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Four cases of warts treated by individualized homoeopathic medicine - a clinical case study
*Corresponding author: Bikash Biswas, Department of Case Taking and Repertory, Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Howrah, West Bengal, India. bikash21592@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Biswas B, Roy PS, Mandal S, Roy P. Four cases of warts treated by individualized homoeopathic medicine - a clinical case study. J Intgr Stand Homoeopathy 2022;5:9-18.
Abstract
Objectives:
The aim of the study was to evaluate the usefulness of homeopathic medicine in the treatment of various types of warts.
Material and Methods:
In each case, medicine was selected after taking the detailed case history and performing analysis, evaluation, and repertorization using Kent’s Repertory. The similimum was selected after Materia medica differentiation. A single medicine was prescribed per the law of homeopathy. Two doses of the selected medicine were administrated followed by placebo as per law of minimum. During the follow-up, there was no change in the potency.
Results:
The first and second cases were of filiform wart. They were treated with Hepar sulph and Arsenicum alb, respectively. The third case was of verruca vulgaris wart, which was treated with Natrum muriaticum. The fourth case was of a cutaneous horny wart that was also treated with Natrum muriaticum. All four cases were cured within 40–45 days with no adverse effects.
Conclusion:
The well-chosen homeopathic remedy was very effective in all four cases in this series; the patients reported reduction of symptoms along with improved general well-being. Individualized homeopathic treatment plays a very important role in such cases. Further, study is suggested for evaluating a larger spectrum of remedies in treating cases of warts.
Keywords
Human papilloma virus
Warts
Verruca vulgaris
Filiform warts
Individualization
Homeopathy
INTRODUCTION
Warts are skin growths caused by human papillomavirus (HPV) infection. HPV is a DNA virus that has not been cultured in vitro.
There are three types of warts:
Common warts appear on any part of the body
Plantar warts appear on the soles of feet
Genital and anal warts appear on the genitalia and anal regions, respectively.
Various treatment procedures are available for removing warts, such as:
Applying salicylic acid, liquid nitrogen, and podophyllin
Loop electrosurgical excision procedure
CO2 laser surgery
Interferon injections.[1]
There are more than 100 types of HPV classified based on the type of virus, mode of entry, and immune status of host. The clinical disease depends on the type of HPV causing the same. Nongenital warts are most frequent in children and young adults (up to 10%), and are transmitted through direct skin-to-skin contact and autoinoculation.[2]
Verruca vulgaris, palmoplantar warts, verruca plana, filiform warts, epidermodysplasia verruciformis, and anogenital warts are some of the known types of warts.[2] Verruca vulgaris (the most common type) are usually asymptomatic, single or multiple, circumscribed, and firm papules with verrucous (hyperkeratotic) dry and stippled surface. Approximately, 60% of common warts resolve spontaneously.[2]
Verruca plana (plane warts) are multiple, slightly elevated with flat smooth papules. The lesions are skin colored or darker and may have an erythematous halo. Lesions may be arranged linearly (Pseudo Koebner’s Phenomenon) due to autoinoculation. They are mostly seen on the face and dorsa of the hands.[2]
Filiform warts are asymptomatic, thin elongated, and firm projections arising from a horny base. They occur most frequently on the face (inoculation by shaving) and scalp.[2]
Homeopathic literature shows that Thuja occidentalis is often indicated in treating warts; this knowledge can be used as a guide for prescription.[3,4] In a case of viral warts in a child of 4 years, Calc phos was selected as a constitutional remedy and it cured the warts.[5]
MATERIAL AND METHODS
Process of study
In each case, symptom totality was evaluated and individualized homeopathic medicine was prescribed. These cases were recorded and presented after they were cured.
Ethical approval
Not applicable.
Study design
Clinical case study.
Consents
Appropriate patient consent forms have been signed by the patients. They have given consent for their images and clinical information to be used in the article. The patients understand that their names and initials will not be published and their identity will be concealed as best as is possible, but anonymity cannot be guaranteed.
Inclusion criteria
Patients of all age groups, both sexes, and chronic and acute cases were included in the study.
Exclusion criteria
Cases of warts with co-morbidities were excluded from the study.
