Venous stasis dermatitis and homeopathy – a case report

Dr Meenukrishna S

ABSTRACT
Stasis dermatitis commonly occurs in older age. It is caused by venous hypertension resulting from retrograde flow due to incompetent venous valves, valve destruction, or obstruction of the venous system. Homeopathic medicines are effective in treating venous stasis dermatitis without any complications. In this article, homeopathic treatment for venous stasis dermatitis is explained through a case.

KEY WORDS: VENOUS STASIS DERMATITIS, HOMEOPATHIC TREATMENT, LACHESIS

INTRODUCTION:
Stasis dermatitis (SD)—also known as venous eczema, stasis eczema, venous stasis dermatitis, or gravitational dermatitis— is a common inflammatory dermatitis of the lower extremities that occurs in individuals with venous insufficiency. Increased capillary pressure with subsequent compromise of endothelial integrity in the microvasculature results in fibrin leakage, and disruption of the epithelial barrier function results in local inflammation. Stasis dermatitis occurs most commonly on the shins but can also affect other areas with chronic oedema, itching, scaling.

A 68 year old female reported to the outpatient Government homoeopathic medical hospital, Bangalore. She presented with complaint of reddish eruption with itching   in the medial aspect of left leg since 3months

CASE HISTORY
Patient started noticing blackish discolouration and itching in the left leg 1 year ago, then it gradually progressed to reddish eruption with swelling and peeling of skin. There is burning type of pain which is more in the night due to which her sleep is disturbed. Also there is itching which is more after scratching, better after warm application and coconut oil. She had Allopathic and Ayurvedic medicine for the same, but no relief. There is no history of contact with any irritants, fever, weight loss.

Past history: Nothing significant

PERSONAL HISTORY:

• Diet: mixed
• Appetite: good, no hunger intolerance
• Thirst: normal
• Desire: spicy 2+
• Aversion: nil
• Bowel / bladder habit:  normal
•  Sleep: good
• Dreams: Unremembered
• Perspiration: generalized
• Thermal sate:  more towards hot

GENERAL PHYSICAL EXAMINATION

• Moderately built and moderately nourished
• Weight : 62 kg, height: 155cm BMI:25.8
•  Vital signs were normal
• Well oriented with time, place, person
• No signs of pallor, clubbing, icterus, cyanosis, lymphadenoathy,

LOCAL EXAMINATION

• Pitting pedeal odema on left leg
• Reddish eruption on lateral aspect of leg
• Scaling of the skin
• Warmth on affected part
• No discharge

INVESTIGATIONS

VENOUS DOPPLER STUDY OF LEFT LOWER LIMB

• Patent deep veins of the left lower limb, no thrombosis
• Saphenofemoral incompetence
• Superficial varicosities and incompetent perforators in left leg along GSV

TOTALITY OF SYMPTOMS

• Burning pain in the left leg  < night
• Itching in the left leg < night. > warmth
• Side affinity: left
• Varicose veins

Prescription :
Lachesis 200( 1 dose) was prescribed on basis of symptom similarity with reference to materia medica.

Follow up

2/6/2020

• Burning , itching , redness reduced
• Sleep –good
• All other generals –good
• Rx- pl

20/7/20

• Burning  pain in the leg< night
• Itching present < night
• Redness reduced- Lach 1M ( 1 dose)

4/8/20

• Burning, itching reduced
• No new symptoms, all generals good
• Rx- placebo

5/10/20

• Burning reduced no itching,
• Redness reduced, feeling better
• No new symptoms
• Rx : placebo

CONCLUSION
Stasis dermatitis is a cutaneous manifestation of venous hypertension that commonly occurs in elderly patients with underlying venous insufficiency. SD is characterized by poorly demarcated erythematous and eczematous patches and plaques of the lower legs, classically involving the medial malleolus. The characteristic features are inflammatory oedema, papules, scaling, crusting, erosions, pigmented stippled with recent and old haemorrhages. This case report shows the efficacy of individualized homeopathic medicines in the case of venous stasis dermatitis. On the basis of patient’s presenting symptoms and on referring to materia medica, Lachesis were administered and showed marked improvement in the follow up.

REFERENCES

1. Sundaresan S, Migden MR, Silapunt S. Stasis dermatitis: pathophysiology, evaluation, and management. American Journal of Clinical Dermatology. 2017 Jun;18(3):383-90.
2. Rzepecki AK, Blasiak R. Stasis Dermatitis: Differentiation from Other Common Causes of Lower Leg Inflammation and Management Strategies. Current Geriatrics Reports. 2018 Dec;7(4):222-7.
3. Das KK. Textbook of Medicine: Two Volume Set. JP Medical Ltd; 2017 Sep 30.

Dr Meenukrishna S
PG scholar MD PART II
Department of Materia Medica
Government Homoeopathic medical college and hospital, Bengaluru

Under the guidance
Dr Renuka S patil
Professor  & HOD,Department of Materia Medica
Government Homoeopathic medical college and hospital, Bengaluru

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