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Case Study

Leucoderma - a Menace of Melanin
Dr Sarla Sonawala.
` Caust / Nat-m / Sulph.

Neither itch nor pain
Swelling or ulcer nowhere lain
Blood and pus-positively nil
Merely a patch of white on the skin
Of bizarre shape and size
Leucoderma is the name of the game..

Mischief innocent of melanin playing truant
Nevertheless, the agony and grief lie
In the eyes of the beholder
While its recovery may rest with
Those sweet pills, white again..!

No emergency, no night-visits, no one ever dies-Leucoderma of skin that proves lucrative to the physician. For some inscrutable reasons- often hereditary- melanin that gives uniform colour to the skin, is conspicuously absent in patches, giving rise to the white revolution of the skin. This uprising is accused of being autoimmune, yet the true cause evades explanation. Often injury or burn may prove catalyst to incite the latent miasma.

Melanin reigns supreme to decide the colour of the skin. Moreover, it forms the screen that shields the skin from deleterious effects of solar radiation. Hence merciful nature has endowed people residing in tropical climates with more pigment and so darker skin.

Truly speaking, idiopathic vitiligo is an inherited disorder, probably an irregular dominant trait. It is rather caused by a defect of melanocytes that leads to the failure of melanin formation. The lesion may be localised, generalised and more often than not symmetrical. Homoeopathy forbids the use of local medication, and aims at restoring melanin which, in turn, lends uniform colour to the skin. Nonetheless, the treatment is long and tries ones patience. A few cases may corroborate its truth.

Case 1:
The father of a boy, aged 20, consulted me on 18th May 1989.

Chief complaint: The boy had burnt his fingers, 12 years ago. Within a month or so, the tips of his fingers turned white-of one hand and then the other. On recommendation, he applied Bavchi oil to the affected areas of the skin. Unfortunately, that aggravated the trouble and the white patches spread to the face-cheek to chin, lips and around-finally to groins and penis. Itching occasional. Diagnosis-Vitiligo.

Other complaints: Since four months, recurrent attacks of colic with nausea, worse after food, better by pressure and bending forward. Eyesight-progressive myopia. Right eye (-9), Left eye (-10)

Physical features:
Height-5 ft 6 inches; fair and thin, good looking. Head full of dark hair. Face-slightly mongol features.
Teeth-cavities, often visits a dentist.
Appetite-less but prefers to eat frequently in titbits. Eats slowly.
Likes spices, salt-not less.
Averse to milk and sweets.
Thirst-plenty for cold water.
Stool-after breakfast. Underwear often soiled with stool.
Sleeps-late, gets up late.
Hot patient, palms and soles warm.

Life situation:
Father is the chairman and managing director of a reputed company. Patient is the youngest child with a brother aged 23, who criticises him often, and a sister aged 27 years, mentally retarded and for whom the patient cares very much. Attached very much to the mother. Shy and withdrawn, has few friends, more so after the onset of vitiligo, especially on the face. Attends no social functions as everybody would ask about his skin affection.
Studies in FY Commerce, academically not good. No hobbies, not fond of games. Reads magazines. Father, who narrated the whole history, said that like his mother, the boy was not brainy at all. Handwriting bad, slow in work, looks dull, but never fails in exams. On the other hand, the boy is practical, takes care of the house-keys, helpful in house-chores.

Mental make-up:
Mild, easy-going, affectionate and helpful. Rarely angry, only when confronted. After vitiligo, sad and often weeps. Not found of company. Anxious before examinations. Memory-weak. Indecisive.
P-H: Big boil on the ear, Mumps, Jaundice.
F-H: Maternal uncle and aunt Vitiligo. Sister mentally retarded.

Causticum 200, daily one dose as the vitiligo had started after burns. Not much change. I reviewed the case. The boy sandwiched between a brilliant father who dominated and dictated and a brother who criticised, seeks emotional release in the mothers attachment and retarded sister whom he cares for. Sad, suppressed and lonely, brooding over vitiligo, he shuns society. On the physical side he eats-not large meals-but in spicy bits. Plus progressive myopia.

Natrum-mur in rising potency did the maximum good. The white patches disappeared in the reverse order of their appearance-first from genitalia, then face. Still the patches, smaller in size-on the finger tips of the burnt hand refuse to leave. Treatment continues with wider gaps between monthly parcels of medicines, the last being sent on 23rd June, 1993. The boy is cheerful, mixes with people, attends social functions as his face is clear of white blemishes. No more colic or nausea.
I have seen the boy just twice-once in the beginning and the second time with his clear face, as he lives far in the South. The father comes often for his board meeting and collects the medicines.

Case 2:
A short case of some 30 years ago, in the beginning of my practice, I shall narrate from my memory.
A girl aged 6 years, came with eruptions on her hands. While examining her, I found white irregular patches of vitiligo on her hands and feet as well as on the knee joints. Her father asked me not to bother about the white patches for which he had already spent a lot, but to avail.

I ventured to give Sulphur in gradually rising potency and infrequent doses. The eruption itched more, but in course of time, the white patches disappeared except one on the right hand. The skin turned smoother and devoid of boils and itch-all in 6-8 months.
Meanwhile, the father was transferred in his job to another city and I lost sight of the patient.
Moral of it:

  1. Disorders when defeated, retreat but insist on leaving their mark.
  2. Perfect similimum yet to found
  3. Perhaps some disorders are the natures way of defending the 2vital organs at a lesser cost.


Beware, by saying this, I claim no universal truth. Many of you might have wiped off vitiligo at one stroke and in toto. My hat off to them... if I wear one!
In treating chronic case in the order of importance, I would place the psychic treatment first. I should be realized that every chronic has been through the hands of several physicians and that all have more or less failed; otherwise there would be no chronic case. This being so, it is easy to recognize that the sufferer with an apparently incurable malady is in nearly every instance, depressed in mind, as well as body and needs to be encouraged, reassured and fortified mentally. I am sure we all believe in the effect of the mind over the body. If we can get the patients mind on higher plane with an outlook upon cheerfulness and hope we have to set to work powerful vital forces which are of unmeasurable assistance to us and to our patient. Therefore, do not forget that every chronic needs all the psychic treatment that we can give him. Optimism should be our key-note. It has been said "if you can regulate the mind, the body will spontaneously go right".