Case no 1: A case of filiform warts
Patient information
A 50-year-old man presented to the surgery outpatient department (OPD) of Mahesh Bhattacharyya Homoeopathic Medical College and Hospital with the complaint of multiple small itching warts over his neck region [Figures 2 and 3] for the past 2 years. He was a clerk in a construction company. He was very irritable mentally, as seen in his attitude, gestures, movements, and facial expressions. The patient was extremely chilly. He had a tendency to catch a cold from slightest exposure to cold. He also had a tendency to develop tonsillitis. His medical history comprised childhood asthma that was treated with homeopathic medicines. His family history was not significant. His appetite was good and thirst was moderate. He had significant craving for sour things. He disliked fatty foods. He had intolerance to cold food and cold drinks as it caused him tonsillitis. His bowel movements were regular, watery, and offensive. His urine was also offensive. His perspiration was offensive and more over the trunk. His sleep was adequate. He was very hurried when doing his daily activities.
Evaluation of symptoms
Irritable
Hurried in nature
Chilly patient
Tendency to catch cold
Tendency to inflammation of tonsils
Desire sour
Aversion to fat food
Sweat, urine, and stool offensive
Wart on neck soft with slight itching.
Remedy selection
After thorough case taking, evaluation of symptoms and consultation with the Materia Medica was done.[6] Using the Zomeo 3.0 app, Kent’s repertory[7] and Kent’s method of repertorizing (generals to particular, importance to the mental generals, physical generals, and the particular symptoms) were used [Figure 1]. Hepar sulph 200 C (two doses) was prescribed on November 16, 2020. The patient was asked to report after 21 days [Table 1].
- In the context of first case, this is a repertorial sheet and analysis.
| Date | Symptoms | Prescription |
|---|---|---|
| November 16, 2020 | Itching warts over neck region for the past 2 years. Very chilly patient with a tendency to tonsillitis. Desire for sour. Offensive stool, urine, and perspiration. Mentally very irritable and physically very hurried [Figure 2] | Hepar sulph 200C/two doses Followed by placebo for 21 days |
| December 7, 2020 | Itching disappeared and warts slightly reduced in size. No new complaints [Figure 3] | Placebo for the next 21 days |
| January 4, 2021 | All the warts disappeared. His perspiration and stool were less offensive now. He was doing well [Figure 4] | Placebo for the next 21 days |
Apart from Hepar sulph, Sulfur, and Arsenicum alb received second and third highest value during repertorization, respectively. Sulfur and Arsenicum are mentally and physically restless, but Hepar sulph has a hurried nature, which was closer to our patient. He also had an easy tendency to suppuration of tonsils, which is very much marked in Hepar sulph. Moreover, the other two medicines were not considered as the patient was extremely chilly, even in summer weather. The patient had an extraordinary craving for sour foods,[7] for which Hepar sulph is a first grade medicine in Kent’s repertory.[7] The patient has aversion to fat foods, but Sulph and Ars have craving for fatty foods. On the basis of this totality, we chose Hepar sulph.
Repertorial analysis[7]
The repertory sheet has been presented in [Figure 1].
Case no 2: A case of filiform wart
Patient information
A 63-year-old man attended the skin OPD of Mahesh Bhattacharyya Homeopathic Medical College and Hospital with complaint of a single cauliflower such as wart on the head [Figures 2-7] for the past 5 months. He was a retired banker and his socioeconomic condition was good. He was very soft-spoken and well behaved, suggesting a gentle nature. He was a religious person and spent a lot of time praying for salvation. He was also very suspicious. He also reported chronic dyspepsia. His medical history comprised cholecystectomy for gall stones. His father died from a cerebrovascular disease and his mother had osteoarthritis. He was very chilly. His appetite was poor but his thirst was profuse. He craved salty food, meat, and potatoes. He had intolerance to onions. His bowel movements had been irregular since childhood. His perspiration was more on the head. He had dreams of daily activities.
- Case no 1: First visit, there was a warty growth in neck.
- Second visit improvement.
- Last visit of case no 1. There was no wart growth.
- Case no 2 repertorial analysis.
- Second case wart on head on first visit.
- Second case second visit, no such improvement.
Evaluation of symptoms
Mild nature
Religious of salvation
Suspicious mind
Chilly patient
Desire for potatoes
Thirst much
Intolerance onion
Constipation from childhood
Wart on head and cauliflower like.
