A patient aged 50 visited us with scaling of skin across the body over a period of 4 years. He had been using steroidal creams to bring down the itching and scaling. The lesions used to disappear after the use of the creams but then reappear soon after stopping the use of the creams. The patient was told that the creams would only suppress the lesions, and that they’d make a reappearance upon stoppage of any use of the ointment.
Psoriasis is a chronic ailment which has a genetic cause and if it has to improve, treatment should be directed towards correcting the internal disturbance. In our practice we never allow the use of any medicated creams, lotions or topical ointments. The only external application we allow is coconut oil, which is aimed at keeping the skin moist. All patients who are in the habit of using medicated creams are always explained that there will be an aggravation after our instructions to stop the usage of the creams.
The patient lived in a beautiful village in goa and had a very quiet life. He had married a lady from England and she had the responsibility of looking after him. He occasionally worked during the tourist season in Goa and did some minimal jobs around the place. He was not ambitious or a go-getter. During the interview, we realized that his wife was the stronger among the two with regards to decision making. Every time the patient was asked something, he looked at his wife for the answer. This was all that was required for us to understand the person infront of us.
The patient was instructed to go back and stop the use of all ointments and to come back after 15 days for the follow up. No medication was prescribed as we wanted to look at the case after stopping of the ointment. After 15 days the patient came back with aggravated picture of his psoriasis, and an old ear discharge which was not mentioned previously. Thereafter single dose of the similimum was prescribed. The patient has been under our care for almost 3 years with occasional flare ups, and the doses have been repeated during this period. But overall he has shown a marked improvement.