Study the efficacy of homoeopathic medicines for the treatment of dermatophytosis

Study the efficacy of homoeopathic medicines for the treatment of dermatophytosis

Dr Uma Bharti 

ABSTRACT
Dermatophytosis is common skin fungal infection. It is becoming resistant and occurring recurrently due irrational use of antifungal ointments used by common population.  But in Homoeopathic literature there has been mentioned many medicines having good results in dermatophytosis. This study was conducted to know how effectively and rapidly Homoeopathic medicines cure the itching and lesion. 

Aim: – to study the efficacy of Homoeopathic medicines for the treatment of dermatophytosis.

Objectives: – to see the changes occurring in itching and patch.

Methods: – This study was carried out in Bharati Vidyapeeth Homoeopathic Hospital OPD and peripheral OPD. Cases presenting clinically in different colors with round patch having raised border, fine scales which subdue centrally and spreads peripherally were included for this study. 30 cases satisfying the case definition and inclusion and exclusion criteria were studied with informal experiment before and after without control study design for a time period of one and half year.

Criteria for assessment: – this was done on the basis of following criteria – GOOD – If itching and lesion resolves within 8 weeks after starting of treatment. MODERATE– If itching and lesion resolves within 12 weeks after starting of treatment. POOR – If itching and lesion does not resolve after starting of treatment for a period of 12 weeks. 

Statistical analysis: – it was done by applying paired t test.

Result: – Homoeopathic medicines are efficacious in treatment of dermatophytosis.

Conclusion: – This study has been able to fulfill aim and objectives of the study. 11 cases had shown good results, 14 moderate and 5cases showed poor result.

KEYWORDS:- Homoeopathic medicines, treatment, dermatophytosis

INTRODUCTION
Dermatophytosis is common skin fungal infection which is caused by keratinophilic fungi which affects skin, nails and hairs². It clinically presents as a patch of various colours having scales and having reddish papules, small vesicles and little pustules on the margin of lesion which progress on periphery and subdue in the center producing ring like shape.¹

In India, due to tropical environmental conditions, there is higher prevalence of dermatophytosis in India. But incidence of dermatophytosis varies in different parts of India because of different environmental conditions in India. The prevalence of dermatophytes has increased since few years due to unhygienic conditions among people living in crowded damp places, patients having systemic clinical conditions like diabetes mellitus, hiv and among patients who un-rationally use antifungal drugs directly taking from pharmacy shops without approaching qualified physician which is not only making the condition very common in India, but also making it more difficult to cure also.

Adults are more commonly affected age group. Males are more commonly affected than females. The factor which predispose for dermatophytosis are sweating, obesity, diabetes mellitus, working in places with high temperature, wearing damp clothes in humid weather, sharing personal clothes with infected person.¹

Distribution-

• Tinea cruris- involve upper thigh
• Tinea corporis- involves whole body except palms, soles and scalp
• Tinea barbae- beard area affected
• Tinea capitis- scalp is affected
• Tinea mannum- hands are involved
• Tinea pedis- feet are affected
• Tinea unguinum- nails are affected

MATERIALS AND METHODS

STUDY SETUP:-This study was carried out in Bharati Vidyapeeth Homoeopathic Hospital OPD, IPD and peripheral OPD.

CASE DEFINITION :-Cases which presented as a patch of various colours having scales and having reddish papules, small vesicles and little pustules on the margin of lesion which progress on periphery and subdue in the center producing ring like shape of age group 15-60 years of both sexes were taken for this study.

INCLUSION CRITERIA: 

1.All cases fulfilling the case definition were taken.

2.Cases of age group 15-60 years of both sexes were taken.

3.Patients who were willing to join research and co-operated with regular follow ups after willingly signing the consent for participation in research project about which the details were explained to the patient.  

EXCLUSION CRITERIA:

1.Cases not fulfilling case definition.

2.Cases of age group below 15 and above 60 was not taken.

3.Cases having dermatophytosis along with other skin diseases like psoriasis, eczema, atopic dermatitis, acne etc. were not taken for the study.

4.Cases presenting with diabetes mellitus, and immunocompromised states malnutrition, pregnancy and other systemic illnesses were not taken.

DIAGNOSIS: Diagnosis was made on clinical basis.

STUDY DESIGN: 30 cases satisfying the case definition and inclusion and exclusion criteria were studied with informal experiment before and after without control study design for a time period of one and half year. Patients diagnosed as dermatophytosis were selected for the study by simple random sampling technique.

CRITERIA FOR ASSESSMENT: this was done on the basis of following criteria –

1. GOOD – If itching and lesion resolves within 8 weeks after starting of treatment.
2. MODERATE– If itching and lesion resolves within 12 weeks after starting of treatment.
3. POOR – If itching and lesion does not resolve after starting of treatment for a period of 12 weeks.

OBSERVATION AND RESULT
This study was conducted for a period of one and half year in Bharati Vidyapeeth Deemed University Homoeopathic Medical College and Hospital for a time period of one and half year. Only 30 patients qualifying case definition, inclusion and exclusion criteria were selected for the study. For this study data presentation has been done in the form of diagrams and tables for age distribution, sex distribution, most common type and medicine prescribed in cases. Data has been analyzed by using t test at level of significance of 0.05 and 0.01.