Remedy selection
The symptom evaluation, repertorization, and Materia Medica differentiation[6] were similar to that done for the previous case [Figure 5]. Arsenicum album 200 C two doses were prescribed on September 9, 2020. The patient was asked to report after 21 days [Table 2].
| Date | Symptoms | Prescription |
|---|---|---|
| September 9, 2020 | A single cauliflower-like wart on the head for the past 5 months [Figure 6]. Dyspepsia frequent. Chilly patient. Constipation | Arsenicum album 200 C two doses Followed by placebo for 21 days |
| October 7, 2020 | The wart reduced in size [Figure 7]. Bowels regular than before. Dyspepsia was better | Placebo for 21 days |
| November 28, 2020 | The wart fell off [Figure 8]. Bowels regular than before. Patient is doing well | Placebo for 21 days |
Apart from Arsenicum album, Sulph, Causticum, and Lycopodium received the highest value during repertorization. None of these remedies were selected as the patient had increased thirst for large quantities at short intervals and was chilly. Lycopodium and Causticum are chilly, but this patient had a very suspicious nature, which is not seen in these medicines. The patient was very religious, which is seen in Arsenic alb (first grade in Kent’s repertory),[7] but the remaining medicines do not have intensity of religiousness. On the basis of this totality, Arsenicum album was prescribed [Figure 8].
- Case 2, third visit wart growth is no more on head.
Repertorial analysis[3]
The repertory sheet has been presented in [Figure 5].
Case no 3: A case of verruca vulgaris
Patient information
A 31-year-old woman presented at the surgery OPD of Mahesh Bhattacharyya Homeopathic Medical College and Hospital with the complaint of a single reddish wart on the left ear [Figures 9-11]. The wart had a dry and rough appearance and it was slightly painful to touch. The wart had appeared 1 year before and was slowly increasing in size.
- Third case repertorial analysis.
- Third case wart on ear. First visit.
- Wart on ear slightly reduced. Second visit.
The patient was very irritable and unable to bear the slightest contradiction when being questioned; the attending doctors noticed her irritable expression. She wanted to stay isolated from friends and family. She reported general aggravation from sun exposure. Her medical history and family history were not significant. Her thermal reaction was hot. Her appetite was very poor. She had burning thirst for cold water. She had a craving for salt and sour things and aversion to meat. Her bowel movements were very irregular and hard. Her urine was normal. She had scanty perspiration [Figures 12 and 13].
- Third visit much improvement.
- Fourth visit there was no growth at all.
Evaluation of symptoms
Irritable
Contradiction aggravation
Desire to be alone
Sun intolerance
Hot patient
Desire salt and sour things
Burning thirst for cold water
Aversion meat
Stool constipated
Wart on ear left side and red in color
Wart is very painful on touching.
Remedy selection
The case taking, symptom evaluation, Materia Medica differentiation,[6] and repertorization were carried out as in the previous two cases [Figure 9].[7] Natrum mur 200 C two doses were prescribed on January 6, 2021. The patient was asked to report after 21 days [Table 3].
| Date | Symptoms | Prescription |
|---|---|---|
| January 6, 2021 | Wart on the left ear with tenderness [Figure 10]. Hot patient. Intolerance to sun heat. Desire for salt and sour. Desire to be alone. Contradiction aggravation |
Natrum muriaticum 200C/two doses Followed by placebo for 21 days |
| January 27, 2021 | Wart decreased in size [Figure 11]. No new complaints | Placebo for 21 days |
| February 17, 2021 | Wart much reduced in size with a little itching [Figure 12]. Patient says her bowels have become regular | Placebo for 21 days |
| March 10, 2021 | Wart disappeared [Figure 13]. Bowels regular. No new complaints. Patient doing very well | Placebo for 21 days. |
Apart from Natrum mur, Sulph, Calc carb, and Puls received the highest values during repertorization. These medicines were not selected because the patient is very irritable and reacts to the slightest contradiction, whereas Puls is a mild type,[6] Calc carb is more obstinate.[6] She desired to be alone, whereas Puls always wants company and sympathy; Calc carb also needs attention. The patient was very hot; Puls is hot but not irritable. The patient had sun intolerance whereas Calc carb and Puls are intolerant to getting wet.[6] Burning thirst for cold water[6] was a marked symptom in the patient, but Puls is thirstless.[6] On the basis of this totality, Natrum mur was prescribed.
