LEUCODERMA & ITS
Leucoderma is a general term applied to decreased
melanin pigmentation of skin.It is a cutaneous
condition,which includes all depigmented (white) lesions
ETIOLOGY OF LEUCODERMA
Substituted phenols (used in foot wear)
adhesives (used in stick-on bindis)
INFLAMMATORY SKIN DISEASES : Lupus vulgaris discoid
( Ref: Synopsis of Dermatology by Neena Khanna)
Vitiligo is a continual and long term skin problem that
produces white depigmentation patches that develop
and enlarge only in certain sections of the skin.
The term Vitiligo is derived from the latin word
Vitilus - meaning calf and was first used by roman
physician Celsus of 1st century AD.The characteristics
white patches of disease resembled the white patches
of a spotted calf in India.
1.Incidence-occurs in about 1% of
2.Gender-no gender predilection
3.Age – affects all ages,peak incidence between 10-30years.
ETIOLOGY OF VITILIGO
Autoimmune: Autoimmune disorders like Thyroid
disorders (Hashimoto thyroiditis and Graves disease),
Addison disease, diabetes mellitus, alopecia areata,
pernicious anemia, and psoriasis are all associated
Genetic: About 20% of affected patients have a
positive family history of Vitiligo.
Neural Theory: segmental Vitiligo is present along a
dermatome in distribution of nerves.It has been
hypothesized that a toxin,which destroys
melanocyte,is released at the nerve endings.
1. There is a positive family history in 20% of
2. Both sexes are affected equally.
3. Half of cases begin before age of 20 years.
4. Patient may state that the first onset occurs after
5. It progresses slowly over the years in a highly
6. Some patients have very stable disease , in
others, it progresses at a alarming rate.
which are chalky or
sometimes,pigment loss is
partial and occasionally,
three shades (trichrome).
Hairs in the lesions may
remain pigmented, though
in the older lesions the hairs
may lose their pigment
Macules have a scalloped
outline and form
geographical patterns on
fusion with neighbouring
on the sunexposed areas.
Common sites affected
• Bony surfaces -back of
and fingers, elbows and
orifices - around the
eyes, mouth and
Body folds - armpits
Others areas -
Occurs after second decade.
May be slowly or rapidly progressive.
Family history is frequently present.
Occurs in children.
Most frequently(50%) seen in distribution of trigeminal nerve.
Has a stable course.
Margins are feathery.
variants of generalized vitiligo are:
Acrofacial Vitiligo: This type of vitiligo is considered only
when the appearance is mostly on the fingers or toes.
Mucosal Vitiligo: The appearance of the depigmentation
generally around the mucous membranes and lips.
Focal Vitiligo: one or a few scattered white patches in a small
certain areas. It is often noticeable in young children.
How will you confirm whether a
white spot is leucoderma?
• If white spot has an outline darkness than the skin.
• If it slowly and gradually increases in size day by day.
• If it is irregular in appearance.
• If appears milky white in color under an ultraviolet
• If appears red in color in mucus membrane.
How is Leucoderma Diagnosed?
Age of onset(usually not present at birth).
Depigmented macules with scalloped borders.
Predilection for sites of trauma.
In addition,medical and family history.
Biopsy of the affected area can confirm the diagnosis
Blood tests done:
To check the thyroid functions
To look for the presence of anti-nuclear antibodies (that
would point towards auto-immune cause)
To rule out pernicious anemia
Examination of the spots under Wood's lamp can be
used to diagnose and evaluate Vitiligo especially when
the changes are not appreciated with the naked eye.
Onset-present at birth
Morphology-feathered margins,uniform pigment dilution
Hair- no leucotrichia
Morphology- scaly hypopigmented macule
Nerves- not thickened
Hypopigmented/ertythematous macules,nodule,plague may be
Hair- decrease in no
Located on upper trunk,less frequently on forearms/face.
Morphology-small perifollicular,scaly macules which may
It is an autosomal recessive disorder
At birth,there is complete absence of pigment in skin, hair
What is the Homoeopathic approach ?
As a rule, Homoeopathy never looks at Leucoderma as a local
disease. Leucoderma has been considered as a local expression
of a system disturbance hence a constitutional remedy has to
be evolved, which calls for individual case study in every case
of leucoderma. That is why there is no single specific remedy
for all the cases of leucoderma. The exact treatment
is determined only on in-depth evaluation of individual case.
