ABSTRACT:
Eczema is a skin condition characterized by surface inflammation. Emollients and topical steroids are used in conventional medicine to treat it. I am presenting the case of a 17- year-old male patient with eczema over the chest and abdomen, who was treated with the homoeopathic medicine, Calcarea carbonicum (cal. Carb) without the aid of emollients and steroids. It is clearly apparent from this evidence- based case report that calc. carb has a positive role in the treatment of eczema. This finding can provide the basis for conducting large scale studies with different study designs regarding the treatment of eczema with calc. carb medicine.
KEYWORDS: Eczema, homoeopathy, case report, calc. carb.
INTRODUCTION:
Eczema is a type of superficial skin irritation that is characterized by redness, itching, edema, vesicles, oozing, crusting, scaling, and occasional lichenification. [5] Though atopic dermatitis is frequently referred to by the term “Eczema,” these two terms are interchangeable. The most typical kind of dermatitis is atopic.[2] Based on the patient’s presenting symptoms, eczema is diagnosed clinically. Avoiding contact with irritants and using emollients on a regular basis are mainstays of eczema therapy. Topical steroids are utilized in conventional therapy, yet relapses are highly frequent. [1] Suppressed eruptions should always be treated with homoeopathic individualized medicine because, in accordance with homoeopathic principles, they invariably result in deeper disease.[6] There are many medicines in the homoeopathic repertory [7,8] and material medica [9] for the treatment of eczema; the remedy prescribed is based primarily on the presenting symptoms of the patient. Here, a case of eczema that was treated with the calc. carb medicine.
TYPES OF DERMATITIS/ECZEMA: [2]
1.Atopic dermatitis
2.Contact dermatitis
3.Seborrheic dermatitis
4.Numular eczema
5.Photosensitive eczema
6.Dyshidrotic eczema [2]
AETIOLOGY OF ECZEMA: [2]
Contacts with various agents may give rise to eczema. These are either caused by primary irritants or may be secondary allergens.
Primary irritants such as acids, alkalis, etc.
Secondary allergens such as penicillin, streptomycin, lipstick, nail varnish, hair dyes, plants or flowers.
Other factors such as genetic, dietetic i.e., egg, fish and milk and exacerbating factors (heat, humidity, dryness) also plays important role in developing eczema.
CLINICAL FEATURES: [2]
In acute stage of eczema- there is erythema which is soon followed by vesicles which is intensely itching in character.
Gradually exudates are dried up and crust are formed
But in chronic stage- skin become thickened and pigmented.
DIAGNOSIS: [4]
1) Physical examination: Examination of skin should take place in a well-illuminated room with patient completely disrobed.
2) Skin biopsy
3) Potassium hydroxide preparation
4) Tzanck preparation
5) Diascopy
6) Wood’s light examination
7) Patch tests
MANAGEMENT: [3]
In case of eczema management is most important part such as: –
- Avoiding irritants and allergens: Use of cotton clothes and beddings covers, families should be advised not to keep cats or dogs. Swimming can also worsen dermatitis because of irritant effect of chlorine.
- Emollients and washing: Regular bathing to remove skin debris and crusts. Soap should be avoided. Only glycerin soap should be used.
- Non-steroidal topical therapies.
- Adjunct therapy etc.
ACTION OF CALC. CARB IN ECZEMA: – [9]
Calc. carb is a great Hahnemannian antipsoric constitutional remedy. it’s chief action in the vegetative sphere, impaired nutrition being the keynote of its action:the glands, skin and bones are very marked. It’s action on the glands, skin and bones being instrumental in the changes wrought. In cal. Carb general and local perspiration is prominent. Scrofulous constitution who take cold easily with increase mucoid secretions, children who grow fat, are large bellied with large head, pale skin, chalky look. Crave eggs and indigestible thing. Cal. carb patient look is fair, fatty and flabby. Mentally cal. Carb patient is forgetful, confused, low spirited. A jagged state, mental or physical due to overwork. Aversion to work or mental exertion. Much perspiration from head wet the pillow far around. Dryness of tongue aggravated at night. Sour eructation, sour vomiting is marked. Petechial eruption, eruption better in cold air
Modalities of calc. carb: – worse from mental and physical exertion, moist air, wet weather,
During full moon, standing.
Better from dry climate, scratching, lying on painful side.
CASE REPORT:
A case of 17-year-old male came in outpatient department(OPD) of R.B.T.S GOVT. HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL MUZAFFARPUR, BIHAR on 13/09/2023 with complaints of reddish itching eruption on the right side of chest, lower abdomen since last 2 months itching aggravated early morning when he is on his bed, patient feels better from scratching after scratching watery discharge and burning occur on that parts.
PHYSICAL GENERALS:
Appetite- Good
Thirst – 2-3L/Day
Tongue – Dryness mostly at night
Desire – Salty food, BOILED EGG
Thermal reaction – Chilly
Perspiration- Profuse mostly from scalp during sleep
Stool – Constipation sometime with hard stool, bowel regular
Urine – Clear
MENTAL GENERALS:
Patient does not want to do mental exertion
Always anxiety about his future
Sad feeling about his health
Does not remembered about his work
APPEARANCE OF THE PATIENT: Patient look is fatty and flabby.