Repertorial analysis[3]
The repertory sheet has been presented in [Figure 9].
Case no 4: A case of cutaneous horny wart
Patient information
A 42-year-old woman presented with a complaint of horny wart near the corner of mouth [Figure 14] for past 4 months. She was a housewife from a lower socioeconomic class. The wart was slowly increasing in size. There was no pain or itching. She was not very expressive and often remained silent during the case taking. She was an introvert and preferred to be alone. She was very sad and hopeless about her future. Her upper body was emaciated. She reported typhoid fever and dengue in childhood. Her mother was diabetic. Her paternal grandfather had pulmonary tuberculosis. She had a poor appetite and felt well when fasting all day. Her thirst was high. She craved salt, fish, and hot food. She was averse to milk and milk products. She frequently had constipation. Her urine was normal. She reported perspiration more on the face and head. Her sleep was disturbed; she could hardly sleep for 3 h due to overthinking. She had bad dreams with anxiety. Her thermal reaction was hot.
- First visit, horny wart on face, corner of mouth.
Evaluation of symptoms
Silent when taking the case
Does not want to talk to others
Hopeless about health
Dreams of anxiety
Gradually emaciated especially the upper part of the body
Ameliorated by fasting whole day
Very hot patient
Desire for water and salt
Sleep disturbed and hardly 3 h due to over thinking
Stool constipated
A horny wart on corner of mouth
No pain and itching.
Remedy selection
The case taking symptom evaluation, Materia Medica differentiation,[6] and repertorization were carried out as in the previous cases.[7]
Natrum mur 200 C two doses were prescribed on December 24, 2020. The patient was asked to report after 21 days [Table 4].
| Date | Symptoms | Prescription |
|---|---|---|
| December 24, 2020 | Horny wart on face [Figure 15]. Stool constipated. Poor appetite. Desire for water and salt. Hot patient | Natrum muriaticum 200 C/two doses Followed by placebo for 21 days |
| January 14, 2021 | Wart greatly reduced in size [Figure 16]. Appetite increased. Bowels regular. No new complaints | Placebo for 21 days |
| February 4, 2021 | Wart disappeared completely [Figure 17]. Patient doing very well | Placebo for 21 days |
Apart from Natrum mur, Phos, Sulph, Calc carb, and Puls received the highest value during repertorization. These medicines were not selected because the patient was very silent, not active such as phosphorus,[6] not clumsy such as Calc carb[6] very much emaciated especially upper part of the body,[6] whereas Phos has a thin body with stooped shoulders[6] and Calc carb is flabby.[6] The patient desires salt;[6,7] Phos also craves salt, but the other generalities such as thermals did not match Ameliorated by fasting is one of the characteristic generalities of this patient;[6] none of the above-mentioned medicines have this symptom. Dreams of anxiety are another feature of Natrum mur. On the basis of this totality, Natrum mur was prescribed.
Repertorial analysis[3]
The repertory sheet has been presented in [Figure 15].
- Fourth case repertorial analysis.
DISCUSSION
In this case series, four case studies were presented. Therefore, homeopathic treatment for warts is mostly constitutional as there are very few symptoms based on the location, morphology, and sensation of the warts. In this case series, four cases of warts are presented. Each case was prescribed individualized homeopathic medicine on the basis of totality of symptoms and repertorization. Here, Hepar sulph, Arsenic alb, and two cases were treated with Natrum mur; the literature has shown that homeopathic medicines are very useful in the treatment of warts [Figures 16 and 17]. All patients were treated within 6 months, no patients’ complaints about any harm or any negative consequences. All medicines were prescribed in centesimal scale. It is therefore suggested further case series on warts or such as observational study should be done in bigger sample size.
- Second visit, much improvement.
- Third visit, there was no wart growth in corner of mouth.
CONCLUSION
The selected medicines were significantly successful in the treatment of various types of warts. In future, more clinical trials need to be undertaken to prove the efficacy of homeopathic medicines in the treatment of warts.
Acknowledgments
We thank the staff of the Department of surgery OPD Mahesh Bhattacharyya Homoeopathic Medical College and Hospital.
Declaration of patient consent
Patient consent was not obtained as their identity was not disclosed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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