Like all other chronic diseases, two factors are necessary to
(i) Inherited and / or acquired miasmatic dyscrasia
(ii) Environmental factors in the form of physical trauma,
chemical irritants, emotional upset etc.
No true aetio-logical factors have yet been demonstrated
nosologically but a homoeopath knows that all true
chronic diseases are nothing but the products of three
basic miasmatic states, — Psora, Sycosis and Syphilis. The
aetiologieal factors mentioned in the text books of
medicine for skin diseases are but precipitating factors.
Unless the basic miasmatic state is there, these
environmental factors can never cause leucoderma.
Complete absence or diminution of melanocytes from the
very birth is due to Syphilitic miasmatic state and requires
antisyphilitic medicines for cure.
Cases where the function of the melanocytes is defective
resulting in relative melanin deficiency is due to Sycotic
miasmatic state as it represents a state of in coordination.
Secondary depigmentation during the course of an illness
may be due to Psora or Sycosis or Syphilis or a
combination of two or three of them.
This can easily be elicited from the past history, personal
history -and family history of the patient.
Homoeopathically, Leucoderma is a one sided disease
having its-chief or only manifestation on the skin to
In aphorism no.185, Dr. Hahnemann discussed about
one sided disease with local manifestations.
(Diseases with too few symptoms and chiefly of chronic nature)
Physical Complaint Mental Complaint
A kind of one sided disease in which the changes
and ailments appear locally on the external parts of
Arising from external lesions
Arising from the internal malady
Naturally, it is very difficult to cure, because we do not
get the exact-sensations, modalities or concomitants in
such cases. But if we-believe in miasmatic concept of
diseases and treat these patients with suitable
antimiasmatic medicines, supplemented by proper
hygienic measures and removal of the possible
obstacles in the way of cure, then, in most cases, we
may be able to cure these patients.
But it must be remembered that melanisation of the
patches from where melanocytes have completely
disappeared is a most difficult task to perform and
requires a prolonged course of treatment and patience
both on the part of the patient and the physician.
Whatever may be the nature and type of
Leukoderma, we must first of all, try to ascertain
the miasmatic background of the patient. Once
this is done the major problem is over.
The next step is to select a medicine which covers
the constitutional totality of the patient
including the miasmatic background.
At the same time we must take care of the
environmental or precipitating factors. Unless the
exciting factors are properly dealt with, no cure,
in the truest sense of the term, is possible in spite
of proper antimiasmatic treatment. The reason is
obvious. The presence of these factors act as
obstacle in the formation of melanocytes.
Vaccinosis in the past and abuse of drugs must
be antidoted as and when necessary during the
course of antimiasmatic treatment.
Frequently, a change in the plan of treatment is
necessary to effect a complete cure (e.g. antisyphilitic treatment followed by anti-psoric or
anti-sycotic as the case may be followed again by
anti-syphilitic and so on) In this way a prolonged
course of treatment (may even be for years
together) is absolutely necessary.
Any attempt to remove only the patches of
leucoderma by Homoeopathic medicine is bound
to be futile as far as this is the reason why we fail in
Homoeopathy to cure such cases.
Formation of complete picture by noting-
The exact character of local affection.
All the changes, sufferings, symptoms observable in
Symptoms which may have been previously noted when
no medicine had been used.
Selection of Homoeopathic medicine whose peculiar
pathogenetic effect corresponds to the totality of
symptoms of the case.
External application is prohibited even though it is
External treatment is always injurious.
We must not be afraid of a few newly depigmented
areas during the course of treatment because these
may occur due to the action of well indicated medicine
and should be considered as a favourable sign instead
of considering it a bad sign provided the old spots
must, at the same time, show some signs of
improvement as mentioned above or the patient as a
whole feels better.
It is also no less important to make care of diet and
other hygienic precautions.
Lemon, sour and citric acid containing food stuffs
are to be avoided as they may act as hindrance in the
way of cure.
Some studies show that avoidance of meat may
expedite cure though the reason is not yet clear.
Use of cosmetics (especially the use of lipstick,
vermilion etc.) is to be avoided or restricted as a
Assurance: The patient must be assured that the disease
is not at all incurable and not infectious or contagious.
