A Case of Eczema with Blackish Discoloration of Skin Cured With Natrum Muriaticum

ABSTRACT

Eczema is a very common skin condition characterized by itchiness, rashes and dry skin and dry patches. 

It is mostly chronic in nature and difficult to cure.  Conventional treatment involves use of anti-inflammatory drugs, histamines, corticosteroids and immune suppressant drugs along with a never ending list of topical steroids and moisturizers which only palliate.

Cure can only be brought by appropriately selected Homoeopathic remedy selected based on homoeopathic principles (Mentals in this case) as advocated by our great master Dr Samuel Hahnemann.

KEYWORDS: Eczema, Dermatitis, Dryness, Skin, Itching, Natrum Muriaticum, Homoeopathy

INTRODUCTION

Eczema is a skin condition involving the skin with symptoms like dry, itchy and inflamed and red skin. It is also commonly known as dermatitis, meaning inflammation of the skin.

Based on the clinical presentation of the skin symptoms, eczema or dermatitis can be categorized in to various sub categories.

They can be 

1.Atopic Dermatitis: Characterized by very dry itchy and red skin. Person with these conditions might have associated allergies to external allergens like various food stuffs, chemicals and odors etc.

Figure 1.

2.Seborrheic Dermatitis: Characterized by itchy and dry scalp with flaky dandruff associated with dermatitis patches on other areas of skin.

Figure 2.

3.Nummular Dermatitis: This type is characterized by coin shaped rashes.These rashes are similar to urticarial rashes.

Figure 3

.

The above-mentioned categories fall in the “Dry Eczema” Category. 

4.Pustular Dermatitis or “WET” Eczema

Another type can be “wet” presentation of eczema which has pus or fluid filled eruptions along with itchy and inflamed skin.

Figure 4.

DIFFERENTIAL DIAGNOSIS

1.Atopic Dermatitis/Nummular Dermatitis-

Dermatitis can both allergic/non allergic in nature. These conditions have redness associated wit dryness and excessive itchiness. Can occur on folds or flexures of the skin.

2.Urticaria-Urticaria is an allergic reaction caused in response to an external allergen which is characterized by wheel like lesions (similar to nummular eczema). The allergen can be a foods, chemical, plants, perfumes, and certain medicines too.

But urticaria can also be associated with swelling of the affected area. Also, there is more of redness of the lesion and dryness of skin is not present as in case of dermatitis/eczema.

CASE PRESENTATION

Presenting Complaints:

1. A female aged 50 years presented with blackish discoloration of the area above the elbows and shin bones since 4 years in October 2021 at my private clinic in Meerut. 
2. The blackish discolorations were superimposed with round white scaly patches which aggravated mainly in winters. 
3. There was also excessive dryness of the skin with scaliness all over the body. However, there was no itching. 

History of Presenting Complaints:

The discoloration patches developed gradually over a period of 4 years which were initially small in size and later converted into bigger dimensions.

Initially patient hesitated to give any more details as she was shy to talk to and came from rural area.

But later in the case, it was known from the relatives that she was living in her parental house even after marriage, as her husband and in laws had disowned her. The reason being that she could not conceive a child. Also presently her husband also was no more in this world. He died 2 years back in an accident.

Past History: Jaundice 10 years back.

Family History: No history of skin diseases

Mother: Diabetic

Maternal Grandmother: Died of Heart Attack.

Physical Appearance: Dark complexioned and dirty looking skin. She was always gloomy looking and had a sad look on her face.

Menstrual History: Menstruation Stopped 4 years back.

Treatment History: Took allopathic medicines, but lesions kept coming back after medicines were stopped.

Physical Generals:

Thermals: Chilly patient 1+

Appetite: Average

Thirst: Decreased Thirst

Desire: Salty things

Aversion: No specific Aversions

Sleep: Disturbed, Not refreshing

Stool: Normal

Urine: Normal

Perspiration: Scanty

Mental Generals:

1.Depressed: Firstly, was depressed that life was not fair to her. 

2.Ailments from grief: The lesions worsened after her husband’s death Constantly remembered him.

3.Brooding: Always thought of her future as was dependent on brother for her living.

4.Supression of Desires/Reserved Displeasure: Could not speak much wither relatives as felt was a liability on them Could not express her true self.

5.Cried when alone.

Physical Examination:

Weight: 50kg

Height :5 feet

Bp: 120/80 mm hg

Pulse: 80/minute

Systemic Examination: No abnormalities found

Diagnosis: Dry Eczema

Totality of Symptoms

Initially only physical symptoms of the skin symptoms was taken into consideration as patient did not reveal more symptoms .The symptoms considered were:

1.Excessive dryness of skin

2.Scaly patches

3.Dirty Looking skin

On the above symptoms initially Graphites and Petroleum was selected and prescribe

But later when the full picture of the case was received and made clear the following symptoms build up the totality of the case:

1. Depressed
2. Ailments from Grief
3. Brooding/ Excessive thinking/sycosis
4. Cried when alone
5. Whitish nature of patches
6. Desire for salty things

Based on the above symptoms Natrum Muriaticum was selected as the Constitutional Remedy of the case.

