EVIDENCE BASED CLINICAL STUDY ON VITILIGO

About the Author:

Dr. Nishanth Kumar Srivastava

Dr. Nishanth Kumar Srivastava

DR.NISHANT KUMAR SRIVASTAVA

  • H.M.S (Pune),
  • D (Hom) Repertory,
  • PhD (Scholar, Materia Medica) Homoeopathy University , Jaipur
  • HONORARY GUEST LECTURER –Solan Homoeopathic Medical College, Solan (H.P).
  • P.T.C, D.S.H.M.C (Pune)
  • Institute of Clinical Research (Pune)
  • G.D.E.M.S, Symbiosis College (Pune).

RECEPIENT:

  • Hemant Kumar Baneerjee National Award 2015
  • Homoeo Friends Hahnemann Award 2013
  • Personality Award 2004 at Bharati Vidyapeeth Homoeopathic Medical College Pune.

MEMBER:

  • Life Member- Asian Homoeopathic Medical League
  • Member LIGA Homoeopathica Internationalis
  • Life Member and Patron – Homoeo friends
  • Homoeopathic Medical Association of India.
  • Homoeo Friends- Patron since 2008.

ADVISOR:

HOMOEO FRIENDS SWASTHA PATRIKA

CONSULTANT:

  • National Institute of Public Cooperation & Child Development, Ministry of Women and Child Development, Govt of India, Lucknow, U.P.
  • State Bank of India, Lucknow, P
  • HONORARY GUEST LECTURER –Solan Homoeopathic Medical College, Solan (H.P).
  • TATA MOTORS, Lucknow (U.P)
  • Ex- Consultant- Gaurang Clinic & Center for Homoeopathic Research

Contact Details:

MAILING ADDRESS:- HD- 196, SECTOR –I,   PRABHAT CHAURAHA JANKIPURAM, LUCKNOW, UTTAR PRADESH,    PIN CODE – 226021

CLINIC:– GEETANJALI HOMEOPATHIC CLINIC & RESEARCH CENTER

ADDRESS ADARSH COMPLEX, LGF – 69, 70, 71, 79

ENGGINEERING COLLEGE CHAURAHA, JANKIPURAM, LUCKNOW

CLINIC 0522-2730500, Residence 0522-2731077

MOBILE– 9044711111, 9956007700

WEBSITEwww.drnishant.com

E-mail:  dr.nishantkumar@gmail.com

ABSTRACT

A total of 150 well diagnosed cases of Vitiligo were registered for treatment at Geetanjali Homoeopathic Clinic & Research Center Lucknow from October 2008 to November 2012. Clinical diagnosis followed by constitutional treatment with homoeopathic medicines showed amazing results in majority of cases. Out of 150 cases 65 cases showed complete repigmentation of all the white patches while 35 cases showed improvement in few patches and rest 30 cases did not show any response to the treatment. 20 cases worsened after treatment in which increment in size and number of white patches was observed. Duration of treatment varied from case to case depending on the size and number of the white patches and response of the patient. In depth case taking was done in each and every case on holistic principle giving more emphasis on causation and mental symptoms. The outcome of this study is very encouraging which gives new dimensions and confidence to young Homoeopaths in treatment of Vitiligo by Hahnemaanian principles of minimum dose and minimum repetition.

INTRODUCTION

Vitiligo is a condition that causes depigmentation of parts of skin. It occurs when melanocytes, the cells responsible for skin pigmentation, die or are unable to function. The cause of vitiligo is unknown, but research suggests that it may arise from autoimmune, genetic, stress or viral causes. The incidence worldwide is less than 1%.The most common form is non-segmental vitiligo, which tends to appear in symmetric patches, sometimes over large areas of the body.

melanin

Prevalence & Incidence

About 0.5 to 1 percent of the world’s population, or as many as 65 million people, have vitiligo. Half the people who have vitiligo develop it before age 20. Most develop it before 40years of age. The disorder affects both sexes and all races equal, however it is more noticeable in people with dark skin.

Vitiligo seems to be somewhat more common in people with certain autoimmune diseases, including hyperthyroidism (an overactive thyroid gland), adrenocortical insufficiency (the adrenal gland does not produce enough of the hormone called corticosteroid), alopecia areata (patches of baldness), and pernicious anemia (a low level of red blood cells caused by the failure of the body to absorb vitamin B12).

Vitiligo may also be hereditary; that is, it can run in families. Children whose parents have the disorder are more likely to develop vitiligo. In fact, 30 percent of people with vitiligo have a family member with the disease. However, only 5 to 7 percent of children will get vitiligo even if a parent has it, and most people with vitiligo do not have a family history of the disorder. 

