Fungal Skin diseases & Homoeopathic Managements

         

“RING WORM”

(Dermatophyte infections) (Tinea)

·         Ringworm is a common fungal infection of the skin and is not due to a worm.

·         The medical term for ringworm is tinea. The condition is further named for the site of the body where the infection occurs.

·         Ringworm causes a scaly, crusted rash that may itch.

·         Ringworm occurs in people of all ages, but it is particularly common in children. Ringworm is contagious and can be passed from person to person by contact with infected skin areas or by sharing combs and brushes, other personal care items, or clothing. It is also possible become infected with ringworm after coming in contact with locker room or pool surfaces. The infection can also affect dogs and cats, and pets may transmit the infection to humans. It is common to have several areas of ringworm at once in different body areas.

Causative organism:         

Ø  3 species are responsible

-         Trichophyton ( Skin, Hair, Nail)

-         Microsporum (Skin, Hair)

-         Epidermophyton (Skin, Nail)

Predisposing factors:

-         Warm humid climate

-         Poor hygienic & Nutrition

-         Contact with infected person

-         Obesity

-         Debilitating diseases – Age of patient, Cancers, Tuberculosis

-         Areas more prone to friction e.g.- Axilla, Thighs.

Types:

-         Tinea capitis

-         Tinea corporis

-         Tinea barbae

-         Tinea faciei

-         Tinea cruris

-         Tinea pedis & Mannum

-         Tinea unguium ( Onychomycosis)

General features:

•      The word Tinea means “Moth eaten”

•      In this condition circular “Ring like” lesions are produced which progress to the periphery while the central parts is healed. They are seen on the advancing periphery.

•      It is a pea sized, pale, red, well defined slightly raised macule, it becomes Scaly soon.

•      Clears in the centre & Spreads, peripherally presenting vesicles & Macular.

•      Itching is severe

Types:

Ø  Tinea capitis – Scalp ring worm (Occipital  & Temporal region).

Mode of transmission -  Spreads by caps, Barber’s instruments, Hair brushes, combs

Ringworm of the scalp commonly affects children, mostly in late childhood or adolescence. This condition may spread in schools.  Tinea capitis appears as scalp scaling that is associated with bald spots (in contrast to seborrhea or dandruff, for instance, which do not cause hair loss).

Type: 

§  Black dot patch

§  Gray patch with scales.

§  Inflammatory lesion with itching, redness.

§  “Favus”- Circular yellow cups made of fungus material surround the hair follicles.  (which from Honey comb like masses)

 

                                               

Ø  Tinea corporis:  (Body ring worm)

Can appear anywhere on the body.

When fungus affects the skin of the body, it often produces the round spots of classic ringworm. Sometimes, these spots have an "active" outer border as they slowly grow and advance. It is important to distinguish this rash from other even more common rashes, such as nummular eczema. This condition, and others, may appear similar to ringworm, but they are not due to a fungal infection and require different treatment.

           

Ø  Tinea faciei (faciale):

Ringworm on the face except in the area of the beard. On the face, ringworm is rarely ring shaped. Characteristically, it causes red, scaly patches with indistinct edges.

Ø  Tinea barbae ( Face) “barber's itch”

            Mode of transmission -    Barber’s instrument

Ringworm of the bearded area of the face and neck, with swelling and marked crusting, is often accompanied by itching, sometimes causing the hair to break off. In the days when men went to the barber daily for a shave, tinea barbae was called barber's itch. Common in adult male.

      Type: 

§  Non inflammatory type spreading peripherally & clear at centre.

§  Inflammatory type – Deeper infection containing pustules.

Ø  Tinea cruris:  “Dhobi’s itch”- (jock itch).

          This is often called 'jock itch' because it occurs in sportspeople and is common among young men. It causes an itchy, red rash in your groin and the surrounding area and is usually seen in men who’ve been sweating a lot. Often you’ll also have athlete's foot, as the infection can be spread by scratching your groin after scratching your infected feet. Inner parts of thighs, Groin.         

 

        

Ø  Tinea pedis ( Foot) Athlete's foot & Tinea Mannum( Hands):

       Plantar surface of foot & palmar surface of Hands.

            Mode of transmission -    The infection is contacted from the bath rooms or urinals.

