Eczema
1. PRELIMINARY DATA
- No.: 201/2026
- Patient's Name: DEF
- Address: Flat 702, Maple Grove Apartments, Pune.
- Occupation: IT Consultant (sedentary job, high screen time, irregular sleep)
- Religion: Hindu
- Date: 01/03/2026
- Age: 42 Years
- Sex: Male
- Education: B.E. Computer Science
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Skin (flexures: cubital & popliteal fossae, neck, wrists) | Dry, rough, thickened lichenified patches with intense itching, occasional oozing & crusting | < Night, < Wool clothing, < Heat of bed, < Stress, > Cold applications, > Open air, since childhood (worse last 8 years) | Restlessness at night, scratching till bleeding, irritability |
| General Skin | Dryness all over body, cracks on palms & soles | < Winter, < Bathing with hot water | Anxiety about appearance, low self-esteem |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Childhood eczema suppressed with strong topical steroids & oral antihistamines; recurrent attacks after suppression; frequent antibiotics for secondary infections; history of suppressed nasal allergy in teens.
- Family History: Mother has chronic bronchial asthma. Elder brother has hay fever. Maternal grandmother had psoriasis.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Normal but erratic due to stress
- Desires: Spicy food (+++), Eggs (++), Sweets (+)
- Aversions: Milk, fatty food
- Thirst: Moderate, for cold water
- Elimination:
- Urine: Normal
- Stool: Occasional hard, unsatisfactory
- Perspiration: Profuse on upper body, offensive
- Sleep: Disturbed due to itching; wakes scratching; unrefreshing
- Thermal State: Hot patient (cannot tolerate warm clothing, prefers cool environment)
B. Reactions - Physical Factors
- Weather: Aggravation in winter and rainy season
- Position: Better uncovering affected parts
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Fastidious, perfectionist, easily irritated
- Anxiety: About work performance, health of skin, future career
- Fear: Fear of disfigurement, fear poverty
- Dreams: Falling, being chased, unsuccessful efforts
- Other: Suppressed anger, feels unlucky
6. PHYSICAL GENERAL EXAMINATION
- Wt: 74 kg | Ht: 172 cm | Temp: 98.4°F
- RR: 16/min | Pulse: 78 bpm | B.P.: 132/84 mmHg
- Face: Dull, anxious look
- Tongue: Slightly coated
- Nails: Brittle, ridged
- Skin: Dry, rough, lichenified patches in flexures, excoriations from scratching
7. SYSTEMIC EXAMINATION
- Skin: Multiple lichenified, hyperpigmented plaques in flexures; dry xerosis elsewhere; no active oozing currently
- CVS: S1, S2 Normal. No murmurs.
- Respiratory: Occasional wheeze on exertion
- GIT: Soft, no organomegaly
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Fastidiousness, anxiety about health & future, suppressed anger (Grade 3)
- Physical General: Hot patient, desire spicy/eggs, profuse offensive sweat, unrefreshing sleep (Grade 3)
- Particular: Chronic flexural eczema with lichenification, < night/wool/heat, > cold air/applications (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic case with prominent Mental Generals (fastidious, anxiety, fears) and Physical Generals (thermal, desires, sweat) dominating the picture; Kentian hierarchy ideal for constitutional prescribing in skin miasmatic diseases.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Fastidious nature
- Anxiety about health and future
- Fear of poverty
- Desire for spicy food and eggs
- Hot patient
- Profuse offensive perspiration
- Dry rough lichenified eczema in flexures
- Itching < night, heat of bed
-
Cold applications, open air
- Suppressed skin eruptions in past
- Family history of asthma and psoriasis
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Fastidious | Mind; FASTIDIOUS | 48 |
| 2 | Anxiety about health | Mind; ANXIETY; health, about | 6 |
| 3 | Desire spicy food | Stomach; DESIRES; spicy | 486 |
| 4 | Hot patient | Generalities; HEAT; sensation of | 1366 |
| 5 | Skin eruption eczema itching night | Skin; ERUPTIONS; eczema; itching; night | 1312 |
| 6 | Perspiration offensive | Perspiration; ODOR; offensive | 1298 |
| 7 | Skin dry rough | Skin; DRY | 1307 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Sulphur | 7/7 | 22 |
| 2 | Psorinum | 6/7 | 18 |
| 3 | Graphites | 5/7 | 14 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Itching, dry skin, fastidious, anxiety | Suppressed eruptions, lichenification | Family respiratory & skin issues | Destructive cracking, brittleness |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Eczema
- Differentiation of Remedies: Compared Sulphur with Psorinum. Psorinum has more despair, hopelessness, extreme chilliness; Sulphur matches hot, dry, rough, itchy skin, burning < heat, > cold air, fastidious yet untidy, strong desire spicy, offensive sweat. Graphites has more honey-like oozing, obesity tendency.
- Selection of Remedy (Materia Medica): Sulphur matches classic psoric chronic eczema with dry rough itchy skin, burning-itching < night/heat, > cold, hot patient, fastidious mind, offensive discharges (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic deep-seated skin miasmatic case, sensitive constitution)
- Actual Prescription:
- Sulphur 200 — single dose (one dose only, wait & watch)
- Placebo — 4 pills twice a day for 4 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 01/04/2026 | Itching reduced 60%, patches less red & dry, no new lesions, sleep better | Placebo | Avoid wool/synthetics, moisturize with coconut oil, reduce spicy intake temporarily |
| 01/06/2026 | Skin 85% clearer, only mild residual dryness, no recurrence despite stress | Placebo | Continue hygiene, avoid suppression, report if any return of old symptoms |