ICTHYOSIS AND ITS HOMOEOPATHIC MANAGEMENT
SREEJA L
dr.sreeja.l@gmail.com
Ichthyosis means resemblance to fish skin. It is a hereditary disorder of keratinisation. Skin became dry and scaly.
Different types:
Ichthyosis Vulgaris:
It is inherited as an autosomal dominant gene. Lesions are usually not present at birth. Lesions develop between 1-4 years of age. Lesions present all over the body sparing flexors like cubital and popliteal fossae, axillae and groins, even in the most severe forms. The lesions consists of dirty brown, angulated scales. The scales are more prominent on the extensor surface of the back than chest and abdomen. In children face ad scalp are initially affected but rend to clear later. In addition, some patients show increased marking of palms and soles. Follicular hyperkeratotic papules are present on the shoulders, arm, buttocks and thighs. Usually the lesions are asymptomatic but some times irritation occur especially during winter season. The lesions improved during summer months and get aggravated during winter. Some times the lesions persist throughout life there is some spontaneous improvement at puberty.
Treatment
Ars. Iod:
Skin dry, scaly,, itching
Marked exfoliation of skin in large scales leaving a raw exuding surface beneath
Ichthyosis, enlarged scrofulous glands.
Graphitis:
Rough, hard, persistent dryness of portions of skin unaffected by eczema.
Unhealthy skin
Cracks in nipples, mouth, between toes, anus
Burning and stinging pain
< Warmth, at night, during and after menstruation
> In the dark, from wrapping up.
Petroleum
Itching at night
Skin dry, constricted, very sensitive, cough and cracked leathery
Thick, greenish crusts, burning and itching, redness, raw, cracks bleed easily.
Thyroidinum
Skin dry, impoverished.
Cold hands and feet
Icthyosis lupus.
Itching without eruption, worse night
Sulphur
Dry, scaly, unhealthy
Every little injury suppurates
Itching, burning, worse scratching and washing.
Excoriation, especially in folds.
Skin affection after local medication.
Pruritus especially from warmth, in evening, often recurs in spring-time,damp weather.
X-Linked Ichthyosis
It is transmitted through a recessive gene located on the distal short arm of the x-chromosome. It is transmitted by females, but seen in the males. In such patients there is a deficiency of an enzyme called steroid sulphatase. It appears more or less like icthyosis vulgaris unlike it is more widespread and involves the cubital and popliteal fossae also. Follicular hyperkeratolic papules on shoulders, buttocks and thighs. It does not improve at puberty. Scales may be present on the side of face and even scalp. Between 20-30 years of age corneal opacity may develop in majority of the patients. Some times associated with cryptorchidism, hypogenitalia and mental retardation.
Treatment:
Aur, Clc., Nat-m., Thuja, Platina
Lamellar Ichthyosis:
It is inherited through autosomal recessive gene of variable expression. Clinical features include erythema and hyperkeratosis, erythema with scaling, which is more severe on flexors. The skin smooth, shiny and shows fine wrinkles when passed between the thumb and the index
finger. The face and scalp are usually scaly. The scalp may even be crusted. It is associated with corneal dystrophes, photo phobia, small stature and mental retardation.
Treatment:
Nat-c, Bell, Aur, Calc-f, Plat.,Sil,Zinc.s, Nat.c
Nat-Carb
- Inclination to perspire easily, or dry, rough, cracked skin.
- Eruption on finger-tips, knuckles and toes.
- Soles of feet raw and sore.
Calc-Flur
- Marked whiteness of skin.
- Chaps and cracks.
- Fissures or cracks in the palms of the hands and hard skin
- Fissure of the anus
Bell.
- Dry and hot skin
- Swollen, sensitive
- Burns scarlet, smooth
- Eruptions like scarlatina suddently spreading
- Erythema, pustules on face
- Alternate redness and paleness of skin
- Induration afger inflammation
- Erysipelas
Epidermolytic Hyperkeratosis
It is also known as bullous vatiety of ichtyoriforn erythioderma and is transmitted by an autosomal dominant gene. The affected children develop crops of bullae and occasionally erythema and also desquamation within a few hours to a week after birth. Bulllae are followed by hyperkeratotic lesions. Irregular even linear warty lesions are seen specially on flexors like axillae cubital and popliteal fossae, groins and some time even on neck, dorsum of the hands and feet. In some cases lesions may offensive due to secondary infection. In some patients palmo-plantar keratoderma is seen. Skin is generally dry.
Treatment
Alum., Sal-ac, Calc-f, Thuja
Salicylicum acidium:
- Itching vesicles and pustules, better by scratching.
- Sweat without sleep
- Urticaria
- Hot and burning skin
- Purpura
- Herpes zoster
