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 Table of Contents  
CASE REPORT
Year : 2019  |  Volume : 13  |  Issue : 4  |  Page : 251-255

Evidence- based homoeopathy: Case report of alopecia areata in an 11 year old boy


Department of Dermatology, Regional Research Institute of Homoeopathy, Gudivada, Krishna, Andhra Pradesh, India

Date of Submission06-Mar-2019
Date of Acceptance29-Nov-2019
Date of Web Publication27-Dec-2019

Correspondence Address:
Dr. Ashish Pandurang Shivadikar
Regional Research Institute of Homoeopathy, Gudivada, Krishna - 521 301, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijrh.ijrh_18_19

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  Abstract 


Introduction: Alopecia areata (AA) is an autoimmune disease characterised by non-scarring hair loss in single or multiple areas of the scalp. The disease affects hair on the head or other parts of the body. AA occurs in people of all ages and affects 1-2% of human population. Homoeopathic literature shows that cases of AA have been treated successfully with homoeopathic medicines. Case Summary: This is the case of an 11 years old boy with alopecia areata. The case presented here is documented from Dermatology clinic at Regional Research Institute of Homoeopathy at Gudivada, Andhra Pradesh. The patient was treated with individualised homoeopathic medicine over a period of 3 years. There was significant improvement with homoeopathic treatment, with complete disappearance of bald patches without any recurrence.

Keywords: Alopecia areata, Autoimmune, Homoeopathy, Inflammation, Lycopodium clavatum


How to cite this article:
Shivadikar AP. Evidence- based homoeopathy: Case report of alopecia areata in an 11 year old boy. Indian J Res Homoeopathy 2019;13:251-5

How to cite this URL:
Shivadikar AP. Evidence- based homoeopathy: Case report of alopecia areata in an 11 year old boy. Indian J Res Homoeopathy [serial online] 2019 [cited 2020 Jan 26];13:251-5. Available from: http://www.ijrh.org/text.asp?2019/13/4/251/274017




  Introduction Top


Alopecia areata (AA) is an autoimmune disorder characterised by patches of non-scarring alopecia affecting scalp and body hair. The disease may be limited to one or more discrete, well-circumscribed, round or oval patches of hair loss on the scalp or body or it may affect the entire scalp (alopecia totalis) or the entire body (alopecia universalis). The lifetime incidence of AA is approximately 2% worldwide.[1] It affects people of all ages and both sexes. Loss of hair is considered as an autoimmune process leading to chronic inflammation due to the presence of organ-specific CD8+ T-cell-dependent response mainly affecting hair follicles. Various triggers such as infections, trauma, hormones and stress are known to worsen the disease. Genetic component plays an important role with a likelihood of severe symptoms seen in first-degree relatives. Its association with other autoimmune diseases such as vitiligo, lupus erythematosus, psoriasis, atopic dermatitis, thyroid disease, allergic rhinitis, pernicious anaemia, diabetes mellitus and rheumatoid arthritis is known.[2]

There is no specific treatment for AA cases. However, topical immunotherapy, intralesional and topical or systemic corticosteroids are used in patients with AA. Other treatment options include immunosuppressant and biologics medicines. The patients under treatment with these drugs should be constantly clinically monitored due to the adverse effects that can be generated.[3] An important element of the management of AA cases is offering psychological support. With psychological support and education about the disease, long-term improvement can be achieved.[4] The diagnosis is clinical and generally simple in the common cases. In diffuse chronic forms, trichogram and biopsy is advised.[5]

Sharquie and Al-Obaidi [6] investigated the effectiveness of topical crude onion juice in the treatment of patchy AA in comparison with tap water. An Iranian research group investigated the effectiveness of topical garlic gel in the treatment of AA.[7] Xie [8] described a case report of a girl with AA treated with a traditional Chinese medicine concoction. Hay et al[9] treated AA with aromatherapy with significant improvement. However, despite all the positive results, unfortunately, no study was of sufficient internal validity to provide robust evidence of the benefit of complementary and alternative medicine (CAM) in AA.

Homoeopathic remedies can offer gentle and safe treatment for patients suffering from AA. Homoeopathy treats the person as a whole. This includes a detailed medical history of the patient, family and causative factors. Any underlying predisposition factor and susceptibility is also considered. Homoeopathic literature mentions many medicines for Alopecia namely Alumina, Arsenicum album, Floricum acidum, Graphites, Natrum muraticum, Nitricum acidum, Phosphoricum acidum, Phosphorus, Pix liquida, Selenium, Sepia, Syphilinum, Thallium, Vinca minor etc.[10]


  Case Report Top


History

An 11-year-old boy reported with extensive AA in the Dermatology Clinic at the Regional Research Institute of Homoeopathy, Gudivada, Andhra Pradesh, India. He presented with multiple bald patches on the head which had troubled him over 1 year. The boy was otherwise healthy without any other skin or nail changes. His parents were concerned about his condition and consulted a homoeopath. He used homoeopathic medicines for 3 months without any improvement. There was no family history of AA or any autoimmune disease in the family. The boy was very intelligent and confident. During his case taking, his mother informed that he was very obstinate and learnt things very fast, was very ambitious, had desires for sweet food, perspired profusely and his thermal reaction was hot. The patient has given his consent for his images and other clinical information.

The following characteristic symptoms were considered for repertorisation:

  1. Intellectual
  2. Obstinate
  3. Ambitious
  4. Desires company
  5. Profuse perspiration
  6. Desires sweet
  7. Hair falling out
  8. Hair baldness in patches.


