Eczema Treated By “Kalium Arsenicosum”: A Case Report

Abstract

Eczema is a reaction pattern in which skin forms blisters, becomes inflamed, crusty, thick, scaly, and pigmented. The aetiology is still unknown. Eczema causes itching, scratching, and burning and it may occur for long period of duration. Homoeopathy has a great role in treatment of eczema. A 47-year old male came with a complaint of severe itching on back. The case was recorded and studied thoroughly. After repertorisation, on the basis of individualisation, Kalium arsenicosum was prescribed. The aim of article is to show the effectiveness of Kalium arsenicosum in cases of eczema.

Abbreviations

Kalium arsenicosum– Kali. ars. Arsenicum album- Ars. alb. Psora- P. Sycosis- Sy. Syphilis- Syp. Latent psora- Lt. P. Latent sycosis- Lt. Sy. Latent syphilis- Lt. Syp. history of – H/o, 1 dose – 1D, thrice a day – TDS.

Keywords: eczema, Kalium arsenicosum, allergy, homoeopathy.

Introduction

The term ‘eczema’ means ‘to boil out’ (ec = out; zema = boil), because it seems that the skin is ‘boiling out’ or ‘oozing out’ in eczema.¹ The term ‘eczema’ and ‘dermatitis’ are synonymous.¹ Patients usually use the term eczema to denote any skin disease which is chronic.¹ They sometime use the term ‘allergy’ as well.¹ Eczema is a reaction pattern¹, it can be acute or chronic and there are several causes.² It is diagnosed clinically on the basis of patient’s presenting complaints.² Acutely, epidermal oedema (spongiosis) and intra-epidermal vesiculation (producing multilocular blisters) predominate, whereas with chronicity, there is more epidermal thickening (acanthosis) with pronounced skin markings, secondary to chronic rubbing and scratching.² Vasodilation and T-cell lymphocytic infiltration of the upper dermis also occur.²

Many medicines are very popular in the treatment of eczema like Arsenicum album, Rhus toxicodendron, Petroleum, Belladonna, etc. But Kalium or Potassium is one of the important minerals which is present in blood plasma as well as in all tissues which causes great disturbance in the circulation of fluids in the tissues⁴ and which also act as a complexion cleaner⁶. Although Arsenicum album run parallel in the repertorial chart but Kalium arsenicosum was chosen. as it covers the mentals, as he was very fearful and very anxious about his health and heart diseases. Time modality was very marked, <1 a.m. to 3 a.m. and it is covered by only Kalium arsenicosum.

Case study

Mr. XYZ, 47 years old, came with the complaint of dry, scaly eruptions on back.

Presenting complaints

Patient was suffering from severe itching on back with dry, scaly skin for 2 years, which was aggravated by undressing and at night, scratching resulted in burning. While sitting, he seemed to be anxious, very restless and patient complained of sleep disturbance at night because of itching, especially between 1 a.m. to 3 a.m. He was unable to sleep again resulting in dullness and irritability whole day. Patient also complained of difficulty in respiration while walking fast.

History of presenting complaints

Patient had history of itching since 2 years on back. Itching started with minor eruptions and it was tolerable but it gradually increased day by day. He took allopathic medication and applied external application on eruptions which relieved and suppressed the complaints but as soon as he stopped the treatment itching appeared severely with eruptions covering the whole back with dry, scaly skin. Since 15 days, he was not using any external application but took allopathic medicine for itching before 5 days.

Past history

H/o chickenpox in childhood.

Family history

Father: 69 years old, healthy and alive and shopkeeper.

Mother: 67 years old, healthy and alive and housewife.

Constitution

Dark complexion with height of 179 cm and weighing 86 kg (BMI= 26.8 kg/m²– overweight)

Patient as a whole

Aversion: Non-vegetarian.

Appetite: 3-4 chapattis/meal; 2meal/day.

Thirst: 2-3 litres/day, took seasonal water.

Stool: Satisfactory and normal bowel habit.

Sweat: On whole body, on physical exertion.

Thermal reaction: Chilly⁺⁺

Mind: Patient was restless and anxious. Fear of his illness and while conversation patient asked that this disease will harm to heart because on walking fast he had difficulty in respiration.

Sleep: Disturbed because of itching.

Analysis of case

Mental generals: Restlessness and anxiety. Fear of his illness, fear of heart disease.

Physical generals: Chilly patient. Desire for sweet things.

Particulars: Itching on back causes burning, Itching <by undressing, at night. Eruptions are dry and scaly. Itching after midnight at 1-3 a.m.; difficulty in respiration on walking rapidly.

Evaluation of symptoms⁵:

Rubrics	P	Sy.	Syp.	Lt.P.	Lt.Sy.	Lt.Syp.
MIND-Restlessness, nervousness	1234
MIND- Anxiety	1		E
MIND- Health, about	123			4
MIND- Heart, disease of	12E
RESPIRATION- Difficult, on walking	12
STOMACH- Desires, sweets	234		4
SKIN- Itching	124
SKIN- Itching, burning	124
SKIN- Itching, undressing agg.	1
SKIN- Itching, night	124
SKIN- Eruptions, scaly	145
SKIN- Eruptions, dry	12

Synthesis Repertory was selected due to presence of mental symptoms and marked particulars.

Provisional diagnosis²

Eczema: severe itching, dry, scaly skin.

Miasmatic diagnosis⁵

Psora-syphilis

Repertorisation was done using RADAR 10.0 and the repertorial result is shown in [Table 1].

Table 1: Repertorisation chart⁸

Fig 2: Before treatment

Fig 2: After treatment

Intervention:

First prescription: On 12 april 2021, Kalium arsenicosum 30C/1D/stat.