IMG_1079

Precipitating Factors:

  • Emotional Crisis – Death in family, Loss of job, Sudden shock etc. Acute Stress may be followed by fast spreading type of vitiligo proving the theory of Troponeurosis. Emotional crisis may be an additional factor
  • Gastro intestinal tract disorders like Worms, Jaundice, amoebiasis etc.
  • Prolonged use of Drugs, antibiotics, Oral an ovulating agents etc.
  • Local causes like trauma, burns exposure to chemicals etc.
  • Pathologically: – A defect in enzyme Tyrosinase is held responsible for vitiligo. According to some Dermatologists, it is a Trophoneurosis and Melatonin, a substance secreted at nerve endings inhibits Tyrosinase, thus interfering in pigment formation.
  • An Endocrinal disorder may be operative; Diabetes, Pernicious anaemia, Thyrotoxicosis, Myxoedema, and Addison’s disease may be associated with vitiligo.
  • Trauma or Local irritations caused by wearing the sari or Trousers too tightly do produce vitiligo in individuals predisposed to it.

Differential diagnosis

Conditions with similar symptoms include:

  • Pityriasis alba
  • Tuberceloid Leprosy
  • Post inflammatory hypo pigmentation
  • Tinea versicolor
  • Albinism
  • Idiopathic guttate hypomelanosis
  • Progressive macular hypomelanosis
  • Primary Adrenal Insufficiency 

MODEL CASE-1

Name: Miss Sandhya Verma

Registration No: S – 220

Age: 18 yrs.

Gender: Female

Occupation: student

Date of First Consultation: 12.03.2012

CHIEF COMPLAINT:

A girl aged 16 was suffering from white discoloration of the skin on face since 8 years. The lesion appeared on her right upper lip and gradually had spread right cheek.

The lesions are well defined with lines and the borders with brown areas of demarcation. The affected areas were white, milky in color.

complaint

ASSOCIATED COMPLAINT

 Headache < sun exposure with tendency to catch cold easily.

 Past history

  • Had been vaccinated for all communicable disease.
  • Had chicken pox when seven years old.
  • H/o Trauma to left feet, wound treated with allopathic medicines.
  • H/o Honey bee bite when five years old.

 Family history

  • Family history of bronchial asthma, Hypertension.
  • No Familial diathesis for vitiligo.
  • Mother had uterine complaints

Physical general

  • Complexion- wheatish
  • Stature – Thin
  • Appetite – Normal
  • Thirst – Normal
  • Stool – Regular
  • Urine – Normal
  • Sweat – Normal
  • Sleep – Normal
  • Desires – Salty food
  • Food Type – Non- Veg / veg

IMG

Mental General:

Childhood of the patient was very troublesome as her father’s died at an early age of 10 in a road accident. This incidence shook her deeply as she was very close to her father emotionally. After her father’s death her mother got the job of her father. Patient has been loner since her childhood as she lacked emotional support. She was  highly introvert in nature  and would never share her feeling with anyone not even with her mother and her siblings. She did not have any friends. This prolonged grief made her very irritable and if anyone tried to sympathize with her she did not like it. Patient was very emotional and slightest of things use to depress her and she continued thinking about the same since very long. 

RUBRICS FOR REPERTORISATION 

  • A/f death of loved one
  • Grief
  • Sentimental+
  • Sensitive++-music-to
  • Company-aversion-for++
  • Anger-talk-indisposed
  • Anger-consoled-when
  • Dwells-on-past-disagreeable-memories
  • Discoloration-face

REPERTORY  USED:

  • Synthesis Repertory
  • Murphy’s Repertory

repertory

Selection of Drug:

Natrum Mur- 1M

Selection of Potency:

Following are the reasons of selecting a high potency like 1M in this particular case.

  • Syphilitic miasm are predominant miasms in this case
  • Presence of characteristic mental symptoms
  • Young age of patient

First Prescription            –                      12.03.2012

Natrum Mur 1m, one dose and Placebo for 30 days.

Follow Up – 1                     –                       10.05.2012

Pigmentation starts appearing on upper lip.
R/x

Placebo for 15 days.

 Follow Up – 2                   –                       08.07.20012

Upper lip almost totally re-pigmented

Pigmentation on right cheek started

Gradual improving mental symptoms observed in this case and patient was less introverted .
R/x
Sac lac for 30 days

Follow Up – 3                    –                      08.08.2012

 Pigmentation on upper lip completed

Cheeks much better.

Sadness and nervousness diminished to much lesser degree.

R/x
Sac lac for 30 days

 Follow up – 4                  –                     10 .10 .2012

 Patient is much better

Total  repigmentation on upper lip has taken place

Patient is still under treatment as slight pigmentation on cheeks is left .

R/x

      Sac lac for 15 days

1st initial  picture/ before treatment

1st initial  picture/ before treatment

2nd pic

2nd pic

3rd pic

3rd pic

CONCLUSION

  • The overall impact of this evidence based scientific study is encouraging. It reveals that homoeopathic drugs have definite action on melanocytic cells which starts reproducing melanin resulting in repigmentation in white spots.
  • The period of treatment varies according to the area and chronicity of the disease & individual response of the patient.
  • Vitiligo can be reduced and cured permanently with suitable Homoeopathic drugs..
  • Homoeopathic drugs are cost effective and easy to take having no side effects.
  • The recurrence rate after homoeopathic treatment in vitiligo is nil or very less.