A Case Study on Homeopathic Management of Psoriasis:
An Alternative Treatment Approach
Department of Pharmacology, ROFEL, Shri G.M. Bilakhia College of Pharmacy,
RSRU, Vapi, Gujarat, 396191, India.
*Corresponding Author E-mail: poojagori7383@gmail.com
ABSTRACT:
The inflammatory skin illness known as psoriasis is a common and long-lasting one that is characterized by elevated, distinct, erythematous skin lesions of varying sizes, covered in silvery-white scales. Psoriasis has become more common in recent times. A variety of psoriasis varieties exist, Plaque psoriasis being one of them. It is rather common and affects the face, ears, scalp, trunk, and extremities. This case study highlights the effectiveness of homoeopathic medications in treating plaque psoriasis and highlights their importance in treating the condition. It poses significant challenges in management due to its complex etiology and varied clinical presentations. There is hyperproliferation of keratinocytes (which play a crucial role in protecting the skin and the underlying tissues from various external factors), meaning they multiply faster than normal. The patients exhibited symptoms such as dry, itchy, scaly, silvery-white patches, inflammation, redness, excessive itching, bleeding, and seasonal variations. Through a holistic approach, individualized homeopathic prescriptions, and regular follow- ups, significant improvements were observed in both cases. For the first case Nux Vomica 200 and Sulfur 200 were prescribed, while for the second case, Natrium Muriaticum 200 and Sulfur 200 were administered. Over subsequent visits, symptoms gradually diminished, leading to the eventual resolution of psoriatic lesions and associated health issues. The incorporation of dietary recommendations and lifestyle modifications further contributed to the overall well-being of the patients. These cases underscore the potential of homeopathy as a valuable therapeutic option for chronic plaque psoriasis, emphasizing personalized care and addressing underlying factors—further research is to validate these findings and explore the broader application of homeopathic medicine in dermatological care.
KEYWORDS: Plaque Psoriasis, Autoimmune condition, Nux Vomica, Natrium Muriaticum, Homeopathic medicines.
INTRODUCTION:
The word “Psoriasis” had been begun from a Greek word called as “psora,” which implies “itch,” “scurf,” or “rash”1,2. Psoriasis is a non-contagious skin condition with no known cause or definitive cure3.
In spite of the fact that the recurrence changes by range, it is around 2% (60 million individuals) all inclusive, and in India, it ranges from 0.44% to 2.8%4. A prevalence study shows psoriasis affects 0.91-8.5% of adults and 0-2.1% of children5. In psoriasis, there is hyperproliferation of keratinocytes (which play a crucial role in protecting the skin and the underlying tissues from various external factors), meaning they multiply faster than normal. This leads to the characteristic thickening of the skin and the formation of scaly patches seen in psoriatic lesions6,7.
Psoriasis is believed to be an autoimmune condition where the body’s immune system, specifically T cells, mistakenly attacks healthy skin. This triggers the rapid production of new skin cells, which then accumulate on the skin’s surface, forming red and inflamed patches called plaques8. It fundamentally influences the skin on the knees, intergluteal cleft, lumbosacral zones, scalp, glans penis, and elbow9.
It is a complex condition influenced by both genetic factors and the immune system. Stress is often the major cause or the trigger point for psoriasis, contributing to its development. There are many factors affecting: 1) Physical, chemical, infectious, and inflammatory causes. 2) Environmental factors-climate, lifestyle, and occupational exposures. 3) Infection-streptococcal infections. 4) Drugs- NSAIDs, corticosteroid withdrawal, lithium salts. 5) Metabolic factors-hormonal factors. 6) Psychological factors- stressful life10,11. Around 10% of people carry genes predisposing them to psoriasis, but only 1-3% develop it, often in families with a history of the disease. Additionally, cold weather, obesity, and deficiencies in folate and vitamin B12 can contribute to the condition12,13.
There are various types of psoriasis:
1. Plaque psoriasis-characterized by raised, red patches of skin covered with silvery-white scales that are dry and itchy.
2. Nail psoriasis-pitting, ridges, discoloration, thickening, and crumbling nails.
3. Guttate psoriasis-small, red scaling spots developed over the trunk, limbs, and scalp.
4. Inverse psoriasis-affects skin folds such as armpits, groin and under breast (as smooth red patches of inflamed skin)
5. Erythrodermic psoriasis-widespread redness, inflammation, and shedding of skin.
6. Pustular psoriasis-involves the formation of pus-filled blisters (pustules) surrounded by red, inflamed skin. Psoriatic arthritis is a type of inflammatory arthritis associated with psoriasis10,14.