Athlete's foot (tinea pedis and tinea manuum). Around one in four adults have athlete's foot (tinea pedis) at some time in their lives. It can be caused by a combination of fungi and bacteria, which makes your skin itchy, dry, scaly and red. Sometimes it causes blisters and cracked skin. It’s especially common between your toes. You often pick up athlete's foot from coming into contact with contaminated skin left behind in swimming pools, showers and saunas. If you don't wash your hands after touching a contaminated area, it can spread to your hands where it's known as tinea manuum. This mostly affects the creases on your palms and sides of your fingers.

Ø  Tinea unguium ( Fungal Nail)

   “Onychomycosis” - is the name for any fungal nail infection.

    - It is a fungal infection common on Nails, Characterized by brittleness, and thickening of Nails.

   - The inflammation usually starts free margin & slowly progresses to the Nail bed.

   - This commonly affects the Great toe, Nails, but other nails are also affected.

Investigation:

Ø  “Skin scraping for Fungal”:

    - Scraping of skin lesion dissolved in 20% potassium hydroxide (20%KOH) & can also be demonstrated by Culture.

Gen Management:

ü  Avoid soap & keep the part dry.

ü  Change the under garments frequently.

ü  Clothes should be washed in hot water.

ü  Foot wear should have sufficient aeration.

ü  Apply powder & keep that area dry. 

“TINEA VERSICOLOR” (Pityriasis Versicolor)

Caused by:  “Malassezia furfur” @ “Pityrosporum orbiculare”

Predisposing factors:

- Freely sweating individuals, Especially Athletes.

Features :

  - It is characterized by Scaly white or Brown, In this condition small white spots appear on the trunk, Neck, upper arms, & Face.

  - The lesion is Velvety, faintly brown or chamois colored, there is No itching, the lesions are most frequently distributed over trunk.

Gen Management:

 - Change of dress frequently

 - Avoid sharing soaps, towels etc.

- Personal hygiene is most important.

- The inner garments should be Boiled & changed daily.

Homoeopathic Management:

The following are the most indicated remedies in fungal infections of skin:

Tinea in general – Bacillinum, Natrum Mur, Phytolacca, Sepia, Tellurium, Thuja, Tuberculinum, Arsalb, Chrysar.

Tinea barbae – Thuja, Bacillinum, Calc carb, Cicuta, Graphitis, Kali bich, Nit acid, Platina, Staphysagria, Sulphur.

Tinea Capitis – Calc carb, Dulcamara, Phyto, Sepia, Mezerum, Psorinum, Tellurium.

Tinea on face – Tuberculinum, Sepia, Graphitis, Natrum carb, Natrum Mur, Tellurium, Thuja.

Tinea versicolor – Thuja, Natrum ars, Sepia.

Rubrics in Murphy’s Repertory:

•        Skin - TINEA, general

Ail. arg-n. CALC. Carb-an. Carb-v. carbn-s. chin. cina cupr. cupr-act. cur. Fil. Form. frag. Gran. Graph. grat. kali-c. kali-i. mag-m. merc. Nat-c. nat-s. nux-v. petr. phos. Plat. Puls. Sabad. santin. Sep. Sil. Stann. sulph. ter. thuj. valer.

•      Skin - TINEA, general - tinea, capitis, favosa

aethi-a. agar. ars. ars-i. Brom. calc. calc-i. Calc-m. calc-s. Dulc. ferr-i. graph. Hep. jug-r. Kali-c. kali-s. lappa Lyc. med. Mez. nit-ac. olnd. phos. Sep. Sil. sul-ac. sulph. ust. vinc. Viol-t.

•          Skin - TRICHOPHYTOSIS

ant-c. ant-t. Ars. Bac. calc. calc-i. Chrysar. Graph. hep. jug-c. jug-r. kali-s. lyc. mez. psor. rhus-t. semp. Sep. sulph. Tell. tub. viol-t.

•      Skin - RINGWORM, general

anac. anag. ars-s-f. BAC. Bar-c. Calc. calc-act. chrysar. clem. dulc. dys. equis-h. Eup-per. Graph. hell. hep. iod. Lith-c. mag-c. med. Nat-c. NAT-M. phos. PHYT. Sanic. SEP. spong. sulph. syc. TELL. THUJ. tor. TUB.