STATISTICAL DATA ANALYSIS TO SEE THE EFFECT ON ITCHING:-
For this data analysis has been done by considering itching as x variable as 1 for the presence of itching before treatment started and y variable as 0 (if itching is not present) and 1 (if itching is present) after completion of treatment given.

Calculated value at n-1 degrees of freedom is 12.011. As this value is greater than critical t value at 0.05(2.045) and at 0.01(2.756) at 29 degrees of freedom. Hence, null hypothesis is rejected.

STATISTICAL DATA ANALYSIS TO SEE THE EFFECT ON PATCH:-
For this data analysis has been done by considering patch as x variable as 1 for the presence of patch before treatment started and y variable as 0 (if patch not is present) and 1 (if patch is present) after completion of treatment given.

Calculated value at n-1 degrees of freedom is 10.7816. As this value is greater than critical t value at 0.05(2.045) and at 0.01(2.756) at 29 degrees of freedom. Hence, null hypothesis is rejected.

INFERENCE:- As both the analysis showed significant difference at high levels of degrees of freedom at 0.05 and 0.01. Hence, null hypothesis has been rejected.

DISCUSSION
For this study 30 cases qualifying case definition, inclusion and exclusion criteria and who completed the study with regular five follow ups were selected for the study. These cases have been studied for various factors contributing to the study. After this study it has been proved by statistical results that Homoeopathic medicines have been effective in treatment of dermatophytosis. Sulphur has been observed to work well to reduce the itching as compared to other medicines like Bacillinum, Sepia, Arsenic Album. It was observed that other medicines like Calc carb, Nat mur are also effective. In this study medicines were given on the basis totality of symptoms  Most of cases required moderate potency and single dose. But, in some cases where there was requirement of repetition to ameliorate the itching then repetition had been done. In no case any kind of external application was used to ameliorate the symptoms as most of the cases responded well to the medicines administered orally. Out of 30 cases, 11 cases showed good response, 14 cases showed moderate response and 5 cases showed poor response to treatment.

In this study most of the patients are of young age group as 21 patients are of age group between 15- 30 and 9 cases come under age group of 30-60. In this study 18 patients are male and 12 patients are females which show the more occurrence of disease in males. In this study 6 patients are those who suffered from tinea corporis and tinea cruris, 17 patients are those who suffered from tinea corporis, 5 patients are of tinea cruris, and 1 patient is of tinea barbae and 1 of tinea pedis which shows that tinea corporis is the most common type. During this study time period I have been not able to register a case suffering from tinea mannum, tinea capitis and tinea unguinum which shows their fewer occurrences. It has been observed that most of the patients belong to low socio economic strata but there are few patients who belong to good socio economic strata and there are patients who maintaining good hygienic conditions but still suffering from the disease. So it had been considered that in those cases underlying cause might be miasm. So, in those cases anti miasmatic medicines were given according to symptom similarity. Most commonly used antimiasmatic medicines used in this study according to symptom similarity were Bacillinum, Tuberculinum and Sulphur. 21 cases presented with psoric miasm and 9 cases presented with tubercular miasm. So this study does not correlate with what Dr Burnett has said that dermatophytosis is purely tubercular miasm.

Along with medicinal treatment patients were advised to maintain proper hygiene by changing and washing their clothes regularly, not to wear wet clothes, wearing clothes only after proper drying of skin, not to share their clothes with anyone else in the family, to dry their clothes under direct sunlight, to wear clothes only after proper ironing their clothes. It was found in this study that patients who followed proper instructions for follow ups, and maintained proper hygiene and those who have not taken any prior allopathic treatment responded very rapidly to the treatment and got cured within short period after starting the treatment.

There are some limitations of this study. Time period for this study was only one and half year. In that period of time it cannot be concluded that recurrence of dermatophytes has been reduced as most commonly cases are seen during rainy and wet humid weather. For that cases need to be followed further for longer duration. There is need of further study related to miasm as this study do not qualify the statement of Dr Burnett of claiming that dermatophytosis is a tubercular miasmatic disease.

CONCLUSION

The main points of the study related to result, findings and limitations of study have been mentioned:-

1. This study has proved that Homoeopathic medicines are effective in treatment of dermatophytosis.
2. Sulphur is the remedy that has acted very well to reduce itching in most of the cases.
3. It is not necessary to give any kind of external application to ameliorate the external symptoms as medicines administered orally are more effective.
4. Medicines which have been given on the basis of current totality are more effective than therapeutic prescriptions.
5. Limitation- time period is only one and half year. We cannot find recurrence of symptoms in one and half year

REFERENCES

1. Skin Diseases and Sexually Transmitted Infections by Dr Uday Khopkar, sixth edition, page no. 54-58
2. Dermatological Diseases a practical approach by Venkataram Mysore, S. Sacchidanand, K H Satyanarayana Rao, second edition, page no. 161-165
3. Principle and Practice of Homoeopathy by M L Dhawale, 4^th revised and enlarged edition, page no- 362-366

Dr Uma Bharti MD(Hom) Scholar
Under guidance of Dr M.A.Nerlekar[M.D.(Hom.)]
Bharati Vidyapeeth Deemed University,
Homoeopathic Medical College And Hospital
Department Of Postgraduate & Research Centre,
Dhankawadi – Katraj, Pune-411043
Email : ubharti8@gmail.com