The essential rule behind homeopathy is “like cures like”. In homeopathy, the treatment approach for conditions like psoriasis focuses on improving not only the external symptoms but also addressing any disturbances in the internal body. The treatment is selected on the individuals’ unique symptoms i.e. personalized medicine with minimal side effects, making it safe for all ages, and giving a long-term effect. Therefore, homeopathic treatment for psoriasis not only targets visible skin lesions but also works to promote overall well-being and long-term health15.
These are the various homeopathic remedies for Plaque Psoriasis which cure the dry, itchy, scaly, and inflamed patches: Arsenicum album, Graphites, Sulfur, Sepia, Rhus Toxicodendron, Calcarea carbonica, and Petroleum 1.
Figure 1: Pathophysiology of Plaque Psoriasis
[LL37-Cathelicidin antimicrobial, TLR7-Toll-like receptor 7, TLR8-Toll-like receptor 8, TLR9-Toll-like receptor 9, PDC-Plasmacytoid dendritic cell, MDC-Myeloid dendritic cell, VEGF-Vascular ethmoidal growth factor, IL17A-Interleukin 17A, IL17F-Interleukin 17F, IL- 12-Interleukin 12, IL23-Interleukin 23, INFα-Interferon α, INFγ-Interferon γ, Inos-Inducible nitric oxide synthase]
The patient had arrived at the clinic and given his/her permission for the doctors' treatment plan after having previously discussed it with his family and demonstrating his willingness. The patient had provided permission to exchange data such as vital signs, laboratory results, and imaging investigations, which would be published to update evidence-based treatment in the present situation. Here, we describe two cases of chronic plaque psoriasis that were managed with therapeutically chosen homeopathic remedies like Sulfur, Nux vomica 200 and Natrum Muriaticum 200.
Case Profile:
A 52-year-old male patient visited the clinic on 10/06/2023 presenting complaints as follows: Dry rough red patches on both elbows, back and on the scalp since the last15 years, at the initial stage it was only on the back and then developed in the further body parts. In the initial stage, it was only on the back and then developed in the further body parts. Presented with lesions on the skin due to itching, there was excessive itching and redness on the skin. Additionally, the presence of lesions resulting from scratching, excessive itching, and inflammation further supported the diagnosis of psoriasis. The itching was more during summer and burns after taking hot showers. The patient had gut issues daily which caused him to pass stool twice every morning. A patient appears normal with some fat around the abdomen. The patient explained sexually active but feels lethargy or lack of energy after coition. The patient had tried the allopathic treatment for the same with temporary relief in itching and a decrease in lesions, but the lesions reappeared after the medication was discontinued.
Personal History:
There is no history of skin complaints in the family members. The patient has borderline diabetes but has not initiated any medication for it, managing through dietary adjustments and a balanced lifestyle.
Lives in a elementary family where the business is jointly-owned. While there is stress revolving around due to the division of the family oriented-shops but does not bother him much.
Treatment and follow up:
On 10/06/2023, after assessment and diagnosis of plaque psoriasis patient was prescribed Nux Vomica 200 OD HS and Sulfur 200 OD in the morning for 15 days. The clinician also suggested avoiding packed food, maida, and packed fruit juice for 15 days. The patient was advised to include omega-3 fatty acid contained food like seeds-flax seeds and collagen-rich food.
The subsequent visits/follow-ups to monitor and make necessary adjustments to the treatment plan are outlined as follows in Table No. 1.
Case Profile: A 32-year-old female patient visited the clinic along with her father-in-law on 25/10/2023 presenting complaints as follows: The patient suffered from this condition for the last ten years after her first pregnancy. In the starting phase, it was only on the right heel and then developed in the other heel. The patient has previously tried various over-the-counter creams and ointments with limited success. She has tried allopathic treatment for the same with temporary relief in itching, and after some time, the patches and lesions reappear after the medication was discontinued.
Personal History:
There is no history of skin complaints in the family members. The patient does not have any pre-existing medical condition or disease. The patient tends to ruminate on negative remarks made by others, leading to feelings of overwhelm. She engages in solitary crying when these thoughts become overwhelming.