Basis of prescription: Medicine selected on the basis of individualisation, symptom totality and in consultation with materia medica was Kalium arsenicosum. Furthermore, Kalium arsenicosum was chosen as it covers the totality of symptoms and the patient’s thermal reaction was chilly. Kalium arsenicosum 30C/1D/stat, was prescribed and on subsequent follow-ups, potency was changed based on the assessment of improvement in itching and eruptions. Kalium arsenicosum  is a deep and long acting remedy³.

Date	Symptoms	Prescription	Justification of potency and doses7
12/04/2021	Severe eruptions on backSevere itching in eruptions Dry, scaly skin on backRestlessness and anxiety about health.Disturbed sleep and fear of fatal disease.	Rx Kalium arsenicosum 30/1D/ stat Rubrum 30/TDS/7 days	Selected low potency due to low susceptibility.
19/04/2021	Slight relief in itching in eruptions.No improvement in eruptions.Patient seemed restless and anxious as well.	Rx Kalium arsenicosum 30/1D/ stat Rubrum 30/TDS/7 days	Repeated as used low potency
26/04/2021	Slight improvement in the state of well being.Improved sleep.Itching and eruptions was present but patient started feeling hopeful.	Rx Phytum 30/1D/ stat Rubrum 30/TDS/7 days	Medicine not given, as it left to act.
03/05/2021	No marked improvement seen.	Rx Kalium arsenicosum 200/1D/ stat Rubrum 30/TDS/15days	High potency given as no improvement noticed.
20/05/2021	Patient felt much relaxed regarding itching.Slight improvement in eruptions seen.	Rx Phytum 30/1D/ stat Rubrum 30/TDS/15days	Medicine not given, as it left to act
31/05/2021	No marked improvement in eruptions.Itching not much annoying but aggravates on undressing.Sleep doesn’t get disturbed due to itching at night.	Rx Kalium arsenicosum 200/1D/ stat Rubrum 30/TDS/15days	Potency repeated due stand still condition
14/06/2021	Slight improvement in eruptions.Improvement in sleep.Much relief in itching.	Rx Phytum 200/1D/ stat Rubrum 30/TDS/15days	Medicine not given, as it left to act
24/06/2021	Fever since 1 day, temp.- 101.2Frontal headache, dull aching pain over eyebrows.Dullness in whole body. Heaviness in eyes. Ame.-from closing eyes, lying down.No thirst, clean tongue.	Rx Gelsemium sempervirens 30/2D/ OD Rubrum 30/TDS/5days	Patient came with acute complaints so on acute totality medicine was prescribed
05/07/2021	Patient feels relaxed.Complaints got  stand-still.	Rx Kalium arsenicosum 1 M/1D/ stat Rubrum 30/TDS/30days	High potency used because of standstill of symptoms
03/08/2021	Started seeing significant improvement in eruptions.Relief in c/o itching.Improvement in scaly skin.	Rx Phytum 200/1D/ stat Rubrum 30/TDS/7days	Medicine not given, as it left to act
14/08/2021	Patient feels better but no significant improvement seen.	Rx Kalium arsenicosum 1 M/1D/ stat Rubrum 30/TDS/30days	Repeated potecy because no marked improvement seen
13/09/2021	Eruptions are much relieved.No complaint of itchingSkin started healing up, not that much dry and scaly.	Rx Phytum 200/1D/ stat Rubrum 30/TDS/15days	Medicine not given, as it left to act
29/09/2021	Complete disappearance of eruptions on back.	Rx Phytum 1M/1D/ stat Rubrum 30/TDS/15days	No complaints noticed and patient is towards cure
18/10/2021	Significant improvement in dryness and texture of skin on the back without any recurrence of new eruptions.	Rx Phytum 1M/1D/ stat Rubrum 30/TDS/30days	Patient is cure but on under observation with no eruptions seen.

Conclusion

With the individualisation of the case, Kalium arsenicosum was considered as the indicated remedy and it proved effectiveness in the treatment of eczema of the patient. According to patient narration, he is about 80-90% better and still under the treatment.

References

1. Khanna, N. Illustrated synopsis of dermatology and sexually transmitted diseases. 5th ed. New Delhi: Reed Elsevier India Pvt. Ltd, 2016,pp.188-194.)
2. Walker, B., Colledge, O., Ralston, S. and Penman, I. (2014). Davidson’s Pinciples& Practice of Medicine. 22nd ed. china: Elsevier Limited, pp.1290-1291
3. Kent, JT, Lectures on Homoeopathic Materia Medica: Together with Kent’s “New Remedies” Incorporated and Arranged in One Alphabetical Order, Available From- http://www.homeoint.org/books2/kentnewr/kalarsen.htm
4. Clarke, J.H., M.D., A Dictionary of Practical Materia Medica (2 volumes in 3; London: Homoeopathic Pub. Co., 1900-1902)
5. Patel, R.P., Chronic Miasms in Homoeopathy and their cure with Classification of their Rubrics/Symptoms in Dr. Kent’s Repertory (Repertory of Miasms)
6. Patil, J.D., MD (Hom.), Group Study in Homoeopathic Materia Medica, Pg. No.-350.
7. Dudgeon, RE. Organon of Medicine. 5^th edition: B jains Publishers; 2011
8. Schroyens, F. Synthesis Repertorium Homoeopathicum Syntheticum (9.1st ed). New Delhi: B. Jain Publishers Private Ltd 2008.

About Author:

1) Dr. Sonia Tuteja

Professor-Department of Materia Medica-Homoeopathy University,Jaipur.Ex-Associate Professor-Department of Materia Medica-Swasthya Kalyan Homoeopathic Medical College & research centre, Sitapura, Jaipur

2) Dr. Shivani Saini

PGR-Department of Materia Medica-Swasthya Kalyan Homoeopathic Medical College & research centre, Sitapura, Jaipur.