A Case Study of Vitiligo with Homoeopathic Treatment According to Individualistic Approach

Abstract – Vitiligo is an autoimmune condition with a familial predisposition, characterized by:- depigmented patches with irregular borders, often with white hair (leucotrichia) in older lesions.- koebner’s phenomenon, where new lesions appear at sites of skin trauma, especially during active phases.lesions can occur anywhere, but often appear on pressure points.two main patterns: segmental (limited to one area) and non-segmental (widespread), including subtypes like focal, generalized, universal, acrofacial, and mucosal.

Homeopathic View Point 

Vitiligo as a reflection of inner imbalance.Vitiligo is seen as a manifestation of an underlying emotional, mental, or spiritual imbalance.

The condition is believed to be a reflection of the individual’s inner state, revealing a deeper disharmony.

Key-word : vitiligo, autoimmune disease, homeopathy.

Definition: Vitiligo is an acquired condition affecting 1% of the population worldwide. Focal loss of melanocytes results in the development of patches of hypopigmentation. A positive family history of vitiligo is relatively common in those with extensive disease, and this type is also associated with other autoimmune diseases. Trauma and sunburn may (through the köbner phenomenon) precipitate the appearance of vitiligo. It is thought to be the result of cell-mediated autoimmune destruction of melanocytes but why some areas are targeted and others are spared is unclear.

Etiology:

Exact etiology of vitiligo is not known and different patterns of vitiligo may have different pathogenesis. 

Genetic: Genetic factors are definitely important, since 20% of patients have a positive family history. Inheritance may be polygenic.

Autoimmune hypothesis: Evidence which points to an autoimmune etiology includes: frequent association with other autoimmune disorders like alopecia areata and thyroid disorders. Presence of antibodies to melanocytes. Presence of lymphocytes in early lesions.

Neurogenic hypothesis: Segmental vitiligo is present along a dermatome in distribution of nerves, suggesting a neurogenic origin. It has been hypothesized that a toxin, which destroys melanocytes, is released at the nerve endings.

Epidemiology 

Vitiligo can affect anyone, regardless of age, gender, or ethnicity, but it’s more noticeable in people with darker skin tones.

Age: Vitiligo can occur at any age, but most cases appear between 20-40 years old.

Gender: Slightly more women are affected than men (55-60% women, 40-45% men).

 Ethnicity: Vitiligo affects all ethnic groups, but it’s more prevalent in certain populations, such as:

    – Indians (2-5%)

    – Africans (1-3%)

    – Middle Easterners (1-2%)

– Hispanics (0.5-1.5%)

Clinical features 

Characterized by depigmented macules, which are chalky or milky white. Sometimes, pigment loss is partial  and occasionally, three shades (trichrome) are seen in the same lesion—depigmented center, surrounded by a hypopigmented rim, which in turn has normal pigmented skin around it . Macules have a scalloped outline and form geographical patterns on fusion with neighboring lesions . Hair in the lesions may remain pigmented, though in the older lesions the hairs may lose their pigment (leucotrichia).

Sites : Lesions can occur in any part of the body. Areas subjected to repeated friction and trauma are frequently affected, e.g., the dorsal aspect of hands and feet, elbows, and knees

Associations- Vitiligo may be associated with a number of diseases.

Cutaneous disorders: Alopecia areata, halo nevus , atopic dermatitis, malignant melanoma, and morphea.

Endocrine disorders: Diabetes mellitus, pernicious anemia, Addison’s disease, hypoparathyroidism, hypothyroidism, and hyperthyroidism.

Homeopathic Management

Constitutional susceptibility: Homeopaths consider vitiligo patients to have a specific constitutional susceptibility, making them prone to this condition. This susceptibility is linked to the individual’s unique characteristics, personality traits, and emotional patterns.

Miasmic perspective: Vitiligo is sometimes viewed as a manifestation of the “psora” miasm, characterized by a tendency towards suppression, fragmentation, and disconnection.the “sycotic” miasm, marked by a tendency towards overgrowth, excess, and turmoil, may also be associated with vitiligo.