Assessment and Diagnosis:
Upon examination, the patient presented with dry and itchy silvery-white patches on both heels from the last 10 years. The itching aggravated from having pickles and papad, which causes inflammation and severe itching. There was also stiffness in heels and difficulty in walking. The patient reported exacerbation of itching during winters and experiencing the formation of pustular and hemorrhagic lesions observed at sites of cracks., consistent with the clinical presentation of plaque psoriasis with psoriatic arthritis affecting the heels. The patient also explained the indigestion and unsatisfactory bowel movement a few times a week. The patient also added that he was unable to digest sour things. He was obese, underconfident and not able to have refreshing sleep.
Treatment and follow up:
]After assessment and diagnosis, Natrium Muriaticum 200 OD HS and Sulfur 200 OD in the morning for 15 days were chosen as the appropriate homeopathic remedy for plaque psoriasis, also suggested avoiding pickle, papad, sour food, and packed food, maida, and packed fruit juice. It was prescribed on 10/10/2023 to target the totality of symptoms and address the patient’s specific constitution, to improve both the skin condition and overall health.
Advice-to include omega-3 fatty acid-containing food like seeds-flax seeds and collagen-rich food. Also, do stretching exercises for the calves and Achilles tendon to improve flexibility and reduce stiffness in the heels.
Table 1: Visits/follow ups and treatment plan for a 52-year-old male
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Sr. No. |
Date |
Symptoms |
Prescription |
|
1. |
10/06/2023 |
Dry rough red patches on both elbows Lesions on the skin Itching during hot showers and in summers Inflammation and bleeding Gut issues Feels lethargy |
Nux Vomica 200 OD HS Sulfur 200 OD in morning for 15 days |
|
2. |
26/06/2023 |
Itching reduced to 75% No burning sensation after hot showers Feels energetic and refreshing |
Nux Vomica 200 OD HS Sulfur 200 OD in morning for 15 days |
|
3. |
12/07/2023 |
Decrease in dry patches Lesions started disappearing |
Nux Vomica 200 OD HS Sulfur 200 OD in morning for 15 days |
|
4. |
27/07/2023 |
No dry red lesions on both elbows, back and on the scalp No itching Gut issues resolved and resolution of constipation Do not feel lethargy or lack of energy |
Plain almond oil for local application for 7 days |
|
Where OD- Once a day, HS- At bedtime |
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Table No.2: Visits/follow ups and treatment plan for a 32-year-old female.
|
Sr. No. |
Date |
Symptoms |
Prescription |
|
1. |
25/10/2023 |
Redness in the heels Itching and scaling on the heels Thick patches Aggravation of itching in the evening Bleeding and lesions observed at sites of cracks Mental health: overthinks a lot in a negative sense Difficulty while walking due to scaling Indigestion and unsatisfactory bowel movement |
Natrium Muriaticum 200 OD HS Sulfur 200 OD in morning for 15 days |
|
2. |
9/11/2023 |
Itching reduced to 65% Patches size was reduced to 50% Disappearing of lesions at the site of cracks Sleep-Feels energetic and refreshing Reduced difficulty in walking No complains of indigestion |
Natrium Muriaticum 200 OD HS Sulfur 200 OD in morning for 15 days Plain coconut oil for local application for 7 days |
|
3. |
23/11/2023 |
Decrease in dry patches Itching reduced to 75% Reduced weight No stiffness in heels |
Natrium Muriaticum 200 OD HS Sulfur 200 OD in morning for 15 days |
|
4. |
03/01/2024 |
No itching and scaling on both the heels Sleep-refreshing Reduced weight Gut health improved No difficulty in walking |
Plain coconut oil for local application for 7 days |
|
OD- Once a day; HS- At bedtime |
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The subsequent visits/follow-ups to monitor and make necessary adjustments to the treatment plan is outlined as follows in Table 2:
Throughout the treatment course, the patient demonstrated notable improvement, with symptoms such as dry, itchy, scaly, silvery-white patches, inflammation, redness, excessive itching, bleeding seasonal variations and other health issues gradually diminishing and ultimately resolving by the conclusion of the treatment regimen. The tailored combination of homeopathic medicines, aligned with the patient’s specific symptoms and response patterns, was pivotal in achieving this positive outcome mentioned in the figure below.
