Abstract: Oral Lichen Planus is rare disease in clinical setup. Here is one such case, where patient was severely affected by the disease. After taking homeopathic treatment he is able to eat and drink normally, which he was notable to do previously. The case emphasizes the need of more widespread study in the area, so that more and more people can be benefited from use of Homeopathy
Introduction: Oral lichen Planus is a rare, chronic inflammatory disease of somewhat autoimmune in nature it often confused with recurrent oral ulcers or vit b 12 deficiency, or just mapped tongue. The affected individual can have severe morbidity, on account of difficulty in eating even simple food articles
Possible causes: The cause of lichen planus is not completely understood but genetics and immunity may be involved. Findings suggest that the body is reaction to an antigen (i.e an allergic type of reaction) within the surface of the skin or mucosa. Some authorities think that lichen planus is an autoimmune disorder in which skin cells lining the mouth are attacked by white blood cells, but more research is needed.
Symptoms: Symptoms of oral lichen planus may include a burning or stinging discomfort in the mouth when eating or drinking. Involvement of the gums with oral lichen planus known as desquamation gingivitis, causes gums to become red and shiny.
Although uncommon, feature of oral lichen planus is a predisposition to cancerous change, with about 1% risk (1 in 100 patients of oral lichen planus) over a period of 10 years.
Present case: Amale patient of 28 years presented with
- Chronic recurrent Mouth ulcers since 3 years
- Burning of whole mouth especially tongue since 3 years, especially after eating and drinking
- Black discoloration of Tongue since 2 years
Patient started having ulcers in mouth since 3 years and burning of mouth started the same, with allopathic treatment, it is said to decrease for some time and again came back with same intensity. After 1 year of above symptoms, patient started feeling appearance of some black discoloration of tongue, which went on to affect the whole of anterior of tongue. Patient had increased salivation
Personal History: No addiction of tobacco, alcohol etc
Thermal reaction: hot
Desires: Bland food, as every food increases burning
Aversion: Nothing significant
Mental Generals: Feeling stressed because of the disease as he is not able to even drink water properly and not getting relief in these symptoms.
Diagnosis: Oral Lichen Planus
Rubrics taken for Repertorisation and Reportorial chart table 1
Treatment: After repertorisation, Arsenicum album and Mercurius solubilis prominently covered all symptoms. Since the patient had increased salivation Mercurius solubilis was chosen. After giving Mercurius solubilis 30, 3 times a day for 3 days, patient reported slight improvement in burning of tongue and ulcers.
He was given Mercurius solubilis 200/1 dose. He gradually felt improvement of all symptoms like burning of mouth, mouth ulcers, and discoloration of tongue. The patient was given treatment for 4 months.
Plan: The plan was to continue Merc sol in higher potency, after patient reported improvement in lower potency
Follow up: Patient was evaluated every week, to assess the improvement. Patient started getting relief at the start of treatment, hence it was decided to continue with the decided plan of treatment. To date patient remains well and no relapse reported
Discussion: During the course of treatment, the comparison of Arsenicum album came up with Mercurius solubilis frequently. Both have similarities, while comparing the mouth symptoms like :-
- Arsenicum album: -Unhealthy, easily-bleeding gums. Ulceration of mouth with dryness and burning heat. Epithelioma of lips. Tongue dry, clean, and red; stitching and burning pain in tongue, ulcerated with blue color. Bloody saliva. Neuralgia of teeth; feel long and very sore; worse after midnight; better warmth. Metallic taste. Gulping up of burning water.
- Mercurius solubilis: -Sweetish metallic taste. Salivary secretions greatly increased; bloody and viscid. Saliva fetid, coppery. Speech difficult on account of trembling tongue. Gums spongy, recede, bleed easily. Sore pain on touch and from chewing. Whole mouth moist. Crown of teeth decay. Teeth loose, feel tender and elongated. Furrow in upper surface of tongue lengthwise. Tongue heavy, thick; moist coating; yellow, flabby, teeth-intended, feels as if burnt, with ulcers, Fetid odor from mouth, can smell it all over room. Alveolar abscess, worse at night. Great thirst, with moist mouth.
Mercurius was decided to be more appropriate on the basis of aggravation from eating and drinking (Gulping up of burning water-Ars) increased salivation, absence of any anxiety , absence of restlessness and thermal reaction (hot)
Conclusion: Burning mouth and recurrent mouth ulcers are not given much importance in clinical setups. The difficulty in eating and drinking, pose significant morbidity to patients day to day life. Proper homeopathic treatment not only relieves the daily pain but also gives long lasting relief from symptoms.
Dr Renu Pande, MD
Founding Member – HomeopathyPoint
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