ANALYSIS AND EVALUATION OF SYMPTOMS:
| S.NO. | SYMPTOMS | RUBRICS | ANALYSIS | EVALUATION | MIASM |
| 1. | Patient does not want to do mental exertion | Mind – mental exertion- aggravation | Mental general | ++ | PSORA |
| 2. | Always anxiety about his future | Mind – anxiety – future about | Mental general | ++ | PSORA |
| 3. | Sad feeling about his health | Mind – despair- health of | Mental general | ++ | PSORA |
| 4. | Does not remembered about his work | Mind – forgetful – mental exertion – from | Mental general | ++ | SYCOTIC |
| 5. | Reddish eruption on the skin | Skin – eruption – red | Particular | +++ | SYCOTIC |
| 6. | Itching eruption on skin aggravated early morning when he is on bed | Skin – itching- morning bed aggravation in | Particular | +++ | PSORA |
| 7. | Itching eruption on skin ameliorated by scratching | Skin – itching- scratching- amelioration | Particular | +++ | PSORA |
| 8. | Much perspiration on scalp during sleep | Head – perspiration- of scalp- sleep aggravation, during | Particular | +++ | PSORO-SYCOTIC |
| 9. | Desire boiled egg | General – food and drink- egg desire, hard boiled | Physical general | +++ | PSORA |
| 10. | Thermal reaction- chilly | General – heat – lack of vital heat | Physical general | +++ | PSORA |
REPERTORISATION BY SYNTHESIS REPERTORY:
REPERTORIAL ANALYSIS:
1.CALC. CARB – 24/10
2. SULPHUR – 15/8
3. SEPIA – 14/7
4. RHUS TOX – 13/7
5. CAUSTICUM – 12/7
Repertorisation was done by synthesis repertory. After Repertorisation calc. carb cover the maximum number of rubrics and gain highest marks. Then after contacting with homoeopathic materia medica of various author, calc. carb was prescribed.
THERAPEUTIC INTERVENTION: –
After case taking on a standard case taking Performa, totality of symptoms was built for the patient based on mental generals, physical generals, constitution, miasmatic background, family history etc. as per the homoeopathic principles.
After Repertorisation, the top medicines were calc. carb, Sulphur, sepia, rhus-tox, causticum. After carefully analyzing the mental and physical generals of patient, considering the reportorial result and referring back to homoeopathic materia medica similimum was prescribed. Individualized homoeopathic treatment was started with Cal. Carb. 200/ 2 dose early morning in empty stomach for 2days which is followed by saclac.
PRESCRIPTION: –
RX- 1) CALC. CARB 200/2DOSE
4 GLOBULES ( no.30) X 2DAYS EARLY MORNING.
2) SAC LAC 200/ 1 DRANCHUM
4 GLOBULES ( no.30) X BD
1ST VISIT:-
BEFORE TREATMENT (DATE- 13/09/2023)
FOLLOW UP CHART:
| DATE OF VISIT | CHANGES IN PATIENT | PRESCRIPTION |
27/09/2023 | Mentally patient feels better, Marked improvement in the itching and eruption.No new eruption had appeared. | SAC LAC 200/ 1 DRANCHUM 4 GLOBULES X BD |
11/10/2023 | Condition of the patient much better than previous visit. Itching ameliorated much. No new eruption. | SAC LAC 200/ 1 DRANCHUM 4 GLOBULES X BD |
25/10/2023 | Itching eruption almost relieved from all parts. Patient feel good. No new complaints of patient. | SAC LAC 200/ 1 DRANCHUM 4 GLOBULES X BD |
15/11/2023 | Now normal skin of patient, patient feel very good. No complaints from patient side. | SAC LAC 200/ 1 DRANCHUM 4 GLOBULES X BD |
DURING TREATMENT:
2ND VISIT ( 27/09/2023)
DURING TREATMENT:
3RD VISIT (11/10/2023)
DURING TREATMENT:
4TH VISIT (25/10/2023)
DISCUSSION AND CONCLUSION:
This case study demonstrates the effectiveness of homoeopathic medicine using calcarea carbonicum in the treatment of dermatitis. According to the materia medica, the patient’s presenting symptoms guided the selection of repertorization calcarea carb; no local application was employed by the patient during treatment. Administration of calcarea carb in this case shows marked improvement in the follow up. Hence cal. Carb shows good effect on eczema. However, this is a single case report of cal. Carb, and further large studies with different study designs and large sample sizes are required for determining the efficacy of cal. Carb and other cal. Gr. Of medicine in different- different cases.
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[Google Scholar]ABOUT THE AUTHOR: –
1.Dr. Sarita Kumari, PGT; R.B.T.S. GOVT. Homoeopathic Medical College and Hospital
Muzaffarpur, Bihar.
2. Dr. Shamim Alam, M.D.(Hom.) Associate Professor & H.O.D. Dept. of community medicine, R.B.T.S.
GOVT. Homoeopathic Medical College and Hospital Muzaffarpur.