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Case Treatment outcome of 52-year-old male |
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Before Treatment |
After Treatment |
Figure 2: Treatment Outcome for Case 2 - 52-Year-Old Male
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Case 2: Treatment Outcome of 32 year old female |
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October 2023 |
November 2023 |
January 2024 |
Figure 3: Treatment Outcome for Case 2 - 32-Year-Old Male
In both cases, homeopathic treatment played a pivotal role in effectively managing chronic plaque psoriasis. Classical homeopathy investigates an individual's response to past genetic and epigenetic factors, whereas conventional medicine focuses on the control of skin inflammation and consequently generalizes the prescription to the diagnosis16. By targeting the totality of symptoms and considering the individual constitution of each patient, homeopathy provides personalized and holistic care. The gradual improvement observed in symptoms such as itching, scaling, inflammation, and bleeding highlights the therapeutic efficacy of homeopathic remedies17.
Additionally, the incorporation of dietary recommendations and lifestyle modifications further contributed to the overall well-being of the patients.
Pharmacology of the medicines used:
Nux Vomica 200 is a diluted, affordable, and widely available homeopathic remedy known for its effectiveness in treating both chronic and acute ailments with minimal effects. It has various proven pharmacological actions, including anti-alcoholism, anti-epileptic, anti-inflammatory, and antipyretic effects, declining migraine as well as impacts on sleep and behaviour. In psoriasis, it is believed to reduce skin inflammation and scaling by potentially regulating the production of inflammatory cytokines, and modulates the activity of immune cells, such as T cells and macrophages, by influencing their signalling pathways. One of its components, strychnine, acts as a central nervous stimulant by blocking inhibitory neurotransmitters like glycine, leading to increased alertness, reduced fatigue, and improved mood.
Sulfur is considered a versatile remedy in homeopathy, and its pharmacological actions may offer symptomatic relief and support the holistic management of psoriasis. It has various proven pharmacological actions, including anti-inflammatory and antipruritic (anti-itch) effects, as well as its ability to promote skin healing, modulate the immune system, and offer psychological benefits. It inhibits the production of pro-inflammatory cytokines, such as interleukins and tumour necrosis factor-alpha, which play key roles in the inflammatory response seen in psoriasis. Sulfur helps to dampen the immune response and decrease inflammation, resulting in a reduction of redness, swelling, and discomfort associated with psoriatic lesions. Its antipruritic effects also relieve itching, enhancing comfort for psoriasis patients.
Natrum Muriaticum 200, commonly known as Nat Mur, is a well-established homeopathic remedy derived from sodium chloride, or table salt. It has various proven pharmacological actions, regulating water balance, balancing emotional and psychological states, and stimulating healing processes. In psoriasis, it acts by maintaining optimal moisture levels, it helps prevent dryness, premature ageing, and other skin problems, promoting a healthy and radiant complexation. Natrum Muriaticum may help decrease stress and induce relaxation, potentially affecting stress hormone levels like cortisol, thus reducing inflammation linked to psoriasis flare-ups. It could also impact neurotransmitter levels such as serotonin and dopamine, leading to a more positive outlook, better-coping strategies, and fewer emotional triggers for psoriasis symptoms.
In conclusion, the presented case studies exemplify the significant role of homeopathy in effectively managing chronic plaque psoriasis. Through the selection of pharmacologically and therapeutically chosen homeopathic remedies such as Nux Vomica 200, Sulfur 200, and Natrum Muriaticum 200, tailored to each patient’s individual symptomatology and constitution, remarkable improvements were observed in symptoms such as dryness, itching, scaling, inflammation, and bleeding. The gradual improvement observed in symptoms throughout the treatment period emphasizes the effectiveness of homeopathy in psoriasis management. The prescribed remedies not only address inflammation and itching but also modulate the immune system and offer psychological benefits, Homeopathy promise in managing the chronic plaque psoriasis by stimulating the body’s innate healing mechanisms and addressing the underlying factor, the mechanisms of action of homeopathy in treating psoriasis.
We extend our deepest gratitude to the clinic for their invaluable support and guidance throughout this study. Our heartfelt thanks go to the patients who generously provide his consent to share experiences and allowed us to use their clinical data and images for this publication. We affirm that all necessary consents were diligently obtained. Special appreciation is also extended to ROFEL Shri G M Bilakhia College of Pharmacy for their unwavering support whenever required.
