CASE PRESENTATION

DR. ESHA BHATIA

JR (NHMC&H)
Date- 27 March, 2023
A CASE OF SEBORRHEIC
DERMATITIS TREATED WITH
HOMOEOPATHY- A CASE REPORT
INTRODUCTION
• Seborrheic dermatitis (SD) is a common, non contagious,
inflammatory skin disease presented with red patches and greasy
scales on affected areas particularly the scalp, face and body.
• It presents as red, flaking, greasy-looking patches in areas of the body
where glands in the skin called sebaceous glands (oil producing
glands) are most abundant.
• Most commonly affected sites includes scalp, eyebrows, glabella
region of the forehead, central chest (sternum area) and genital
region.
EPIDEMIOLOGY
• Prevalence- Approximately 5-10% of general population worldwide. It
affects all ethnic groups and all regions globally.
• SD has bimodal distribution. It occurs in first 3 months of life
(INFANTILE SD) and second it begins at puberty and reaching its peak
at 30-40 years of age. (ADULT SD).
• Men are more frequently affected than women.
• Incidence of SD is also higher in HIV positive patients and others
immunodeficiency disorders.
ETIOLOGY
Although the etiology of adult SD is not definitely known, there are 3
factors that play a role:-
• Sebaceous Gland overproduction
• Alteration in colonization and metabolism of cutaneous microflora
(Malassezia species)
• Individual susceptibility and host response
• Sebum permits growth and
proliferation of yeast of
Malassezia family which
through the action of lipase
degrade lipids on skin surface
with production of unsaturated
fatty acids.
• The inflammation causes
stratum corneum
hyperproliferation (scaling)
which alters the stratum
corneum barrier and impairs its
function.
CLINICAL FEATURES
• Infants with seborrheic dermatitis presents with focal or diffuse,
white or yellow, greasy scaling and crusting of the scalp. The lesion
may become so thickened that it forms a cap, known as CRADLE CAP.
• In adults, seborrheic dermatitis presents as greasy scaling of the scalp
(dandruff).
• It also presents as ill defined erythematous patches with yellow white,
greasy scales on nasolabial folds, eyelids, eyebrows, glabella, anterior
chest and less commonly on the upper back.
• Pruritus is common in adolescent seborrheic dermatitis with scalp
involvement.
DIAGNOSIS- Diagnosis is mainly clinical based on characteristic clinical
morphology of scaling and erythema in typical sebum rich areas.
• Homoeopathy is a science based on law of similars, which means it
treats the disease with medicines producing similar symptoms when
given in healthy individuals.
• This case shows how homoeopathy can be helpful in treating
seborrheic dermatitis when the remedy is prescribed on the basis of
homoeopathic principles.
CASE SUMMARY
• A 20 years old male patient presented in OPD of NHMC&H on 6 Feb,
2023 with complains of itchy red forehead, dandruff over scalp with
itching and small scaly patches on scalp with itching since 3 years.
Location- Scalp, over forehead (glabella)
Sensation- Itching
Aggravation- in winters
Causation – association with exam stress
• Past history- Dengue in 2016
• Personal history- N.S.
• Family history- N.S.
PATIENT AS A PERSON-

• Mild, sensitive but sometimes aggressive and shouts in anger

• Very fastidious and perfectionist in his work
• Loves singing
• There is a history of prolonged suppression in the patient since
childhood. When he is in school, he is always kept under the pressure
of coming first in class by his parents. He wants to become a singer
but due to pressure by his parents he became engineer.
PHYSICAL GENERALS:-
• Appetite- Adequate
• Thirst- Adequate
• Desire- N.S.
• Aversion- N.S.
• Intolerance- N.S.
• Urine- Satisfactory
• Stool- Satisfactory
• Sleep- Satisfactory
• Thermal Reaction- Chilly(2+)
SELECTION OF REMEDY AND BASIS OF PRESCRIPTION-

Carcinosin 30, 1 dose was prescribed followed by sac lac for 3 weeks on
the basis of following symptoms-

• By nature, patient is mild and sensitive who has an artistic touch.

• The patient is fastidious and perfectionist by nature.
• Prolonged history of suppression of emotions.
• Chilly patient
RESULTS-

