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Help sought on acne rosacea

Posted: Sun Jun 06, 2004 12:54 am
by Hans Radax
A local homeopathic MD who, unfortunately, does not speak English, has asked me to seek help on the following case.
Patient: Woman, born 1954, with butterfly shaped acne rosacea on her cheeks

Anamnesis:

1972: Acne vulgaris with a variety of treatments (antibiotics, facial creams and later on herbs and honey which "cured")

1977: Surgery to remove tonsils after recurrent tonsillitis. After this, allergic problems started: Allergy to (canned) tuna-fish (fresh fish does not cause adverse reactions, neither does other canned food), peanuts and maracuya fruits. Also allergic to certain yellow colorants and some antibiotics.

1981: Diagnosis of a toxic node in the left lobe of her thyroid gland (it was suspected that she had suffered from hyperthyroidism from very young, as she always was very skinny). From then on, she took (not regularly, though) thyroxin medication. First problems with chronic colitis, no treatment.

1982: Surgery to remove lipomas from her right breast. She still has a small lipoma on her left breast without causing her problems.

1990: Operation of appendicitis, where a strangulated uterine myoma was detected and removed.

1994: Premature menopause (due to her thyroid problem, according to the medics).

1998: Pre-surgical treatment of hyperthyroidism with a medicament (she does not remember the name) which, as a side effect, lowered her immune response. After an insect pricked her left ankle, her foot and ankle swelled greatly with a bluish discoloration. After a treatment with a "fifth-generation antibiotic" (she does not remember the name), she developed a pseudomembranous colitis with diarrheas resembling mashed strawberries. She had to be hospitalized.

1999: After increased growth of the thyroid gland, surgical removal of ¾ of the gland (all of the left lobe, ½ of the right lobe). Subsequently, until now, regular substitution of Thyroxin.

Present state:

Mentals: Timid, low self esteem (although she is very intelligent, a graduated economist. She runs the financial area of a larger company). Easily frightened. Fear at night, of the dark, fears that the "devil" or some evil might hurt her. Very religious, prays much, before leaving her home, she blesses it several times with the cross sign (fear that something evil might happen?). Mild disposition, but stubborn on occasions. Easily offended, and suffering form the impression that other people might laugh over her facial problem.

Generals: Acne rosacea worse from heat, heat of the sun (we are living here at 2500 m above sea level, very near to the equator, so the sun radiation is tremendous), extreme cold. Even hot food or drinks aggravate. Worse from alcoholic drinks (wine). Worse from physical exertion, from emotions.

Abdominal symptoms worse from fat food, which she does not like. She likes sweets, chocolate, meat. After the thyroid operation, she has gained weight.

She easily catches a cold (which has improved tremendously through Gels 12 as a prophylactic).

Very sensitive to smells and noise.

She is easily impressed by bad news, scenes of suffering on TV, etc.

She likes bright colors and elegant, tight fitting clothing.

Particulars: Acne rosacea, butterfly shaped on cheeks, with pimples on cheeks and nose. Rosacea on forehead (which she also had before) has disappeared. Aggravation expresses itself in form of an intense red coloration and swelling of cheeks, especially and foremost of the left cheek. Gastritis with burning, after eating fat food. Chronic colitis with flatus. Varices on her legs. Painful corns on the soles of her feet (starting right, which was removed, now on her left foot). Retention of liquids, with swelling of her feet, ankles, and hands. On both feet, hallux valgus (? "juanete" in Spanish)

Treatment:

1. Allopathic treatment of rosacea: Antibiotics (Oxytetracycline, with no effect; Metronidazole, with slight improvement); anti-allergic sun blocker which caused a severe allergic reaction.

2. Homeopathic treatment: She has received so far a series of remedies, with no positive results:

Sulphur: Caused aggravation with no improvement

Rhus toxicodendron: Caused aggravation with a slight, temporal improvement

Arsenicum Iodatum: Caused aggravation with no improvement

Lycopodium: Caused aggravation with no improvement

Her present homeopath considered this to be a clear case of Pulsatilla.

Pulsatilla caused initial aggravation with no improvement in none of the applied potencies (30, 200, m, xm, 50m). Presently, after waiting for several months, her doctor has prescribed a single dose of Silicea 30 (Pulsatilla's chronic), with slight aggravation so far.
Any input would be highly appreciated.
Many thanks,

Hans Radax

Cuenca - Ecuador
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Re: Help sought on acne rosacea

Posted: Sun Jun 06, 2004 1:05 am
by Rochelle
I have a couple of queries/suggestions here.
1. Look at Mancinella re the mentals
2. You say butterfly shaped. Could it be Lupus?
3. Premature menopause? - Look at Oophorinum - which has rosacea in it.
4. It has intense red coloration and swelling of the cheeks- what is the sensation she feels? Any or is the problem cosmetic?
5. Maybe she would be better with a water potency - succussed and repeated daily until there is a reaction then stop.

Regards
Rochelle (who has a very long standing rosacea patient who turned the corner with Rad brom!!!)
www.rochellemarsden.co.uk

Re: Help sought on acne rosacea

Posted: Sun Jun 06, 2004 4:33 am
by Rosemary C Hyde PhD
I was wondering about Lupus too -- that kind of rash is characteristic, in which case, it would be important to prescribe on different symptoms that would be individualizing.