The authors declare no conflicts of interest regarding the publication of this article.
1. Dr. Dahat AB, Dr. Bansode S, and Dr. Pal S. Insight to psoriasis and homeopathic treatment. International Journal of Homoeopathic Sciences. 2021;5(4): 294–297.
2. Dethliya M, Jain NK. Formulation and Evaluation of Nanogel used for the Treatment of Psorasis. Research Journal of Pharmaceutical Dosage Forms and Technology. 2023; 15(1): 19-4.
3. Sharma MC, Sharma M. Novel applications of Cold Atmospheric Plasma for the treatment of Plaque Psoriasis. Research Journal of Pharmacy and Technology. 2023; 16(5): 2543-8.
4. Dogra S, Yadav S. Psoriasis in India: prevalence and pattern. Indian J Dermatol Venereol Leprol. 2010; 76(6): 595-601.
5. Mahajan T, Singh N, Goyal K, Jindal S, Pandit V, M.S. Ashawat. Recent Updates on Psoriasis: A Review. Asian Journal of Pharmaceutical Research. 2022; 12(1): 76-3.
6. SinghS, PrasadR, TripathiJ and Rai N. Psoriasis -An Overview. World Journal of Pharmaceutical Sciences. 3. 2019; 1732-1740.
7. Sondhi S, Singh N, Goyal K, Jindal S. Development of Topical Herbal Gel of Berberine Hydrochloride for the Treatment of Psoriasis. Res. J. Pharma. Dosage Forms and Tech. 2021; 13(1): 12-18.
8. Sukare P, Bhattacharya R. Herbal plant used in Treatment of Psoriasis - A Systematic Review. Res. J. Pharmacognosy and Phytochem. 2020; 12(1): 57-62.
9. Sumithra. M, Mohamed Majeed. A, Chitra. V. Cell Lines and Animal Models of Psoriasis. Research J. Pharm. and Tech 2020; 13(3): 1601-1608.
10. Nguyen CT, Bloch Y, Składanowska K, Savvides SN, Adamopoulos IE. Pathophysiology and inhibition of IL-23 signaling in psoriatic arthritis: A molecular insight. Clin Immunol. 2019; 206: 15-22.
11. Nabilah N, García DS, Kondaveeti SB, Batra HS, Viktor P, Jamali MC, Wei CR, Bhuiyan JR, Mudhafar M, Khalaf OM, Syrmos N, Roy S, Matyakubovich AM, Afrin S, Mahedi MRA. Examining the Interplay of Psychological Factors in Chronic Skin Disease: A Review on Depression, Anxiety, and Stress. Res J Pharm Technol. 2024; 17(4): 1902-8.
12. Dhabale A, Nagpure S. Types of Psoriasis and Their Effects on the Immune System. Cureus. 2022. 14(9): e29536.
13. Singh N, Sondhi S, Jindal S, Pandit V, Singh M. Treatment and Management for patients with mild to severe Psoriasis: A Review. Asian J. Pharm. Res. 2020; 10(4): 286-292.
14. Sharma S, Sharma R, Goyal K, Jindal S. Potential of herbal treatment of Psoriasis: A Laconic Review. Asian J. Pharm. 11(1): January - March, 2021.
15. Sondhi S, Singh N, Jindal S. Natural Remedies used in the Treatment of Psoriasis: A short Review. Asian J. Pharm. Res. 2021; 11(1): 43-45.
16. Dr. Savera KK, Dr. Rose AM. Management of palmoplantar psoriasis through homeopathic medicines with more than one year of follow up: A case study. Int J Hom Sci. 2021; 5(2): 234-238. DOI: 10.33545/26164485.2021.v5.i2d.388
17. Mahesh S, Shah, V, Mallappa M, and Vithoulkas G. Psoriasis cases of the same diagnosis but different phenotypes-Management through individualized homeopathic therapy. Clinical case reports. 2019; 7(8): 1499–1507. https://doi.org/10.1002/ccr3.2197
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Received on 02.08.2024 Revised on 13.12.2024 Accepted on 15.02.2025 Published on 28.02.2025 Available online from March 03, 2025 Asian J. Pharm. Res. 2025; 15(1):1-5. DOI: 10.52711/2231-5691.2025.00001 ©Asian Pharma Press All Right Reserved
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