BEFORE AFTER
TREATMENT RECORD
DATE PRESCRIPTION FOLLOW UP
06 FEB, 2023 Carcinosin 30/1 dose empty Remedy was selected based on
stomach+ SL 30/ twice daily for 3 symptom similarity and
weeks. homoeopathic principles.
1 MARCH, 2023 SL 30/ twice daily for 2 weeks Patient was better with relief in his
itching and dandruff by 50%
19 MARCH, 2023 SL 30/ twice daily for 2 weeks Patient was better with no new
complaint.
CONCLUSION
• There was no relapse of Seborrheic Dermatitis. In subsequent follow
ups scaling was reduced with relief in itching.
• To conclude that seborrheic dermatitis is cured a long follow up is
required (atleast 6 months are required as patient was suffering since
long time) and the case is still followed up.
MIASMATIC APPROACH OF SEBORRHEIC
DERMATITIS
PSORA
SKIN Psora has eczema and eruptions of all kinds in which
DRYNESS predominates.
Psoric skin appears dirty, dry and harsh. The skin
cannot endure water and has an unwashed, unhealthy,
dirty look.
Itching and burning occurs late in the evening before
midnight and is most unbearable.
> From natural discharges like perspiration.
SCALP Bran like dandruff with or without itching.
& Dry eruptions which becomes brown and turn into
HAIR dead scales appear on the scalp.
There is severe itching and dryness.
FACE Psoric face has dry, itching pimples and simple acne.
SYCOTIC
The sycotic patient is subject to warts,
moles, condyloma, skin tags and
lipomas.
Sycotic skin looks oily and the tip of
the nose appears red.
Sycotic skin eruptions are < by
consumption of meat, in humid and
rainy weather, > in dry weather.
Hair falls out and alopecia occurs in
circular, circumscribed patches.
Vesicular type of skin eruptions
appears on scalp.
Sycotic face can be pale, bluish and
dropsical.
SYPHILITIC
Ulcers and abscesses on different
parts of skin are syphilitic.
Threatening (ulcerative and
destructive) appearance.
All symptoms of syphilis < in
night, in summer, from warmth of
bed, warmth in general.
> Comes with any abnormal
discharges.
Dandruff with thick yellow crusts.
Hair falls out in bunches.
Syphilitic scalp eruptions have
offensive, oozing pus and
aggravated by washing.
A greyish, greasy face is
characteristic of this miasm and
general look is like wrinkled, old
man.
HOMOEOPATHIC REMEDIES WITH THEIR
INDICATIONS FOR SEBORRHEIC DERMATITIS
• KALI SULPH- Third stage of inflammation with yellow discharges and
desquamation. Sharp, shooting, shifting pains. Head- bald spots, dandruff with
scald head.
• KALI MUR- Dandruff is whitish and copious.
• THUJA OCCIDENTALIS- White scaly dandruff, hairs falls out easily, wants warmth
around head, <humid atmosphere.
• GRAPHITES- Scales with itching, crust, burning round spots on head, there is
discharge of watery, transparent, sticky fluid.
• NATRUM MUR- Sensitive scalp, white scaly dandruff, hairs falls out on touch, oily
greasy skin.
• PHOSPHORUS- Hair fall in bunches with dandruff, desire for cold things, bleeding
tendency.
• ALUMINA- Skin dry, tettary eruption. Burning < winters, chilly patient, falling of
hairs, itching without eruption , scratches until it bleeds.
• LYCOPODIUM- Great falling out of hairs. Eczema, moist oozing behind ears.
Premature baldness and gray hairs, skin becomes indurated, violent itching <
from warmth.
• SULPHUR- Violent itching and burning, >scratching, feels good to scratch,
scratching causes burning < heat of bed.
• MEZEREUM- The head is covered with thick, leather like crust under which thick
and white pus collects here and there, hair is glued and matted together, pus
after a time is ichorous, becomes offensive and breeds vermin.
• MAG CARB- Sourness of all discharges and secretions. Head- pain on vertex as if
hair were pulled.
• CANTHARIS- Large scaly dandruff, hairs falls while combing.
REPERTORIAL APPROACH IN SEBORRHEIC
DERMATITIS
KENT’S REPERTORY
• Head, dandruff, white
• Head, dandruff, yellow
• Head, eruption, crusts, scabs
• Head, eruption, crusts and scabs, desquamating
• Head, eruption, crusts and scabs, white
• Head, eruption, crusts and scabs, yellow
• Head, eruption, eczema
• Head, eruption, eczema, margin of hair from ear to ear posteriorly
• Head, eruption scales
• Head, eruption, itching
• Head, hair, dryness
• Face, eruption, crusty, scabby
• Face, eruption, desquamating
• Face, eruption, eczema
• Face, eruption, eczema, margins of hair
• Skin, dry, burning
• Skin, eruption, crusty
• Skin, eruption, desquamating
• Skin, eruption, eczema

BBCR REPERTORY-
• Head, external, dandruff
• Head, external, desquamation, itching
• Head, external, eczema
• Head, external, eruption on, crusty
• Head, external eruption on, dry
• Head, external, eruption on, ears about
• Head, external, eruption on, scaly
• Hair, falling out, from head
• Face, eruption, forehead on
• Skin and Exterior body, eruption in general, desquamating
• Skin and Exterior body, eruption in general, scabby
• Skin and Exterior body, desquamation, exfoliation, peeling, white scales
PHATAK REPERTORY-
• Eczema, hair, margins at
• Eczema, itching without
• Eczema, washing agg
• Eczema, sun exposure from
BOERICKE’S REPERTORY-
• Skin, eczema, behind ears
• Skin, eczema, of face
• Skin, eczema, of scalp