Leucoderma and homeopathy:
The word vitiligo is derived from the Greek vitelius, meaning calf. The white spots of vitiligo resemble white patches on a calf. Vitiligo is an acquired loss of pigmentation characterized histologically by absence of epidermal melanocytes. It may be an autoimmune disease associated with antibodies (vitiligo antibodies) to melanocytes. Studies suggest there is some genetic mechanism involved in the etiology of vitiligo and that it is polygenic in nature. There is a positive family history in at least 30% of cases. Both sexes are affected equally.
1. All injuries, wounds, ulcers, boils, burnt skin with fire or hot coal, hot liquids, etc., destroy the skin and its chromatophores (special cells in the skin on which colouring matter melanin is contained). It is also found in hair and eyes. Melanin is a dark brown or black pigment which is found in the chromatophores, hair and the choroid layer of the eye-ball between the retina and the sclera which contains blood vessels and black pigment that absorbs excess light and so prevents blurring of vision.
Melanocyte (melanophore) is a cell within the epidermis of the skin that produces the dark brown or dark pigment melanin. Thus, in injuries, wounds, ulcer or in burnt skin these melanocytes are destroyed and as such they do not manufacture the colouring matter melanin and so the affected spots on the skin turn into white scars and at later stage these scars change into leucoderma.
2. The production of melanin in the skin by melanocytes is increased by the action of sunlight, and when the skin is not properly exposed to sunlight or we do not have regular sun-bath, then there is less or stopped production of melanin in the skin, thus white. patches are formed over the skin - in similar way when the boot polish is ignored for sufficient long period, and the colour of the shoe is diminished or changed into white patches from its wear and tear, and from want of colouring matter, i.e. , boot polish.
3. When the skin requirement of melanin is not met well from our daily food (i.e. food without vegetables, fruits etc.), then skin becomes discoloured from the areas of the skin where the colouring pigment melanin is less supplied, and skin becomes white in similar way as in the case of boot polish explained above. Thus proper and balanced diet is very necessary for the maintenance of skin colour.
4. Excessive fried food, alcohol, meat, eggs and fish destroys the body tissues and cells and thus affect the manufacture of colouring pigment for the skin.
5. Sweat glands in the skin do not function properly due to poor bathing or poor hygienic condition of the body and poor rubbing of the skin with towel after bath, and poor action of sweat glands means poor production of melanin.
6. Excessive use of cosmetics over face, or use of red colour which the Indian ladies fix on their forehead in between the eyebrows produces leucoderma because the chemicals used in cosmetics and bindya are corrosive in nature-that tend to destroy the upper skin along with its colour thus making the skin white.
7. Poor nutrition etc. make the body weak and anaemic, there is lack of vital heat in the body and poor circulation of blood, which may cause leucoderma.
8. Excessive of allopathic drugs or sour things, especially tamarind may cause increase in the white spots.
1. Leucoderma is difficult to cure, and has lengthy treatment from 6 months to 4 years, and patient is fed up with such lengthy treatment.
2. Egg, meat, fish and alcohol are strictly restricted during the treatment, but the patient prefers to leave the treatment and start enjoying alcohol and meat.
3. The poor patients want to be cured, but they are not in a position to pay the charges of medicines for long time.
4 Patients who have taken strong allopathic drugs and injections around the white patches also fall in the uncured category of 40%.
5. A government servant left the treatment when he was transferred from the place.
6. Leprosy or leprous condition in the body makes cure difficult. Similarly mixed constitution has psoric, syphilitic and sycotic miasms, which create some difficulties in the cure of leucoderma. A good doctor gives miasmatic remedy in homoeopathy for speedy cure of white patches.
7. Blood groups A+ve, B+ve, etc., make the leucoderma to spread quickly and takes long time to cure. Blood groups A+ve, B+ve, AB+ve, etc., show speedy cure, especially in persons having black complexion. Blood group A+ve, O+ve, etc., may show leucoderma over lips, palms and soles, which is difficult to cure because of thick skin and rubbing action between lip and lip, sole and shoe.
Guidance for treatment :
1. All persons who have black complexion and blood group A+ve, B+ve, AB+ve, AB, etc., are cured quickly when they are given intercurrent medicine, like Bacillinum or Psorinum 200, one dose every one or two months.
2. A patient should be educated regarding the length of treatment and be asked to test his blood group.
3. First, second and third remedies should be selected at once and each be given for 15-20 days, one after the other in the trio form, with some indicated intercurrent medicine in 200 potency till cure. This is done so, because with one indicated medicine there would be signs of proving of the medicine due to its continuous administration. In trio treatment it never happens.