Repertorisation Sheet

Repertorisation Sheet – Zomeo Pro
Physician Name : Dr. Neha kakkar  , Patient Name :Asha Khatri,Age:50 yrs                Date : 10th/Feb/202
Remedy	Nat-m	Calc	Con	Verat	Sulph	Lach	Caust	Nit-ac	Ars	Puls	Graph	Ign	Phos	Lyc	Ph-ac
Totality	33	30	27	27	27	26	25	25	25	25	24	24	23	22	22
Symptoms Covered	11	10	11	10	8	9	11	11	9	9	9	8	10	9	9
[Complete ] [Skin]Dryness:	3	4	2	3	4	4	3	3	4	3	4	2	4	4	3
[Knerr ] [Outer Head]Eruption(undefined):Eczema:Dry, patches of exfoliated thin, furfuraceous scales, with itching:	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
[Complete ] [Eyes]Discoloration:	4	4	4	4	4	4	3	3	4	4	4	4	4	3	4
[Complete ] [Extremities]Discoloration:Spots:Lower limbs:	1	4	3	0	3	3	1	1	3	1	3	0	1	1	1
[Kent ] [Skin]Discoloration:Pale:	2	3	2	3	3	0	1	3	2	3	1	1	2	3	1
[Kent ] [Mind]Grief:Ailments, from:	3	0	1	1	0	3	3	1	1	2	2	3	0	1	3
[Complete ] [Mind]Grief:Ailments from, agg.:	4	3	3	3	3	4	4	3	4	4	3	4	3	4	4
[Complete ] [Mind]Brooding:	4	2	3	3	3	1	1	2	1	3	1	4	1	1	3
[Boenning ] [Mind]Meditation, reflection, brooding, etc.:	0	0	0	0	0	3	0	0	0	0	0	0	0	0	0
[Miasms ] [Obesity]STOMACH:Desires:Salty things:	3	2	2	3	0	0	2	2	0	0	0	0	2	0	0
[Boenning ] [Appetite]Desire for:Salty things:	4	2	2	3	0	0	2	2	0	0	0	0	2	0	0
[Kent ] [Mind]Sadness, mental depression:	3	3	2	3	3	3	3	3	3	3	3	3	2	3	2
[Boenning ] [Mind]Depression:	2	3	3	1	4	1	2	2	3	2	3	3	2	2	1

Follow Up of the case

Date	Symptoms presented	Prescription
10 Oct 2021	Blackish discoloration on shin bones and above elbows along with superimposed whitish dry patches. Dirty Looking skin	Graphites 200 BD dose for 15 days
25 oct 2021	Similar complaints, dryness reduced.No relief in dry patches and discolorations.	Graphites 200 BD and Petroleum 200 BD dose for15 days
Nov 2021	Dryness reduced. Dry patches better by 20 per cent.No improvement in discoloration	Graphites 200 and petroleum 200, both BD for 1month
Dec 2021	Dry patches reduced by 30 per cent.Dryness very much better.No improvement in discoloration.	Graphites 200 BD /1month Petroleum 200 BD/1 month
Jan 2022	Patches better by 40 percent.	Graphites 200 BD/1 monthPetroleum 200 BD/1 month
Feb 2022	Reappearance of dry patches Dryness better.No improvement in discolouration	Case again re-evaluated on basis of mental symptoms as procured from the patient’s relatives.NatrumMuraticum selected  NatrumMur 200 OD / 15 days Sac lac BD/15 days
25th FEB 2022	No relief in dry patches,Dryness of skin better No improvement in discolouration	Again Natrum mur 200 OD dose for 5 days along with saclac prescribed
March 2022	Aggravation in dry patches No improvement in discoloration	Sac lac BD /1 month
April 2022	30 per cent relief in dry patches.Dryness is much relieved,No improvement in pigmentation	Natrum Mur OD dose /15 days followed bySac Lac 200 OD for 15 days
May 2022	50 per cent relief in dry patches,Slight improvement in discoloration.	Repetition of previous prescription
Same treatment was given for 3 months i.e. Natrum Mur 200 OD dose for 15 day followed by Sac Lac 200 BD Dose for 15 days
August 2022	80 per cent relief in dry patches.50 per cent improvement in discoloration.	Same treatment repeated
Sep 2022	Recurrence of patches on the shin area	Natrum Mur 1M one dose /weekly followed by Sacrum Lactis  Prescription for 15 days
30th Sep 2022	No further improvement in new patches	Natrum Mur 1M repeated BD dose /weekly followed by Sac Lac for 15 days.
Oct 2022	20 per cent relief in dry patches	Sac Lac prescribed BD dose for 1 month.
Nov 2022	50 percent relief in dry patches, no dryness of skin even in wintersDiscoloration better by 30 per cent	Natrum Mur 1M Od dose/weekly followed by Sac Lac BD dose for 1 month.
Dec 2022	No further relief in Symptoms.	Natrum Mur 10 M single dose followed By Sac Lac BD dose for 1 month
Jan 2023	80 percent better in dry patches, but no further relief in discoloration	Sac Lac BD dose /1 month Berberis Aquifolium mother tincture 25 drops once daily in warm water for 1 month
Feb 2023	No new dry patches Better in discoloration by 50 percent	Sac Lac BD dose for 1 month
March 2023	No new Dry patches, Discoloration  better by 60 percent	Sac Lac BD dose continued for 3 months
June 2023	No new dry patches Discoloration better by 80 percent.Sometimes complains of itching.	Sac lac 200 continued till date.

The patient came to me Last on 15th October.

She had no new patches ,discoloration is  very much better .Some discoloration still left but she has stopped the medicine and is happy with the result.

Conclusion 

Remedies selected on local symptoms only give temporary relief and does not bring permanent cure.

Remedies prescribed based on mentals are more appropriate and bring about permanent cure of the disease as advocated by Dr Hahnemann in Aphorisms 211 to 230.

       References

1. Homoeopathic Materia Medica by William Boericke, M.D.
2. Allen’s Keynote 
3. Homoeopathic Repertory by William Boericke, M.D.
4. Boger Boenninghausen’s Characteristics & REPERTORY, C.M. Boger
5. Organon Of Medicine, Samuel Hahnemann.
6. Homoeopathic Software: Zomeo Pro 

After 12 months medicine

After 18 months medicine