Management of erythrodermic psoriasis with individualised homoeopathy: An evidence-based case report

Abstract

Introduction: Erythrodermic psoriasis (EP) is a rare and severe variant of psoriasis, with an estimated prevalence among psoriatic patients ranging from 1% to 2.25%. It presents as erythema, oedema, pruritus, ill-defined psoriatic plaques, scaling, hair loss and occasionally exudative lesions and palmoplantar diffuse desquamation with nail changes ranging from mild pitting to severe onychodystrophy, more commonly involving the fingernails than the toenails. Case Summary: A 60-year-old male patient, already diagnosed with EP, presented with extensive involvement of body surface area (80–90%). He was treated with Hepar sulphur based on the acute totality, followed by Arsenicum sulphuratum rubrum starting from 30C and then higher potencies as per the requirement and adherence to the homoeopathic principles. At the baseline, the scores of psoriasis area severity index and dermatology life quality index were 54 and 30, respectively and reduced to zero after 8 months of homoeopathic intervention, without any adverse events. Furthermore, during the 2-year follow-up, the patient had two episodes of recurrence of the same complaints with lesser intensity and was treated with the same medicine with favourable results. The causal attribution of changes to homoeopathy was explicitly represented by Modified Naranjo criteria for Homoeopathy and before and after photographs. This evidencebased case report may pave the path for further research in treating difficult cases like EP with individualised homoeopathic treatment.