ABSTRACT

Wart (verruca) is a benign lesion that occurs in the mucosa and skin caused by Human papillomavirus (HPV). It is prevalent worldwide affecting approximately 10% of the population of both sexes. Any age group can be affected but children, teens, people who bite their nails or pick at hangnails and people with an enervated immune system are more susceptible. Warts are easily transmitted by direct or indirect contact, especially if there is a disruption of the normal epithelial barrier. Here is a case of Filiform warts, treated for two months with individualized homoeopathic medicines. After detailed case taking, physical examination and analysis, THUJA OCCIDENTALIS was prescribed in 200th potency based on the totality of symptoms. There was noticeably, a gradual improvement in the signs and symptoms and the general well-being. Patient had shown marked improvement in the case which is used to measure the disease activity in the past 2 months. Individualised homoeopathic medicines prescribed based on homoeopathic principles had reduced the severity of the disease significantly. The treatment outcome measure provides documentary evidence that homoeopathic medicines are effective in managing Filiform Warts  by reducing the severity of the suffering and improving the quality of life of the patient over 2 months.

KEYWORDS: Warts, Homoeopathy, Thuja Occidentalis, Eyelid

*Corresponding author e-mail: raghavirajendran72@gmail.com

INTRODUCTION:

Wart (verruca) is a benign lesion that occurs in the mucosa and skin caused by Human papillomavirus There are around 100 subtypes of HPV. In general, they are benign but HPV strains 5, 8, 20 and 47 have the malignant potential and sometimes develop into what is known as Verrucous carcinoma.On the basis of location and appearance warts may be of the four types [1]. This case report deals with the treatment of filiform wart other types being Verruca vulgaris or Prevalent wart, Plantar wart or Foot wart or mosaic wart and Flat wart. Filiform wart looks akin to the long thread or thin fingers that stick out and grows on the face around the mouth, eye and nose. It is caused by HPV subtypes 2 and 4. It is less prevalent than other types. Filiform warts look different than most warts. They have long, narrow projections that extend about 1 to 2 millimetres from the skin. They can be yellow, brown, pink or skin-toned and don’t generally form in clusters. Since they tend to form around the eyelids and lips, they’re also known as facial warts. While they’re not cancerous, filiform warts can cause discomfort Different types of treatment modalities are available with varying outcome like intralesional bleomycin; cimetidine; contact immunotherapy; cryotherapy; duct tape occlusion; formaldehyde, glutaraldehyde; homeopathy; photodynamic treatment; pulsed dye laser; surgical procedures; topical salicylic acid; and zinc sulphate etc[2]. Homeopathy relishes a reputation of providing successful management of wart conservatively which has been validated by various research studies . Risk of developing warts include people who work with raw meat, family members who have warts, person with weakened immuned system.Few precautions like not to share towel, shoe, gloves avoid touching and scratching the warts after scratching virus may spread. Individualized homeopathy i.e medicine prescribed on the basis of stringent individualization of the given case, not only helps to remove the wart but also the disposition to develop which is evident in this case report[3]. This case report is aimed at sharing with the homoeopathic professionals the effectiveness of homeopathy and affinity of Thuja-occ. in case of filiform warts.

CASE PRESENTATION:

A 12 year old girl presented with the sign and symptoms of multiple Warts on the left eyelid from last 5 month. Total warts were 10 to 12 in number. Elongated multiple thread like warts is present. Mild Pain by pressing the Warts hard. Gradually the warts size was increasing . Discomfort in opening the eyes. The patient was apparantely normal before 6 month then she gradually got the sign and symptoms of warts .The Patient was previously taking Allopathic medicines . Doctors adviced for Currettage treatment . Family was against for surgical treatment so they stopped Allopathic treatment and came for homoeopathic treatment. On the physical level, the patient had desire for sweets, fast food. Stool is Constipated. Mentally the patient is irritable. The case was diagnosed as Filiform wart on the basis of location, size and presentation.

DIAGNOSTIC CRITERIA:

Diagnosis of warts is based on clinical appearance.

INSPECTION :

There were abnormal thread like growth, irregular contour having long, narrow projection, raised skin lession that extends upto 2 mm from the left eyelid giving them a distinctive appearance and change in skin tone. Total 12  warts were present.

PALPATION :

Surface was rough, Hard in consistency. No Tenderness, Painless during palpation and Immobile.Temperature of skin was normal.

ANALYSIS OF CASE:

  1. Multiple warts on left eyelid

 2. Discomfort in opening the eyes

 3. Desires for Sweets, fast food

 4. Constipation.

 5. Mind Irritable

GENERALITIES:

 Mental Generals: Irritable in disposition

 Physical Generals: Desire for sweets, Fast foods

PARTICULARS:

Multiple warts located below the left eye and corners of the mouth.

TOTALITY OF SYMPTOMS:

1. Multiple warts on left eyelid.

2. Discomfort in opening the eyes.

3. Desire for sweets,fast food.

4. Constipation

5. Mentally irritable.

MIASMATIC ANALYSIS:

After case taking the miasmatic analysis showed that the patient is mixed miasmatic with sycotic predominance as given below.

Sycotic symptoms:

 1. Warty growth.

 2. Thick hairs.

Psoric symptoms

 1. Desire for sweet.

 2. Hard, constipated stool.

 3. Irritable.

Prescription:

 Rx

THUJA OCCIDENTALIS 200 (3 x TDS)

OBSERVATIONS & DISCUSSION:

Based on the totality of symptoms, THUJA OCCIDENTALIS was the first choice of remedy that was given in 30th potency as daily dose which showed marked improvement by the end of 2 months. Hahnemann recommended using a single, well-chosen homoeopathic remedy at a time. This single remedy should be based on the totality of symptoms, and he cautioned against using multiple remedies simultaneously to avoid confusion in assessing the effectiveness of treatment. THUJA has been called as “TREE OF LIFE” It has various medicinal benefit. THUJA improves the severity of WARTS,ECZEMA, including bacterial and Viral infections[4].

Hahnemann recommended using a single, well-chosen homoeopathic remedy at a time. This single remedy should be based on the totality of symptoms, and he cautioned against using multiple remedies simultaneously to avoid confusion in assessing the effectiveness of treatment[5].

CONCLUSION:

Warts are comman but it is more comman in children. In these case there was no complete cure and the doctors suggested for Curretage treatment . Then Patient came for Homoeopathic treatment THUJA based on Totality of symptoms. Homoeopathic Medicine Thuja is succesful in the treatment of Warts and gave a complete cure to the patient.

REFERENCES:

1.  Al, A. M., & Nigam, P. K. (2019). Wart (Plantar, Verruca Vulgaris, Verrucae) [Internet]. Nih.gov. Stat Pearls Publishing.

2.  https://www.ncbi.nlm.nih.gov/books/NBK431047

3.  Loo  SK,  Tang  WY;  Warts  (non-genital);  BMJ Clinical Evidence,(2014);1710

4.  Boericke, W. (2007). Boericke’s New manual of homoeopathic materia medica with repertory. Ninth ed. New Delhi: B. Jain Publishers (P) Ltd.

5.  Hahnemann, S. (2002). Organon of medicine. Fifth ed. New Delhi: B. Jain Publishers (P) Ltd.