4. The likely intercurrent remedies are Bacillinum, Psorinum, Natrum sul, Calc c, Sul, Thuja or Tuberculinum.
5. The selection of medicine should be based on totality of symptoms, esecially mind symptoms, likings, aggravation from hot or cold air, symptoms of the digestive system, etc.
6. If a wrong medicine has been selected, then treatment may cause some severe eruption of pimples, boils or pustules over the skin, especially with medicine, like Arsenicum sul flav, which is generally used by all homoeopaths as it is the only remedy written in the materia medica.
7. Eating of meat, eggs, fish, sour things prepared from tamarind, mango pickles and coffee should be avoided.
8. The deep-acting medicines (as given under) should only be tried if indicated:
Alum, Apis, Arg n, Ars s f, Calc c, Calc sil, Graph, Lyc, Nat c, Nat m, or Puls 30. See also above at S. No. 4. Sulphur ointment may also be applied externally over the white spots.
1. CP3X, KM3X, KS3X, NM3X 2-4 grain dose in combined or single form be given in alternation with any indicated medicine.
2. Wapchi or wakuchi oil should be applied externally over white spots at night every day. This oil is prepared as under :
In, Til oil (mitha oil in Hindustani) fry dry seeds of wapchi for 5-10 minutes. Then sieve the oil and put it in bottle. The oil is ready for external application. (Use 100 grams of wapchi in one kg of oil.) It was found in my practice that 1-2 % of the patients had irritation of the skin, and so, it should be avoided in such cases. In such cases use Sulphur ointment.
Various Opinions of Homoeopathic Physicians :
1. Dr S.P. Koppikar, the famous homoeopath from Madras, states that best results are obtained by him with Acid Nit. 200 and 1M. Sepia up to 10M is also helpful when indicated. Nylon 30 and 200 has also helped him. He has suggested that oil of Bavchi or the Mother Tincture should be added to plane Vaseline in very small proportion and to apply externally on the skin might bring some colour. He has also suggested besides Nylon, Rastinon, but I have not used both the remedies so far.
2. Dr R.P. Patel, past Principal of Kottayam Homoeopathic College and an ingenious research worker, has suggested the following line of treatment:
(i) Syphilinum 200, 1M single dose every 15 days if syphilitic miasm is there and mucus membrane - lips, genitalia is affected or patches are on bones.
(i i) Medorrhinum 200, 1M on history of Psychotic Miasm and too much vaccination and if patches are on muscular parts.
( iii) Sepia 3, mostly in children and women. Patches on face, lips and scalp.
v) Lyco 3, 6, 30 in patients who have liver complaints due to chronic dysentery, alcohol, hepatitis or jaundice.
(v) Ars. Iodide 3, for those children and women who have TB history or hereditary TB.
(vi) Hydrocotyle 1, 3, 10M in cases of suppressed skin troubles and history of Lupus, Filaria.
(vii) Bacillinum 1M, helps in many cases who had asthma, tuberculosis, skin trouble - ringworm in the past.
Extensive patches take years. Bilateral type takes longer. Those which are itching type require Nat. Mur 3. Sulphur brings back white spots which were healed. So beware of it.
(viii) Rastinon: Cases depend on liver problems.
ix) Radium Bromide: In case of radiation exposures followed by white spots. Dr Curie proved it by placing on abdomen radium dust.
3. Dr R.S. Pareek of Agra suggests as follows:
(i) Cuprum Aceticum 6: Copper being the chief source to produce melanin and have produced different kinds of skin lesions in poisoning, specially various forms of discoloration.
(ii) Cobaltum Nitricum: In industrial workers handling cobalt, they have faced with the problem of discoloration of the skin usually having hypopigmentary patches. This remedy in lower dilution has helped to devlop re-pigmentation in the victimes.
(iii) Cantharis-V: This is a supreme remedy giving maximum benefit. My uncle, a great Hahnemannian homoeopath, Dr Ganpati Roy, who accomplished dramatic cures in the disease, disclosed me as a specific for vitilago. He supported his reason by saying that in burns, the skin loses its pigments and Cantharis being a great burn remedy, restores it back. Guided by his explanation and 50 years experience with the patients we have been using this drug very often with very good results. With every case of course, we try to push a dose of constitutional remedy which certainly helps the treatment. Our results in the treatment of Vitilago are to the tune of 25% total recovery.
4. Dr P.S. Krishnamurthy of Hyderabad has written an article on amoebiasis which was published in the British Homoeopathic Journal, 1966. He is of the opinion that amoebiasis does a lot of harm and causes white patches on the skin. He has mentioned miasmatic theory in support of the same. He states that along with this miasm, tuberculosis, filariasis and amoebiasis in tropical countries come under that group. He states when these patients become debilitated by stress and strain or by some acute infection, the dormant dysenteric miasm will take the upper hand like psora and invade the organism. He mentions Mercury as a principal remedy. Along with this, Nux Vomica, Pulsatilla, Bryonia, Rhus Tox, Colchicum and Dulcamara are included.
