A Case Of Psoriasis & Lichen Planus

Words: Dr Naveen Kumar BOGGARAPU 

AR [59] presented with palmoplantar psoriasis, a condition that had stayed put for 5-6 years. He complained of severe itching, dryness, scaling with deep cracks in the affected areas. He had taken conventional treatment, but it had only [in his words] provided transitory respite. His symptoms, he reported, occurred the moment the medications were stopped.

Palmoplantar psoriasis refers to psoriasis that develops on the palms of the hands and soles of the feet. The symptoms are: recurring skin rash on the palms and soles, small red patches on the skin that leisurely expand and become scaly with plaques, silvery scales, pain, inflammation and/or itching, cracked skin, bleeding from scratching, emotional distress, difficulty in walking, and while performing manual tasks involving the hands.

AR’s wife reported that AJ, who just ‘loved’ salt, kept a ‘tight control’ on his emotions. This, she believed, led to his sullenness and self-dejectedness. Despite a desire for company and of being independent and strong, AR felt increasingly awkward in social situations and isolated himself to avoid being ‘uneasy.’

I put him on the homeopathy remedy, Natrum muriaticum 200C, as a ‘constitutional’ remedy, based on AJ’s presenting and other symptoms, and Mezereum 6C, as a ‘specific.’ His itching and scaling reduced considerably in about six months with tangible relief of symptoms emerging after 24 months of treatment.

Lichen Planus

KM [43] presented with papulovesicular lesions on her shin and dorsum of foot with intolerable itching. Her condition had bothered her, oft and on, for 3-4 years. It was diagnosed as lichen planus with eczematisation. She had tried multiple therapies with no great results.

She appeared to be calm and she graciously answered all my questions during our detailed case-taking. However, she seemed to be tight-lipped about her personal life and other issues that often help us to prescribe the most suitable homeopathic remedy.

All the same, I prescribed her Arsenicum album 200C as a first remedy. There was a noticeable change in her behaviour during follow-up, a few weeks later. She now began to slowly recount several events from her life, viz., stern parenting, her temperamental mood swings and tentativeness. She also effortlessly moved from a rather excited state to a weepy disposition, at the drop of a thought, during our conversation.

Lichen planus [LP] is a chronic, recurrent inflammatory skin disorder. The cause is unknown; it is said to be triggered by a certain autoimmune response with a peculiar initial ‘prompt.’ The rash is categorised by small, flat-topped, many-sided [polygonal] bumps that can grow together into rough, scaly plaques on the skin.

The name lichen planus originates for its similitude to a plant called ‘lichen’ which grows on rocks and tree barks, while ‘planus’ is the Latin word for ‘flat.’ My analysis into KM’s behaviour, her medical history and presenting symptoms led me to prescribe Pulsatilla nigricans 200C — a classical homeopathic remedy for mood swings and other symptoms that she presented with. Her eruptions responded to treatment awfully slowly; but, it worked because she was extremely patient and willing to wait.

It ought to be mentioned that temperament and behaviour patterns of the patient, in cases such as this, are imperative in prescribing the most appropriate homeopathy remedy.

Dr NAVEEN KUMAR BOGGARAPU, BHMS, PG Fellow in Homeopathic Dermatology [FCHD], is a Hyderabad-based senior homeopathic physician with a vast clinical experience of 20+ years. A former regional head of a chain of homeopathic clinics in corporate homeopathy, Dr Kumar has a certificate programme in homeopathic paediatrics too. He has participated and presented papers in several homeopathic medical conferences across India.

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