•        Skin - RINGWORM, general - ringworm, beard

            ant-t. anthraci. ars. aur-m. Bac. Calc. calc-s. chrysar. Cic. cinnb. cocc. cypr. Graph. Kali-bi. kali-m. lith-c. Lyc. mag-p. med. merc-pr-r. nat-s. Nit-ac. petr. phyt. plan. Plat. rhus-t. sabad. sep. sil. Staph. stront-c. sul-i. Sulph. tell. THUJ.

•       Skin - RINGWORM, general - ringworm, face

            anag. Bac. bar-c. calc. cinnb. clem. dulc. Graph. hell. kali-chl. lith-c. lyc. Nat-c. Nat-m. phos. SEP. sulph. tarent. Tell. Thuj. TUB.

•       Skin - RINGWORM, general - ringworm, head

                        CALC. DULC. Phyt. Sep. tell. thuj. tub.  

•      Skin - TINEA, general - tinea, versicolor

            ars. ars-i. bac. calc. carb-an. carb-v. chrysar. kali-s. mez. Nat-act. nit-ac. phos. phyt. psor. Sep. sil. sulph. tell. THUJ.

HYPERACIDITY & INDIGESTION - HOMOEOPATHIC CARE FOR DYSPEPSIA

Hyperacidity is also called Acid Dyspepsia, which is one of the most common problem. Hyperacidity is a medical condition in which the stomach secretes a lot of acids. Dyspepsia, also known as indigestion or upset stomach, is a term that describes discomfort or pain in the upper abdomen. It is not a disease. Various conditions cause dyspepsia. It can be caused due to various medications, stressed lifestyle and spicy foods. The main symptom is usually pain or discomfort in the upper tummy (abdomen). In addition, other symptoms that may develop include Bloating, Belching, Quickly feeling full after eating, Feeling sick (nausea) & Being sick (vomiting).

Causes of Dyspepsia

Indigestion is usually related to lifestyle and what we eat and drink. It may also be caused by infection or some other digestive conditions.

Some common causes include:

·        Life Style factors - Eating too much, Eating too rapidly, Consuming fatty or greasy foods, Consuming spicy foods, Consuming too much caffeine, Consuming too much alcohol, Consuming too much chocolate, Consuming too many fizzy drinks, Emotional trauma, moderate to intense exercise immediately after eating.

·        Functional dyspepsia - a type of indigestion that may undermine the stomach's ability to accept and digest food and then pass that food on to the small intestine.

·        Gallstones

·        Gastritis (inflammation of the stomach)

·        Hiatus hernia

·        Infection, especially with bacteria known as Helicobacter pylori

·        Nervousness

·        Obesity - caused by more pressure inside the abdomen

·        Pancreatitis (inflammation of the pancreas)

·        Peptic ulcers

·        Smoking

·        Some medications like Antiinflammatory medicines are the most common culprits. These are medicines that many people take for arthritis, muscular pains, sprains, period pains, etc. For example: aspirin, ibuprofen,and diclofenac but there are others. Antiinflammatory medicines sometimes affect the lining of the stomach and allow acid to cause inflammation and ulcers.

·        Various other medicines sometimes cause dyspepsia, or make dyspepsia worse. They include: digoxin, antibiotics, steroids, iron, calcium antagonists, nitrates, theophyllines and bisphosphonates.such as antibiotics and NSAIDs (non-steroidal anti-inflammatory drugs)

·        Stomach cancer

Clinical manifestations of Dyspepsia

Most people with indigestion feel pain and discomfort in the stomach or chest area. The sensation generally appears soon after consuming food or drink. In some cases symptoms may appear some time after a meal. Some people feel full during a meal, even if they have not eaten much. Heartburn and indigestion are two separate conditions.

Heartburn is a burning feeling behind the breastbone, usually after eating.

The Common symptoms are Nausea, Belching, Feeling bloated (very full)

In very rare cases indigestion may be a symptom of stomach cancer.

