Vitiligo
1. PRELIMINARY DATA
- No.: 241/2026
- Patient's Name: NOP
- Address: Flat 2702, Topaz Enclave, Pune.
- Occupation: Office Administrator (desk job, stress from routine)
- Religion: Hindu
- Date: 05/09/2026
- Age: 41 Years
- Sex: Female
- Education: B.Com
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Skin (face, hands, arms, legs – symmetrical) | Depigmented milky-white patches, irregular borders, gradual spread, no scaling/itching usually | < Stress/emotional shock, < Sun exposure (burns easily), < After injury, < Cold weather, > Warm environment, > Gentle sun (sometimes repigmentation), since 8 years (progressive, started on hands, now face/neck) | Anxiety about spread, low self-esteem, social withdrawal |
| General | Fatigue | < Emotional upset | Depression, irritability |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Patches started after major family stress 8 years ago; suppressed with topical steroids (temporary, rebound spread); recurrent thyroid issues (hypothyroidism diagnosed 3 years ago); suppressed childhood eczema.
- Family History: Mother has vitiligo. Maternal aunt has thyroid disease. Father has diabetes.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Normal
- Desires: Warm drinks (+++), Sweets (+)
- Aversions: Cold food
- Thirst: Moderate
- Elimination:
- Urine: Normal
- Stool: Regular
- Perspiration: Scanty
- Sleep: Disturbed by worry; wakes anxious
- Thermal State: Chilly patient (prefers warm clothing)
B. Reactions - Physical Factors
- Weather: Aggravation in cold weather
- Position: Better warm room
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Anxious, sensitive, withdrawn
- Anxiety: About appearance, social stigma
- Fear: Fear of total depigmentation, fear rejection
- Dreams: Being different, isolated, criticized
- Other: Depression, low confidence
6. PHYSICAL GENERAL EXAMINATION
- Wt: 66 kg | Ht: 160 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 80 bpm | B.P.: 128/82 mmHg
- Face: Depigmented patches on cheeks/forehead
- Tongue: Clean
- Nails: Normal
- Skin: Multiple depigmented macules, Koebner phenomenon positive |
7. SYSTEMIC EXAMINATION
- Skin: Symmetrical depigmented patches on face/hands/arms/legs, no inflammation
- Endocrine: Thyroid mildly enlarged
- CVS: S1, S2 Normal
- GIT: Normal
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Anxiety about appearance, depression, fear rejection (Grade 3)
- Physical General: Chilly, desire warm drinks, scanty sweat, depigmented patches (Grade 3)
- Particular: Vitiligo patches spreading, < stress/cold/sun, > warm (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic autoimmune pigmentary disorder with strong Mental Generals (anxiety, depression) and Physical Generals (chilliness, sudden onset) dominating; Kent suits skin rubrics for vitiligo.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Anxiety about appearance
- Depression/low confidence
- Fear rejection
- Desire warm drinks
- Chilly patient
- Depigmented patches milky-white
- Spread after stress
- < Stress, cold, sun
-
Warm environment
- Koebner phenomenon
- Family vitiligo/thyroid
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Anxiety health | Mind; ANXIETY; health, about | 6 |
| 2 | Sadness depression | Mind; SADNESS | 75 |
| 3 | Desire warm drinks | Stomach; DESIRES; warm drinks | 486 |
| 4 | Skin discoloration white | Skin; DISCOLORATION; white | 1306 |
| 5 | Skin eruptions vitiligo | Skin; ERUPTIONS; vitiligo | 1310 |
| 6 | Chilliness | Generalities; COLD; agg. | 1348 |
| 7 | Generalities stress agg. | Generalities; MENTAL EXERTION; agg. | 1372 |
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 | Phosphorus | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Depigmentation, anxiety, chilly | Autoimmune patches, spread | Family autoimmune | Destructive fear rejection |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Vitiligo
- Differentiation of Remedies: Compared Arsenicum with Sulphur. Sulphur has more burning/itching, hot; Arsenicum matches vitiligo with anxiety about appearance/health, chilly, fear rejection/cancer, desire warm drinks, irritability/depression. Phosphorus more bright/open.
- Selection of Remedy (Materia Medica): Arsenicum Album matches vitiligo with depigmented patches, anxiety/fear about spread/rejection, chilly patient, desire warm drinks (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic autoimmune skin miasmatic case, sensitive constitution)
- Actual Prescription:
- Arsenicum Album 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 | No new patches, slight repigmentation in old ones, mood better | Placebo | Reduce stress, gentle sun exposure, avoid chemicals |
| 20/01/2027 | Patches stable, repigmentation 40%, confidence improved | Placebo | Continue stress management, nutritional support |