Individualised Homoeopathic Medicine Resolved Multiple Recalcitrant Verruca Vulgaris: An Evidence-Based Case Report

Abstract

Background Verruca vulgaris commonly known as warts are characterised by common, benign, localised epidermal lesions caused by human papilloma viruses. Various treatment options are available but many of them are invasive and destructive, which may cause damage to the epidermis or discomfort to the patient.

Objective The main objective of this case report is to produce pieces of evidence systematically, favouring homoeopathy.

Method This is a reported case of verruca vulgaris, presented with multiple rough, itchy, cauliflowers like warty growth on the dorsal aspect of both the feet. Outcome Related to Impact on Daily Living (ORIDL) scale was used as a patient-reported outcome measure for subjective assessment. Dermatology Life Quality Index (DLQI) questionnaire was used to assess the improvement in the quality of life. Photographs were taken as objective evidence. Lastly, possible causal attributions were evaluated by using Modified Naranjo Criteria for Homeopathy (MONARCH).

Result The case was improved on the ORIDL scale (score +4). Quality of life was improved (score 10 to 0) and documented through the DLQI questionnaire. Photographs were presented as objective evidence. The high total score (+9) of MONARCH established the possible causal attributions between the homoeopathic intervention and clinical improvement in the patient.

Conclusion In this case, individualised homoeopathic medicine, Thuja occidentalis, is proved to be effective in the resolution of all warts within a plausible time frame of medicine intake. Further documentation and studies are warranted in the future.

Keywords

Homoeopathy - Thuja occidentalis - Verruca vulgaris - Case Report - ORIDL - MONARCH

Patients' Consent

Informed consent has been obtained from the patient.

