoeopathic Medical College and Hospital Bengaluru – 560079
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