Rosemary

Re: Help sought on acne rosacea

Posted: Sun Jun 06, 2004 6:59 pm
by Hans Radax
Dear Rochelle and Rosemary:



Yes, thank you. My friend has told me that he is also considering
Stramonium. The most prominent aspect of fear in her case appears to be:
"Fear in the dark when being alone"

>

She was tested for Lupus some years ago. The result was negative. As a
matter of fact, even though Lupus was discarded as a diagnosis, she suffers
from the idea that it might be Lupus after all. Fears are a very prominent
feature in the patient.

>

This is a very good hint, thank you! Is there a proving of Oophorinum? The
information available in Vijnosky's materia medica (and in Clarke's) is
quite scanty...

>

Usually it is a cosmetic problem. But when the disease aggravates (from
remedies, sun radiation, nervousness - she is very nervous) then she
describes the sensation as a feeling of heat, pulsation, slight burning and
"as if the face would explode," some outward pressure, all these especially
left sided. In other words, the discoloration of the face is symmetrical,
but aggravations are predominantly left sided.

>

Yes, this could help with the aggravation.

Another symptom I have just been told is: Coffee makes her feel very sleepy
when she takes it at night (about 8 pm). This does not happen in the
morning.

Many thanks for your thoughts!

Hans
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Re: Help sought on acne rosacea

Posted: Mon Jun 07, 2004 12:25 pm
by Rochelle
>

This is a very good hint, thank you! Is there a proving of Oophorinum? The
information available in Vijnosky's materia medica (and in Clarke's) is
quite scanty...>>

This is all I could find.

Regards
Rochelle
--------------------------------------
Vermeulen Concordant\OophorinumOophorinum
Ov.

Ovininum; Ovarian Extract

Suffering following excision of ovaries. Climacteric disturbances generally. Ovarian cysts. Skin disorders and acne rosacea; 6 at climaxis. Prurigo. 6 Symptoms amel during menses; 6 may prove a keynote and relates the remedy to Zinc.

Compare: Orch. [Testicular extract; after ovariotomy, sexual weakness, senile decay].
Murphy Lotus\Ovary glandOvary Gland
(Oophorinum)


Ov. The Ovary Gland. Oophorinum. Ovarian extract. A Sarcode. Trituration of expressed juice of ovary of sheep or cow. Historical dose: Trituration and all potencies, low triturations.

On the analogy of the action of Thyroid in myxedema, Ovary or Oophorinum has been used with much success in cases of suffering following excision of the ovaries and for the menopausal sufferings of women. Clarke had good results with it in such cases in the lower triturations.

Moon, Venus.

Ovary has been suggested as a remedy in ovarian cysts. Suffering following removal of the ovaries, (Sepia). Menopausal disturbances generally. Cutaneous disorders and acne rosacea. Prurigo.

Acne rosacea. Menopausal, sufferings. Flushings. Nervousness, menopausal. Ovaries, tumors, disease. Prurigo.

Infantile genitalis. Hot flashes. Menopause. Menses are frequent too early. Menses are clotted, coagulated, copious. Menses of short duration. Infertility.

E. Saalfeld in view of Landau's observations on the effect of Ovary on the nervous sufferings of women at the menopausal, gave Ovary to women suffering from acne rosacea and other skin disorders of the menopausal.

A woman, 20 after double oophorectomy had lichen-like eczema. This was relieved by Ovary as well as the accompanying nervous symptoms and adiposity.

He obtained good results also in some non-menopausal cases as:(1) Acne and seborrhea in chlorotic women.

(2) A case of prurigo which had lasted from childhood in a woman of 26. In this case the itching was better for a short time after the period. This better during menses may prove a keynote and relates the remedy to Zinc.

(1) Orchitinum, Testicular extract - after ovariotomy, sexual weakness, senile decay.

Boericke. Clarke.
Murphy Reversed Medical Repertory\OvinumOvinum
(Ov) 23 rubrics.

Atrophy, ovaries.

Cysts, ovarian.

Infantilismus, genitalis.

Infertility.

Insufficiency, of ovaries.

Itching menses, during amel. UNIQUE

Menopause, general.

Menses, clotted.

Menses, frequent, too early, too soon.

Menses, late, too.

Menses, profuse.

Menses, short, duration.

Ovaries, complaints following surgery.

Tumors, ovaries (see cancer, cysts, fibroids).

Meat, aversion to mutton.

Mutton, agg.

Elderly, people.

Alzheimer's disease.

Dementia, madness senile, (see alzheimer's disease).

Sensitive, mental impressions, to.

Acne, rosacea.

Prurigo.

Nausea, mutton, smell of. UNIQUE
www.rochellemarsden.co.uk

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Re: Help sought on acne rosacea

Posted: Mon Jun 07, 2004 7:17 pm
by Hans Radax
Thank you! That's the problem with many remedies: Lack of provings! How can we prescribe a remedy if we do not know it's symptoms?