Mild indigestion is rarely anything to worry about. if symptoms continue for more than two weeks. Consult a physician immediately if pain is severe, and symptoms like

Loss of appetite or weight loss, Vomiting, Black stools, Jaundice (yellow coloring of eyes and skin), Chest pain, Shortness of breath, Sweating, Chest pain radiation to the jaw, arm or neck.

Investigations

Majority of patients indigestion is mild and does not occur very often. In such cases no treatment from a doctor is required. People who experience indigestion regularly consult a good physician.

Blood test - if the patient has any symptoms of anemia then blood test is needed.

Endoscopy - patients who have not responded to treatment, or those with certain signs and symptoms, may be advised to have their abdomen examined in more detail like endoscopy is advised.

Tests to diagnose Helicobacter pylori infection - this may include a urea breath test, a stool antigen test, and a blood test. Peptic ulcers are often cause by this bacterium.

Liver function test – if the patient may have a biliary condition, which affects the bile

ducts in the liver. This involves a blood test that determines how the liver is working.

X-rays - usually an upper-gastrointestinal and small bowel series. X-rays are taken of the esophagus,stomach and small intestine.

Abdominal ultrasound - high-frequency sound waves make images that show movement, structure and blood flow.

Abdominal CT (computed tomography) scan.

Management

Lifestyle changes

For all types of dyspepsia, the National Institute for Health and Care Excellence (NICE) recommends the following lifestyle changes like Make sure you eat regular meals, Lose weight if you are obese, If you are a smoker, consider giving up, Don't drink too much alcohol.

Changing the way you eat may help your symptoms. Steps you can take include: Allow enough time for meals, Chew food carefully and completely, Avoid arguments during meals, Avoid excitement or exercise right after a meal, Relax and get rest if indigestion is caused by stress.

Posture - Lying down or bending forward a lot during the day encourages reflux. Sitting hunched or wearing tight belts may put extra pressure on the stomach, which may make any reflux worse.

Bedtime - If symptoms recur most nights, the following may help:

·        Go to bed with an empty, dry stomach. To do this, don't eat in the last three hours before bedtime and don't drink in the last two hours before bedtime. If you are able, try raising the head of the bed by 10 – 20 cms (for example, with books or bricks under the bed's legs). This helps gravity to keep acid from refluxing into the oesophagus. If you do this, do not use additional pillows, because this may increase abdominal pressure.

·        Spices and condiments such as pepper, mustard must be avoided.

·        Vinegar or pickles, which make food more palatable and lead to overeating, must be avoided.

·        Alcohol, tobacco, strong tea and coffee must be avoided. Highly seasoned meats, pulses, potato, rice, cheese, refined, processed, stale and tinned foods should all be avoided.

Home Remedies:

1.      For instance, drinking a glass of water at the first sign of indigestion can give you much relief. Water helps dilute stomach acids thus giving you relief from bloating and burning.

2.      Apple cider vinegar is often used to kick start a slow stomach and settle indigestion due to its antibiotic properties. Add one tablespoon apple cider vinegar to a cup of water. Mix in one teaspoon honey. Drink this solution two to three times a day for quick relief.

3.      Fennel seeds can be really helpful for indigestion caused by very spicy or fatty food. Fennelseeds contain oil that can help reduce nausea and control flatulence.

4.      Ginger stimulates digestive juices and the flow of enzymes that help you digest your food. This makes ginger an effective remedy for indigestion from overeating.

5.      Baking soda - Indigestion often happens due to high levels of stomach acids. Baking soda is one of the most simple and effective treatments for indigestion because it acts like an antacid. Stir one half teaspoon of baking soda into half a glass of water. Drinking this solution will neutralize the acid in your stomach and give your relief from bloating.

6.      Coriander is an effective spice to treat indigestion. Add some roasted coriander seeds to half a glass of buttermilk and drink it twice a day.

7.      Drinking herbal tea after eating a heavy meal can greatly reduce indigestion. Dip your favorite herbal tea bag into a hot cup of water and cover it for five minutes. Drink it while it is still warm. You can try herbal tea containing mint, raspberry and blackberry for instant relief. Peppermint or chamomile tea can also calm your stomach, especially after overeating.