Publication History

Article published online:
06 November 2023

• References

• 1 Nofal A, Nofal E, Yosef A, Nofal H. Treatment of recalcitrant warts with intralesional measles, mumps, and rubella vaccine: a promising approach. Int J Dermatol 2015; 54 (06) 667-671
• 2 Loo SK, Tang WY. Warts (non-genital) Search date October 2013 Warts (non-genital). BMJ 2013; 2014 (06) 1-28
• 3 Khanna N. Illustrated Synopsis of Dermatology and Sexually Transmitted Diseases. Fourth rep. Reed Elsevier India private Limited; New Delhi, India; 2013
• 4 Lipke MM. An armamentarium of wart treatments. Clin Med Res 2006; 4 (04) 273-293
• 5 de Villiers EM, Fauquet C, Broker TR, Bernard HU, zur Hausen H. Classification of papillomaviruses. Virology 2004; 324 (01) 17-27
• 6 Sterling JC, Gibbs S, Haque Hussain SS, Mohd Mustapa MF, Handfield-Jones SE. British Association of Dermatologists' guidelines for the management of cutaneous warts 2014. Br J Dermatol 2014; 171 (04) 696-712
• 7 Sanchez MR. Duct tape for the treatment of common warts in adults. JAMA Dermatol 2013; 149 (08) 959
• 8 Pazyar N, Yaghoobi R, Bagherani N, Kazerouni A. A review of applications of tea tree oil in dermatology. Int J Dermatol 2013; 52 (07) 784-790
• 9 Fox PA, Tung MY. Human papillomavirus: burden of illness and treatment cost considerations. Am J Clin Dermatol 2005; 6 (06) 365-381
• 10 Pingel S. Homöopathie. Grundlagen und Prinzipien ihrer Anwendung in der Dermatologie. [Homeopathy. Basic aspects and principles of use in dermatology] Hautarzt 1992; 43 (08) 475-482
• 11 Bhadoriya Y. Homeopathic Management of Psoriasis – A Case Study. World J Pharm Med Res 2020; 6 (06) 250-252
• 12 Shaikh MI. Case studies for treatment of warts with homoeopathy. Indian J Res Homoeopath 2016; 10 (04) 272-278
• 13 Oza PM. Homeopathic management of warts. Indian J Drugs Dermatology 2016; 2 (01) 45-47
• 14 Garg AK, Agarwal N. Wart treated with constitutional homoeopathic remedy natrum muriaticum: a case study. Homoeopath Links 2020; 33 (02) 126-129
• 15 Sahoo AR, Barik B, Hati AK, Paital B. Right potency matters: a case report of homoeopathic treatment of verruca palmaris. Homœopathic Links 2018; 31 (03) 204-208
• 16 van Haselen RA. Homeopathic clinical case reports: development of a supplement (HOM-CASE) to the CARE clinical case reporting guideline. Complement Ther Med 2016; 25: 78-85
• 17 Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D. CARE Group*. The CARE guidelines: consensus-based clinical case reporting guideline development. Glob Adv Health Med 2013; 2 (05) 38-43
• 18 ICD-11 Coding Tool Mortality and Morbidity Statistics (MMS). . Accessed June 18, 2021 at: https://icd.who.int/ct11/icd11_mms/en/release
• 19 Reilly D, Mercer SW, Bikker AP, Harrison T. Outcome related to impact on daily living: preliminary validation of the ORIDL instrument. BMC Health Serv Res. 2007; 7: 139
• 20 Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)–a simple practical measure for routine clinical use. Clin Exp Dermatol 1994; 19 (03) 210-216
• 21 Basra MK, Fenech R, Gatt RMSM, Salek MS, Finlay AY. The Dermatology Life Quality Index 1994-2007: a comprehensive review of validation data and clinical results. Br J Dermatol 2008; 159 (05) 997-1035
• 22 Hongbo Y, Thomas CL, Harrison MASM, Salek MS, Finlay AY. Translating the science of quality of life into practice: what do dermatology life quality index scores mean?. J Invest Dermatol 2005; 125 (04) 659-664
• 23 Stub T, Salamonsen A, Alraek T. Is it possible to distinguish homeopathic aggravation from adverse effects? A qualitative study. Forsch Komplement Med 2012; 19 (01) 13-19
• 24 Stub T, Kristoffersen AE, Alræk T, Musial F, Steinsbekk A. Risk in homeopathy: Classification of adverse events and homeopathic aggravations–a cross sectional study among Norwegian homeopath patients. Complement Ther Med 2015; 23 (04) 535-543
• 25 Lamba CD, Gupta VK, van Haselen R. et al. Evaluation of the Modified Naranjo Criteria for assessing causal attribution of clinical outcome to homeopathic intervention as presented in case reports. Homeopathy 2020; 109 (04) 191-197
• 26 Streit MGJ. Therapie kutaner Verrucae. „Warz' ab“ oder „wart's ab“?. Der Dtsch Dermatologe 2017; 65: 592-600
• 27 Abeck D, Tetsch L, Lüftl M, Biedermann T. Extragenital cutaneous warts - clinical presentation, diagnosis and treatment. J Dtsch Dermatol Ges 2019; 17 (06) 613-634
• 28 Linden A. Assessing regression to the mean effects in health care initiatives. BMC Med Res Methodol 2013; 13 (01) 119
• 29 Kainz JT, Kozel G, Haidvogl M, Smolle J. Homoeopathic versus placebo therapy of children with warts on the hands: a randomized, double-blind clinical trial. Dermatology 1996; 193 (04) 318-320
• 30 Labrecque M, Audet D, Latulippe LG, Drouin J. Homeopathic treatment of plantar warts. CMAJ 1992; 146 (10) 1749-1753
• 31 Smolle J. Homeopathy in dermatology. Dermatol Ther 2003; 16 (02) 93-97
• 32 Hahnemann S. Organon of Medicine; Combined Fifth & Sixth Edition; Dudgeon RE and Boericke W (Translators). New Delhi: B Jain Publishers (P) Ltd.; 2015
• 33 Manchanda RK, Mehan N, Bahl RAR. Double blind placebo controlled clinical trials of homoeopathic medicines in warts and molluscum contagiosum. CCRH Q Bull 1997; 19 (3&4): 25-29
• 34 Kent JT. Lectures on Homoeopathic Philosophy. Reprint edition.. New Delhi: B Jain Publishers Pvt. Ltd.; 2003