Recently a Cuban cure for Leucoderma was advised in the press. This is a placenta extract. It is in the form of a lotion to be applied on white patches thrice daily with a 15 minutes exposure to ultra violet-rays once a day. It is also available in the form of injections. I tried to get a homoeopathic potency to try on patients but could not. This requires further research.
The trade name is Melagenina.
5. Professor Ranjit K. Panja of Medical College, Calcutta, has published a paper on 'Etiology of Vitiligo'. The precise cause of vitiligo remains an enigma. Studies on the etiopathogenesis of the disease through clinical genetic, physiological, biochemical, histological, immunological and experimental methods, especially during the last three decades, document isolated but significant facts on the various patho-physiological aberrations. Genetic concept of vitiligo evolves from positive family histories in 7.5-21% in India and 33-38% in Western countries and occurrence in mono-zygotic twins. The disease is thought to be transmitted through an autosomal dominant gene. Various sorts of gastro-intestinal ailments with or without parasitic infestations are by far the commonest associations of vitiligo in Indian patients.
Trauma induces vitiligo, as has been reported after severe sunburn, onset at sites of rubbing and vaccination, sari and dhoti injuries at the waist and gingivitis, herpes simplex, drug rash and heavy smoking predisposing vitiligo of the lips. All mysterious diseases have been linked with auto-immunity and it has indeed been so in vitiligo due to circumstantial association of other auto-immune diseases with demonstrable organ specific antibodies, viz. Addison's disease, hypo and hyper-thyroidism pernicious anaemia, as also diabetes mellitus. The tyrosinase system remaining normal, it may be quite probable that melanin production from tyrosine in vitiligo patients is blocked at the quinone system due to a hypoxic state and the semiquinone system may be the modus operandi.
6. Dr Govind Agrawal, M.B. B.S.
Medical Officer, Police Hospital
Vidisha (M.P. )
He is also doing research on Leucoderma with homoeopathic remedies. His patients are all from village side and he is able to take pictures at various stages of cure. He has given me 4 cases which are published in this book. In all, he has treated 154 cases in 10 years. Diagnosis is on clinical grounds only. He states all patients were given: Ferrum Phos 30, Lyco 200 and Arsenic sulf-flavum 30 in common with hydrocotyle Q or Psoralia Q or Piper methysticum Q in common. In addition to this, Nat Mur, Nux Vomica, Cina, Acid Nit., Argentum Nit., Cal-phos, Pulsatilla, Silica (its chronic Silicea) as well as Merc. Sol. and Tuberculinum have been used as inter-current medicines.
Potencies: 30, 200, 1M were used.
According to him, about 50 per cent cure is obtained in those who take treatment for one to three years.
He states that this disease belongs to tubercular group of miasm because Tuberculinum as inter-current remedy gives a good result.
Diet and regimen:
it is hence recommended that vitiligo people should prefer the following in their food
· Vegetables: like Green Leaves, Beetroots, Spinach Broccoli, Brussels sprouts, cabbage, Carrots
· Fruits: like Peaches and Apricots apple, banana mangoes, Black dates
· Grains: Whole grains like porridge an whole wheat products are better than the highly refined carbohydrates like pasta.
· Pulses & Legumes: Chickpeas have recently been shown in India to be very helpful in vitiligo
· Protein: Vegetable proteins especially from Soya beans have been found useful for controlling the skin depigmentation. Animal proteins like meat and fish are however generally discouraged by the herbalists.
· Oils and fats: Vegetable oils like Olive oil are rich in good fats keep you healthy anyways.
· Nuts: (are also very useful because of a high content of vitamin E and the "good fats” that are beneficial for skin.
· Fluids and water: Adequate hydration is an important component of healthy diet which should not be ignored
Foods Rich in vitamin C, like citrus fruits, tomatoes and green tea should either be avoided or consumed in minimal quantities.
· Non-Veg: Traditional herbalist believe that people with vitiligo should also avoid from eating Non-Vegetarian foods like Fish and Red Meats, as they may be highly antigenic and may worsen the auto-immune process. It is better to avoid even the Eggs, Milk, and Dairy products
· Alcoholic and Flavored drinks as well as Ice Creams and Chocolates,are not good for most of the people whether or not they vitiligo and are best avoided.
· The so called Junk food & Spices are also discouraged in vitiligo people.
· Sour Foods like pickles, sour yogurt and sour strawberries are also considered to be risky.
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Habif clinical dermatology 3rd edition