Acne (adult)
1. PRELIMINARY DATA
- No.: 239/2026
- Patient's Name: HIJ
- Address: Flat 2503, Pearl Residency, Pune.
- Occupation: Graphic Designer (sedentary, screen time, irregular sleep)
- Religion: Hindu
- Date: 01/09/2026
- Age: 32 Years
- Sex: Female
- Education: B.Des
- Status: Single
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Face & Back | Persistent inflammatory acne (papules, pustules, nodules), scarring, oily skin, blackheads/whiteheads | < Stress, < Hormonal changes (pre-menstrual), < Spicy/oily food, < Heat, > Cool open air, > Cold applications, since 15 years (adult persistent, worse last 5 years) | Itching, pain in nodules, low self-esteem, anxiety about appearance |
| General | Hormonal imbalance | < Menstrual cycle | Depression, irritability |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Teenage acne suppressed with antibiotics/topicals; recurrent flares post-25; suppressed with isotretinoin (partial relief, side effects); PCOS diagnosed 3 years ago (on metformin); irregular menses.
- Family History: Mother has adult acne & PCOS. Sister has hormonal acne. Father has oily skin.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Normal
- Desires: Cold drinks (+++), Sweets (+)
- Aversions: Fatty food
- Thirst: Increased, for cold water
- Elimination:
- Urine: Normal
- Stool: Regular
- Perspiration: Profuse on face/back, sour
- Sleep: Disturbed by stress; wakes anxious
- Thermal State: Hot patient (prefers cool, uncovers)
B. Reactions - Physical Factors
- Weather: Aggravation in hot humid weather
- Position: Better open air
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Irritable, sensitive, low confidence
- Anxiety: About appearance, social interactions
- Fear: Fear of permanent scarring, fear rejection
- Dreams: Being ugly, criticized, isolation
- Other: Depression, feels unattractive
6. PHYSICAL GENERAL EXAMINATION
- Wt: 68 kg | Ht: 162 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 82 bpm | B.P.: 124/80 mmHg
- Face: Oily, multiple acne lesions/scars
- Tongue: Clean
- Nails: Normal
- Skin: Oily, comedones, inflammatory papules |
7. SYSTEMIC EXAMINATION
- Skin: Face/back acne grade III, cysts/nodules, scarring
- Endocrine: Signs of PCOS (hirsutism mild)
- CVS: S1, S2 Normal
- GIT: Normal
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Irritability, anxiety about appearance, depression (Grade 3)
- Physical General: Hot patient, desire cold drinks/sweets, profuse sour sweat, oily skin (Grade 3)
- Particular: Adult acne with inflammation/scarring, < stress/hormonal, > cool air/cold (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic skin disorder with strong Mental Generals (anxiety, depression) and Physical Generals (thermal, desires, sweat) dominating; Kent suits skin rubrics for adult acne.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Anxiety about appearance
- Irritability/depression
- Desire cold drinks/sweets
- Hot patient
- Profuse sour perspiration
- Acne inflammatory scarring
- Oily skin blackheads
- < Stress, pre-menstrual
-
Cool air, cold applications
- Hormonal/PCOS link
- Family acne/PCOS
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Anxiety appearance | Mind; ANXIETY; health, about | 6 |
| 2 | Sadness depression | Mind; SADNESS | 75 |
| 3 | Desire cold drinks | Stomach; DESIRES; cold drinks | 484 |
| 4 | Skin eruptions acne | Skin; ERUPTIONS; acne | 1309 |
| 5 | Skin oily | Skin; OILY | 1310 |
| 6 | Perspiration sour | Perspiration; ODOR; sour | 1298 |
| 7 | Heat sensation | Generalities; HEAT; sensation of | 1366 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Pulsatilla | 7/7 | 21 |
| 2 | Sulphur | 6/7 | 18 |
| 3 | Sepia | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Acne, irritability, hot | Scarring, hormonal imbalance | Family acne/PCOS | Destructive fear rejection |
Dominant Miasm: Sycotic-Psoric
14. FINAL STEPS
- Provisional Diagnosis: Acne (adult, inflammatory)
- Differentiation of Remedies: Compared Pulsatilla with Sulphur. Sulphur has more burning/itching, hot/untidy; Pulsatilla matches changeable acne, weepiness/irritability, hot patient, desire cold drinks, < hormonal/stress, > cool air. Sepia more indifference/hormonal.
- Selection of Remedy (Materia Medica): Pulsatilla matches adult acne with inflammation, scarring, oily skin, weepiness/anxiety about appearance, hot patient, desire cold drinks, < hormonal (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic skin/hormonal miasmatic case, sensitive constitution)
- Actual Prescription:
- Pulsatilla 200 — single dose (one dose only, wait & watch)
- Placebo — 4 pills twice a day for 8 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 20/09/2026 | New lesions reduced 60%, inflammation milder, mood better | Placebo | Gentle cleansing, avoid oily food, stress reduction |
| 20/01/2027 | Acne mostly clear, scarring fading, confidence improved | Placebo | Continue skincare, hormonal check if needed |