Psoriasis
1. PRELIMINARY DATA
- No.: 202/2026
- Patient's Name: GHI
- Address: Bungalow 8, Orchid Valley, Pune.
- Occupation: Business Owner (textile shop, stress from sales & competition)
- Religion: Hindu
- Date: 05/03/2026
- Age: 48 Years
- Sex: Male
- Education: B.Com
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Skin (elbows, knees, scalp, lower back) | Thick, silvery-white scaly plaques with dry, cracked, bleeding fissures; intense itching & burning | < Winter, < Stress, < After bathing, < Night, > Sun exposure (mild), > Cold applications, since 12 years (progressive worsening last 5 years) | Joint stiffness in morning, irritability, low mood |
| Nails | Pitting, thickening, discoloration, onycholysis | < Trauma to nails | Anxiety about spreading to face |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Childhood recurrent tonsillitis treated with repeated antibiotics; suppressed skin rash in youth with ointments; history of gouty attacks 10 years ago; overweight since adulthood.
- Family History: Father had chronic psoriasis. Paternal uncle had rheumatoid arthritis. Sister has hypothyroidism.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Good, eats heavily under stress
- Desires: Sweets (+++), Salty food (++), Warm drinks (+)
- Aversions: Fish, sour things
- Thirst: Increased, large quantities
- Elimination:
- Urine: Normal
- Stool: Hard, constipated tendency
- Perspiration: Profuse on scalp & back, sour
- Sleep: Disturbed by itching; wakes early morning with joint stiffness
- Thermal State: Chilly patient (wants warm covering, worse in cold)
B. Reactions - Physical Factors
- Weather: Aggravation in winter & monsoon
- Position: Better stretching affected joints
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Irritable, impatient, dictatorial at home/shop
- Anxiety: About business losses, family finances
- Fear: Fear of poverty, fear being alone
- Dreams: Business failure, falling from height
- Other: Broods over past mistakes, feels unlucky
6. PHYSICAL GENERAL EXAMINATION
- Wt: 92 kg | Ht: 170 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 82 bpm | B.P.: 140/88 mmHg
- Face: Round, flushed
- Tongue: Coated white
- Nails: Pitted, thickened
- Skin: Multiple well-defined erythematous plaques with silvery scales on extensor surfaces; Auspitz sign positive
7. SYSTEMIC EXAMINATION
- Skin: Extensive plaques on elbows, knees, scalp; fissured heels; no pustules
- Musculoskeletal: Mild morning stiffness in knees & fingers
- CVS: S1, S2 Normal, mild tachycardia
- GIT: Soft, no tenderness
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Irritability, anxiety about finances, fear of poverty (Grade 3)
- Physical General: Chilly, desire sweets/salt, profuse sour sweat, thirst large quantities (Grade 3)
- Particular: Chronic scaly psoriasis on extensors, fissuring, < winter/stress, > sun (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic multi-miasmatic skin disease with strong Mental Generals (irritability, financial fears) and Physical Generals (thermal, desires, sweat) predominating; Kent suits deep constitutional analysis in psoriatic cases.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Irritability and dictatorial nature
- Anxiety about money/business
- Fear of poverty
- Desire for sweets and salt
- Chilly patient
- Profuse sour perspiration
- Thick silvery scaly psoriasis on extensors
- Cracks/bleeding < winter
-
Sun exposure
- Nail pitting
- Family history of psoriasis & arthritis
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Irritability | Mind; IRRITABILITY | 57 |
| 2 | Anxiety about money | Mind; ANXIETY; money matters, about | 8 |
| 3 | Fear poverty | Mind; FEAR; poverty, of | 46 |
| 4 | Desire sweets | Stomach; DESIRES; sweets | 486 |
| 5 | Skin eruption psoriasis | Skin; ERUPTIONS; psoriasis | 1316 |
| 6 | Perspiration sour | Perspiration; ODOR; sour | 1298 |
| 7 | Chilly | Generalities; COLD; agg. | 1348 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Arsenicum Album | 7/7 | 21 |
| 2 | Sulphur | 6/7 | 18 |
| 3 | Lycopodium | 5/7 | 14 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Itching, scaly eruptions, irritability | Thick scales, fissuring | Family autoimmune history | Destructive nail changes, cracking |
Dominant Miasm: Psora-Syphilitic
14. FINAL STEPS
- Provisional Diagnosis: Psoriasis
- Differentiation of Remedies: Compared Arsenicum with Sulphur. Sulphur is hot, untidy, desires spicy; Arsenicum matches chilly, fastidious yet anxious/fearful about finances/health, burning-itching < night, thirst large quantities, perfectionist irritability, profuse sour sweat. Lycopodium has more digestive issues & right-sidedness.
- Selection of Remedy (Materia Medica): Arsenicum Album matches chronic psoriasis with burning-itching < night/cold, chilly patient, anxiety/fear of poverty, thirst large quantities, fastidious mind, offensive discharges (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic multi-miasmatic skin case, sensitive constitution)
- Actual Prescription:
- Arsenicum Album 200 — single dose (one dose only, wait & watch)
- Placebo — 4 pills twice a day for 6 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 05/04/2026 | Scaling reduced 50%, itching milder, no new plaques, sleep improved | Placebo | Avoid stress triggers, use mild moisturizer, light sun exposure |
| 05/07/2026 | Plaques cleared 80%, nails improving, no joint complaints, energy better | Placebo | Maintain diet low in processed food, report any return of old symptoms |