Abstract
Introduction: Warts are generally firm, skin colour papules of various sizes, typically on hands and feet. Warts are caused by a viral infection, specifically by the Human Papillomavirus (HPV) and are contagious by contact with the skin of an infected person. Clinically, the lesions are asymptomatic and manifest in different forms, have irregular verrucous surface and keep on growing slowly.
Material and methods: Two cases are presented here, who were prescribed considering the totality of symptoms and character of eruptions. Both the cases were followed up regularly and did not show any reoccurrence of warts till date.
Conclusion: Warts are the expression of deranged vitality reflected on skin and must not be treated as local or regional maladies. A well selected suitable remedy is required to cure the disease in its whole extent. Homeopathy is a unique system of medicine which deals with the disease in a holistic manner and at the root.
Introduction
Warts (also known as a verruca when occurring on the sole of the foot or on toes) are generally firm, skin colour papules of various sizes, typically on hands and feet but often other locations, which can resemble a cauliflower or a solid blister. Warts are caused by a viral infection, specifically by Human Papillomavirus (HPV) and are contagious by contact with the skin of an infected person. A tiny cut or scratch in the epidermis of any area is more vulnerable to warts. They have low infectivity; therefore, a casual contact with an infected individual is unlikely to result in the disease. Clinically, lesions are asymptomatic and manifest in different forms, have irregular verrucous surface and keep on growing slowly. Individuals with depressed cell mediated immunity due to treatment with immunosupressive drugs, Hodgkin’s disease, malignant lymphomas and lymphocytic leukaemia are likely to have large number of warts.
Types
A range of types of warts have been identified, varying in shape and site affected, as well as the type of human papillomavirus involved. These include:
- Common Wart (Verruca Vulgaris): A firm skin coloured papule of various sizes with roughened surface, most common on the dorsum of hands and fingers.
- Plain Wart (Verruca Plana): A smooth flat topped, flesh-coloured wart, which can occur in large numbers; most common on the face, neck and hands especially in children.
- Filiform or Digitate Wart: Thread or finger-like projections, irregular surface, most common on the face, especially near the eyelids, lips and scalp.
- Plantar Wart (Verruca Pedis): This is occasionally a painful wart found on any part of the sole. This should not be confused with corn which has a smooth surface and is continuous with the surrounding skin of the sole.
- Genital Wart (Venereal Wart, Condyloma Acuminatum, Verruca Acuminata): A wart that occurs on genitalia and is usually transmitted through sexual exposure.
- Periungual Wart: A cauliflower-like cluster of warts that occur around the nails.
Case Study
Case 1
A female aged 50 years reported on 23.04.2010 with a complaint of papular eruptions on the left feet for past one and half years. The examination of the feet yielded the following information:
· Multiple eruptions on the extensor surface of left feet
· Papular eruptions with irregular surface, tiny to pea size, but not more than 1cm
· Soft, non-itchy eruptions
· History of bleeding from warts 2-3 months back
Other associated complaints which were not told by the patient as presenting complaints:
· Occasional unsatisfactory stools
· Episodes of indigestion
Past History: Patient took allopathic treatment for the wart for 2-3 months initially, but without any relief. There is no other history of any severe illness, operations or accidents etc.
Family History: No family history of any systemic illness, autoimmune disorders, surgeries etc.
Gynaecological and Obstetrics History: Patient attained menopause two years back. She has two daughters both of which were born by Full term normal vaginal delivery (FTNVD) and are alive and apparently well.
Physical Generals: Desires for fried and fatty food, chilly, mild sensitivity to sunlight. All other physical generals were within normal limits.
Mental Generals: Patient was irritable, unhappy and an obstinate person complaining all the time about the disease. She told that she is unable to forget and forgive people who have offended her. She is reluctant to take any suggestions regarding her home or children from anybody. She also gets furious if someone contradicts her. There is no apparent history of suppression of emotions.