Anyway, when I wrote about her sensation during aggravation (the glowing left cheek), I was reminded of bovista. Hering states:

"Cheeks hot, feel as if they would burst."

In Roberts' "Sensations As If," Bovista is the only remedy under this rubric, and so it is in Knerr (p. 280, "Face, bursting"). I find it is truly striking and uncommon. The question is: Is it good practice to base a case on just one keynote?

Her history of recurrent tonsillitis (=chronic process with exacerbations) and thyroid problem could be interpreted as tubercular. Dr. Krishnamoorty once wrote:

"For a patient with chronic tonsillitis, you would generally look into the Repertory against the following:
Tonsils, inflamed (quinsy, tonsillitis) (page 389 of Knerr's Repertory)
But remedies in this list may be useful for acute complaints of tonsillitis. For curing tonsillitis permanently, it needs `treatment of chronic diseases.' Chronic tonsillitis is in most cases due to tuberculosis (See MEDICAL DISEASES OF INFANCY AND CHILDHOOD BY Dawson Williams, M.D., London: Cassel & Co. page 338-348)
(a) When tuberculosis affects lungs we call it tuberculosis of lungs or phthisis pulmonum; with family history of tuberculosis, when t.b. affects bones or glands it is
called `scrofula' or `struma' in homoeopathy.
(b) All chronic affections of glands are due to tuberculosis in the family. Chronic affections of bones may be due to tuberculosis or syphilis; (in syphilitic affections of bones we find nightly boring pain.)
THEREFORE, to cure a chronic tonsillitis patient, we must examine the remedies given in Knerr's Repertory again the following head.
Page 1191-Constitution, scrofulous (strumous):... enlarged glands:"

Sadly, Bovista does not figure there, nor does it under "tubercular constitution". On the other hand, according to Banerjea's Miasmatic Weightage of Medicines, Bovista is quite tubercular.
I would appreciate reading your opinion.

Best regards,

Hans

Re: Help sought on acne rosacea

Posted: Tue Jun 08, 2004 6:30 am
by APEX PRECITECH
Dear Hans,

Looking at Therapeutic Pocket Book, for this case:

The Heated becoming Agg Versus Fats agg yielded
Acon,ant c, carb v,hep,k carb,natm,nux
v,puls,sep,sil,staph,thuj
mind: gentleness
Locations (&phenomenon)
face,face (red),face eruptions,feet, flatulence
sensations:
burning,swelling
modalities; FATS AGG, HEATED
BECOMING,exertion,emotions

My results were puls 48/11, sep 46/11,natm 41/11,thuj
37/11,ant c 28/10
nux v 40/10(both lack gentleness)
Thuja is a possibility. Read up Boericke and esp
Hering for those
facial particulars.

LATE ADDITION:I saw your last post where the fright
agg was prominent. that would reduce the possibility
to Just Puls, Natm and Sep. (still cant rule out thuj)
Imho heat agg is the eliminating rubric. Since the
ailment is deep seated Natm High can be considered to
bring back the suppressions.
Regards
Venkat
.

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Re: Help sought on acne rosacea

Posted: Tue Jun 08, 2004 9:00 am
by Liz Lalor
This is a very tricky thing to treat in my experince, after a lot of
failures I now do thuja 200 once a week and more times than not Sulph 6c
once a day ? not your results but since you were considering the thuja I
thought I would say I find it invaluable. and I also suggest they do a
candida diet to help eliminate yeasts and sugars that seem to fuel the
problem.

Re: Help sought on acne rosacea

Posted: Tue Jun 08, 2004 4:45 pm
by Hans Radax
Dear Venkat:

Thank you very much for your excellent analysis. Indeed, when reading Thuja in Hering, the facial symptoms seem to agree remarkably:

"Face : red and hot, with a fine network of capillaries ; circumscribed burning redness of cheeks ; bloated, dropsical,"

When I tried to follow your repertorization using the Boger Bönninghausen repertory (p. 202), I noticed that Thuja does not figure at all under the rubric of "Mind: Gentle, mild, tender"; nor does it in Knerr's. But it is there in Kent under "Mind: Mildness" in the second grade. So, it appears it shows up in the Therapeutic Pocket Book? I guess I'll have to make this addition to the rep.

Best regards,

Hans

Re: Help sought on acne rosacea

Posted: Tue Jun 08, 2004 6:10 pm
by J.VENKATASUBRAMANIAN
Dear Hans,
Here's something more. The woman prefers tight fitted clothes

Boger's
Pg 1135, Agg & Amel in General: Pressure of clothes
amel:2 Flu ac, 3 nat m

I will Keep Natm always as standby.

Regards
venkat
--- In minutus@yahoogroups.com, "Hans Radax" wrote:
reading Thuja in Hering, the facial symptoms seem to agree remarkably:
circumscribed burning redness of cheeks ; bloated, dropsical,"
Bönninghausen repertory (p. 202), I noticed that Thuja does not
figure at all under the rubric of "Mind: Gentle, mild, tender"; nor
does it in Knerr's. But it is there in Kent under "Mind: Mildness" in
the second grade. So, it appears it shows up in the Therapeutic
Pocket Book? I guess I'll have to make this addition to the rep.