Repertorisation was done using Hompath8 Software (complete repertory) (Mind Technologies private limited, Mumbai, Maharashtra State, India),[11] and the repertorial result is shown in [Table 1].
Table 1: Repertorisation chart

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Intervention

First prescription: On 20 October 2012, Lycopodium 30C, once a day for 1 month.

Basis of prescription: Medicine selected on the basis of individualisation, symptom totality and in consultation with Materia Medica was Lycopodium. Furthermore, Lycopodium was chosen as it covers the totality of symptoms and the patient's thermal reaction was hot. Lycopodium 30C, once a day for 1 month, was prescribed. On subsequent follow-ups, potency was changed based on the assessment of improvement in bald patches.

Follow-up and outcomes

Follow-up of the patient was assessed monthly or as required. The date-wise detailed follow-ups are summarised in [Table 2].
Table 2: Time line including follow-up of the case

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  Results Top


The bald patches on the head showed new hair growth. Initially, Lycopodium 30C showed improvement. However, much significant improvement was observed with higher potency Lycopodium 1M. Bald patches on the head completely disappeared within a period of 3 years of homoeopathic treatment [Figure 1], [Figure 2], [Figure 3].
Figure 1: Before treatment

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Figure 2: During treatment

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Figure 3

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  Discussion Top


The patient presented with multiple bald patches on the head. There was no family history of AA or other autoimmune disease in the family. This case treated with individualised homoeopathic medicine showed complete hair re-growth without any recurrence in a follow-up period. As there is no effective treatment in conventional medicine, a substantial number of AA patients resort to CAM. Itamura [12] reported an Alopecia universalis case treated with Mercurius with significant improvement. Willemsen et al.[13] used hypnosis to treat AA.

In this case, after careful history recording, repertorisation and consultation with Materia Medica, Lycopodium medicine was prescribed. The patient showed improvement in the beginning which proved correct selection of the medicine, but there was slow improvement with low-potency Lycopodium 30C. However, marked improvement was observed with higher 1M potency. This case shows the effective role of homoeopathic medicine in treating AA when prescribed on the basis of homoeopathic principles.


  Conclusion Top


Homoeopathy is a specialised system of medicine. It treats patient as whole and not just symptoms. A complete hair re-growth without any recurrence of bald patches is a documentary evidence [Figure 1], [Figure 2], [Figure 3]. This case shows a positive role of Homoeopathy in treating AA. However, as this is a single case study and AA is associated with a variable and unpredictable remission,[14] well-designed studies may be taken up for scientific validation of results.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initial will not be published, and due efforts will be made to conceal his identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

None declared.



 
  References Top

1.
Villasante Fricke AC, Miteva M. Epidemiology and burden of alopecia areata: A systematic review. Clin Cosmet Investig Dermatol 2015;8:397-403.  Back to cited text no. 1
    
2.
Shivanna CB, Shenoy C, Priya RA. Tofacitinib (selective Janus kinase inhibitor 1 and 3): A promising therapy for the treatment of alopecia areata: A case report of six patients. Int J Trichol 2018;10:103-7.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Juárez-Rendón KJ, Rivera Sánchez G, Reyes-López MÁ, García-Ortiz JE, Bocanegra-García V, Guardiola-Avila I, et al. Alopecia Areata. Current situation and perspectives. Arch Argent Pediatr 2017;115:e404-11.  Back to cited text no. 3
    
4.
Brzezińska-Wcisło L, Bergler-Czop B, Wcisło-Dziadecka D, Lis-Święty A. New aspects of the treatment of alopecia areata. Postepy Dermatol Alergol 2014;31:262-5.  Back to cited text no. 4
    
5.
Rivitti EA. Alopecia areata: A revision and update. Bras Dermatol 2005;80:57-68.  Back to cited text no. 5
    
6.
Sharquie KE, Al-Obaidi HK. Onion juice (Allium cepa L.), a new topical treatment for alopecia areata. J Dermatol 2002;29:343-6.  Back to cited text no. 6
    
7.
Hajheydari Z, Jamshidi M, Akbari J, Mohammadpour R. Combination of topical garlic gel and betamethasone valerate cream in the treatment of localized alopecia areata: A double-blind randomized controlled study. Indian J Dermatol Venereol Leprol 2007;73:29-32.  Back to cited text no. 7
[PUBMED]  [Full text]  
8.
Shaoqiong X. Three typical dermatological cases treated by Dr. Li Yueping. J Tradit Chin Med 2005;25:129-31.  Back to cited text no. 8
    
9.
Hay IC, Jamieson M, Ormerod AD. Randomized trial of aromatherapy. Successful treatment for alopecia areata. Arch Dermatol 1998;134:1349-52.  Back to cited text no. 9
    
10.
Boericke W. Pocket Manual of Homoeopathic Materia Medica and Repertory. New Delhi: B. Jain Publishers Pvt. Ltd; 1994.  Back to cited text no. 10
    
11.
Complete repertory of Hompath Classic. Ver. 8.0. Mumbai: Computer Software, Mind Technologies; 2006.  Back to cited text no. 11
    
12.
Itamura R. Effect of homeopathic treatment of 60 Japanese patients with chronic skin disease. Complement Ther Med 2007;15:115-20.  Back to cited text no. 12
    
13.
Willemsen R, Vanderlinden J, Deconinck A, Roseeuw D. Hypnotherapeutic management of alopecia areata. J Am Acad Dermatol 2006;55:233-7.  Back to cited text no. 13
    
14.
Harries MJ, Sun J, Paus R, King LE Jr. Management of alopecia areata. BMJ 2010;341:c3671.  Back to cited text no. 14
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2]



 

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