Case Analysis: Following symptoms were taken into consideration for prescription in this case:
· Vindictive in character
· Obstinate personality
· Irritable
· Desire for fried and fatty food
· Soft warts with history of bleeding
Prescription: On the basis of these symptoms and signs ‘Acidum nitricum’ was prescribed. Symptoms were verified from materia medica before final prescription. Initial prescription was one dose of ‘Acidum nitricum’ 30 daily for one month. The details of prescription and follow up are given below:
First visit on April 23, 2010: Acidum Nitricum 30 one dose of 04 pills, globule size 30, empty stomach in the morning. The patient was asked to report every month or wherever there is change and/or appearance and disappearance of symptoms.
Second visit on May 25, 2010: The patient reported that her eruptions had started drying and there is mild itching on those dried eruptions. There was no other complaint. Patient was prescribed placebo and advised to report after one month (or earlier in case there is any change or appearance of new symptoms). Patient was also advised to apply coconut oil in case there is itching and was discouraged to apply anything of medicinal properties (ointments etc)
Third visit on June 26, 2010: The patient reported that all her eruptions disappeared and only mild pigmentation at the site of eruptions is left. There is no local itching or discharge. Patient was prescribed placebo for one month and advised to report back if eruptions re-appeared. She was advised to apply coconut oil at the pigmented site.
Result: No reoccurrence of eruptions till date.
Case 2
A male aged 26 years reported on 29.08.10 with the following complaints:
- Tiny warts on right upper eyelid, below right eye-brow and a big eruption on right side of forehead for the past six months
- Eruptions gradually increasing in size and number
- History of bleeding from eruptions
- Surface rough to touch
Past history: There is no history of any severe illness, operations, accidents etc.
Family history: Mother is hypothyroid, there is no family history of any other systemic illness, autoimmune disorders or surgeries etc.
Physical generals: Nothing specific
Mental generals: Patient was worried because of eruptions (for cosmetic reasons). Otherwise, he was sympathetic and mild in nature.
Case Analysis: Following symptoms were taken into consideration for prescription in this case:
- Sympathetic
- Warts on face
- Large easily bleeding warts
Prescription: Considering the totality of symptoms and patient as a whole, he was prescribed Causticum 30, one dose (of 04 pills), daily for 15 days and asked to report after 15 days. Symptoms were verified from materia medica before final prescription.
Before treatment
Follow up: Patient was followed up every 15 days to one month. Patient was prescribed placebo on subsequent visits and there was gradual disappearance of eruptions. During the course of treatment, no new or other eruptions appeared. The patient is still under observation on monthly follow ups.
After treatment
Discussion and Conclusion
There are many remedies for treating warts; most of these drugs are prescribed on the basis of constitution. Few indications of common remedies are given below:
- Thuja is a drug of choice for all type of warts on any part of the body. It is being used locally in the form of mother tincture and orally in different potencies.
- Antim-crud is found effective in painful plantar warts
- Calc carb can be used for the warts over face, arms and hands
- Causticum can be given in any type of wart but the usual location is on finger tips or areas around the finger nails, face, near eyebrows etc which are rough to touch
- Staphsygaria is useful for cauliflower like pedunculated dry warts present on genitals
- Dulcamara is useful for plain or common warts
- Nitric acid can be given for filliform warts, common warts or any type of warts which bleeds easily on washing
- Ruta is useful in flat smooth warts with or without pain
Although above mentioned indications are keynotes to warty eruptions, but it is seen in practice that a well selected suitable constitutional remedy is required to deal with individual as a whole in a holistic manner. (Aphorism 5)
Thus we can conclude that:
- Warts are the expression of deranged vitality reflected on skin and should not be treated as local or regional maladies. They have been considered as local maladies and treated accordingly with suppressive applications. They may disappear in months but may take years and can recur.
- A well selected suitable remedy is required to cure the disease in its whole extent
- Homeopathy is a unique system of medicine which deals with the disease in a holistic manner.
Source: Homeobuzz