Emotional and mental connections: Vitiligo is often linked to emotional and mental factors, such as:

  – Stress, anxiety, and trauma

  – Low self-esteem, self-worth, and confidence

  – Fear of being noticed, judged, or rejected

  – Difficulty expressing emotions and feelings

Individualized Homeopathic Approach

• Treatment focuses on understanding the individual’s unique experiences, emotions, and characteristics.
• Homeopaths select remedies based on the patient’s distinct symptoms, personality, and constitutional type.
• The goal is to address the underlying imbalance, promoting emotional, mental, and spiritual harmony, and encouraging the body’s natural healing processes.

Some Common Homeopathic Remedies

Arsenicum album (for anxiety, insecurity, and fear of rejection)

Calcarea carbonica (for emotional vulnerability, sensitivity, and fear of being hurt)

Graphites (for emotional numbness, detachment, and skin dryness)

Natrum muriaticum (for emotional suppression, grief, and skin dryness)

Sepia (for emotional exhaustion, detachment, and hormonal imbalances)

Case summary

Identification of the patient

A 35 year old female mrs xyz  resident of Karond, Bhopal visited in Government Homoeopathic Medical College and Hospital Bhopal

Presenting complaints 

Presented with vitiligo patches on her forehead for the past 5 years . She experienced emotional stress, anxiety and sleep disturbances. She is concerned about the security , protection , routine , safety , task and shelter .The main concern is about lacking formation , maintaining or losing the structure .

• White patches on the skin , gradually increasing in size
• Emotional stress, anxiety and irritability
• Sleep disturbances, insomnia, and vivid dreams 
• Digestive issues, bloating and flatulence 
• Menstrual irregularities, heavy bleeding and cramps 

History of presenting complaints 

Duration – since 5 year

Mode of onset- gradual 

Probable cause – not known 

Past history

Nothing significant found

Family history

Not significant 

Personal history 

Occupation – housewife

Generalities 

Physical generals–

General modalities-most of the complaint aggravated in hot and dry weather, gastric derangement after cold fruits, ice cream

Thermal reaction-chilly 

Appetite – good 

Thirst –small quantity in small interval, moderate 3- 4 liter a day 

Desire – fried food 

Tongue- clean 

Salivation – moderate 

Bowel habit – gastric derangement after cold fruits, ice-creams, habitual diarrhea 

Urine –clear 

Sleep – disturbed

Dreams – not specific 

Menstrual history –

LMP- 10-07-2023

Quantity- profuse, 4-5 days earlier than due date

Character- more of watery

Color- bright red

Odor- offensive smell occasionally

Any discharge- no abnormal discharge

Obstetric history-

G3 P2 L2 A1

One spontaneous abortion of 2 weeks, 2 live child FTND, both children are healthy.

Mental generals 

She is anxious about money & the future of her family. Impatient, always in a hurry, sometimes making the wrong decision in a hurry.

Fearful of being alone at home.

Short tempered, get irritated easily.

Physical Examination

• Appearance pale, dark complexion, his vital signs were normal.

• Clinical findings: red scratchy scabs over back, nape of neck.

Analysis and Evaluation of Symptoms-

Mental generals-  Anxious about her money and protection future, melancholic temperament.3+

Physical generals- Thirst for small quantity at small intervals, desire fried food, menses profuse and painful, disturbed sleep, vivid dreams2+

Particulars- white spots over forehead, digestive troubles after eating ice cream, cold fruits 3+.

Repertorial analysis:

Mind –anxiety

Mind – irritability

Mind- confusion of mind

Mind- fear alone of being

Mind- impatience

Mind- loathing life

Sleep- disturbed

Sleep- dreams vivid 

Abdomen- flatulence

Abdomen- distension

Genitalia female- menses, copious

Genitalia female- menses, painful,

Skin- discoloration, white

Face- discoloration, white spots