HOMOEOPATHIC MANAGEMENT

Homoeopathy is a remarkable resource for those dealing with digestive disorders. Homeopathic constitutional treatment based on the individual case is the most suitable and would aim to heal the underlying physical or emotional crisis causing digestive disorders. The unique physical, emotional and mental expression of illness is characteristic and is used to channel the course of Homoeopathic treatment. The remedies work by stimulating body’s natural ability to heal itself, acting as a catalyst for healing. Homoeopathy can be of assistance in retrieving normal motility and treating any psychological issues related to IBS. Homeopathic remedies can help rebuild mind, body and spirit as well as personal relationships for a balanced lifestyle. Homeopathy will reinforce and tone the body’s systems. Homeopathic remedies can help deal with anxiety, depression, and stress along with digestive problems. It will attend to nutritional problems and help the patient develop a healthier body image.

Some Homoeopathic remedies for Dyspepsia are

Indicated Remedies	Indications
Arsenicum album	This remedy may be indicated if a person feels anxious, restless yet exhausted, and is worse from the smell and sight of food. Burning pain is felt in the stomach and esophagus, which often is relieved by warmth and sitting up. Vomiting and diarrhea are possible. Upsets from spoiled food or from eating too much fruit often respond to this remedy.
Bryonia	When this remedy is indicated, the stomach feels heavy, with rising acid and a bitter or sour taste. Pain and nausea are worse from motion of any kind. The person may have a dry mouth and be thirsty for long drinks, which may increase discomfort. Bryonia is strongly suggested if a person is grumpy and wants to stay completely still and not be touched or talked to.
Carbo vegetabilis	Sour belching bringing only small relief, burning pain in the stomach and abdomen, and flatulence after eating may be seen when this remedy is needed. The person feels cold and faint, with a strong desire for fresh or moving air. Digestion may be slow and incomplete, with nausea or cramping.
Colocynthis	Cutting, cramping pain in the stomach and abdomen, with relief from hard pressure or from doubling over, indicates a need for this remedy. A bitter taste in the mouth, a feeling that the intestines are about to burst, or a sensation that stones are grinding together in the abdomen may be present. Indigestion may be worse when the person feels upset, especially after suppressing anger.
Lycopodium	This remedy is indicated for many digestive troubles. The person’s appetite may be ravenous, but eating even a small amount can cause a feeling of fullness and bloating. Rumbling gas may form in the abdomen, pressing upward and making breathing difficult. The person often has a strong desire for sweets, is sleepy after meals, and feels worst in the late afternoon and evening.
Natrum carbonicum	This remedy can be helpful to mild people who have trouble digesting and assimilating many foods and have to stay on restricted diets. Indigestion, heartburn, and ulcers can occur if offending foods are eaten. Milk or dairy products can lead to flatulence or sputtery diarrhea that leaves an empty feeling in the stomach. Cravings for potatoes and sweets are common; also milk, but it makes these people sick, so they have usually learned to avoid it.
Natrum phosphoricum	A sour taste in the mouth, an acid or burning sensation in the stomach, sour vomiting, regurgitated bits of food, and a yellow coating on the tongue are all indications for this remedy. The person may have problems after consuming dairy products or too much sugar. Another indication for Natrum phos is a craving for fried eggs.
Nux vomica	This remedy is often useful for indigestion, and is especially suited to those who overindulge in stimulants, food, and alcohol. Chilliness, irritability, and sensitivity to odors, sound, and light are often seen. Pain and weight can be felt in the stomach, with cramps or constricting pains. The person often feels an urge to vomit or move the bowels (which may make the person feel better, but is rarely successful).
Phosphorus	Burning pain in the stomach that feels better from eating ice cream or other cold, refreshing foods suggests a need for this remedy. The person is usually thirsty for cold drinks, but often feels nauseous or vomits once liquids warm up in the stomach. People needing Phosphorus may have a tendency toward easy bleeding and sometimes develop stomach ulcers.
Pulsatilla	Indigestion that is worse from eating rich and fatty foods, with a feeling of a lump or pulsation in the stomach, suggests a need for this remedy. Discomfort often is worse from warmth, especially in a stuffy room, and the person may feel better from gentle walking in open air. A bitter taste in the mouth can take the pleasure out of eating. A person who needs Pulsatilla usually does not feel thirsty and may be tearful and emotional.