Otherwise, persistent mental anxieties and worries due to
wrong conception of the disease will doubtlessly act as an
impediment in the way of cure Hence the patient should be
assured that the disease is not a sin and there is nothing to
be ashamed of.
From Homoeopathic view point these cases are never to be
treated with local medicines because that will lead to
suppression and, consequently, destruction of some of the
Expose the affected areas of the body to the early
morning sun for 20-30 minutes daily.
Use a mild soap while bathing.
Avoid using any cosmetic applications on skin.
Make sure that your diet contains
enough iron, cereals, beans and
green leafy vegetables which are
some of the best sources of iron.
Avoid consuming sour foods,
citrus fruits, fish,red meat, crabs
Use of synthetic clothes should be
Avoid stress and learn to relax.
Keep a positive attitude.
Thus, it is possible to be leucoderma free with
Homeopathic treatment, hence one must consider
Homeopathy for healthier living.
ACCORDING TO KENT’S
BOERICKE REPERTORY: Leucoderma-
Recent CCRH Research
For Leucoderma In Clinical Research Publication in Indian Journal of Homoeopathic
Research in Homoeopathy CCRH.
-Dr. Ravi Kumar -A Case of Vitiligo treated with
(Indian Journal of Research in Homoeopathy 2008;page-49-57)
-Dr. Jha , Dr. L.Debata-A Case of Vitiligo treated by
(Indian Journal of Research in Homoeopathy 2009;page-34-40)
Clinical Research Publication Book of CCRH-Clinical
-Dr.R.V.R Prasad,Ch.Ravendar,Bharatha Lakshmi k
singh,Dr.A.K Vichitra,Praveen Oberai,Renu Mittal
-Clinical Evaluation of Predefined Homoeopathic
Medicines in Vitiligo.
(Clinical Research studies
Good remedy for Leucoderma
Skin chafed about genitals.
Marked exfoliation of skin in large scales,leaving a raw
exuding surface beneath.
Debilitating night sweats.
Acne hard,shotty,indurated base with pustule at apex.
Acrid excoriating discharge.
> from eating,
Apis Mellifica Swelling or Puffing up of various parts.
Red rosy hue, Burning sensation
Intolerance of heat-Warm blooded(worse in warm and
Intolerance of slightest touch(agg.from touch)
Awkwardness (let things fall from hands)
Right sided troubles
< Heat in any form,
late in afternoon,
in closed and heated room
> in open air,
Chilly(worse by cold)
Wants company(aversion to being alone)
Inclined to obesity
Lying on painfull side aggravates.
Broken down constitution(pale,anaemic,poor
Sharp , cutting pain.
Stinging pain in muscles.
Burning as from a mustard plaster
Modalities < after coition,
in cold weather,
from soup and coffee,
in morning(about 3’o clock),
lying on lt. side and painful side
> warm weather,
while moving about.
< evening , night,
from fat food,butter,coffee,milk,
Face-oily , shiny , as if greased.
Liable to take cold.
Craving for salt.
Worse from over exertion in sun
Cannot bear heat of sun.
Ailment with silent grief.
Mental exertion aggravates.
Fear of Thunderstorm.
Ailments from mortification.
< noise , music,
> open air,
going without regular meal,
lying on rt. side,
pressure against back,
Tuberculinum Intense Itching.
Worse at night.
Tuberculosis in their Family.
Light complexion,blue eyes,tall,slim, narrow
chested,active & precocious mentally,weak physically.
Susceptible to cold.
Emaciation on while eating well.
before a storm,
> open air.
Stupor,alternating with restless melancholy,irritable.
Worse least opposition,goesinto a range of trifles.
Psoriasis associated with adiposity.
Cold Hand and Feet.
Itching without eruption < at night.
Marked sensitiveness to cold Hypothyroidism after acute
Tendency to fainting,palpitation,cold hand and
feets,low B.P,chilliness & sensitive to cold.
Modalities< cold, cold weather,
during puerperal period,
> lying on abdomen.
Bibliography Synopsis of Dermatology
-By KHANNA NEENA
-By P.HABIF THOMAS
Organon of Medicine(5th and 6th Edition)
-By DUDGEON R.E
Lectures on Homoeopathic Materia Medica
-By KENT J.T
Pocket manual of Materia Medica and Repertory
-By BOERICKE WILLIAM
Systemic Materia Medica of Homoeopathic Remedies
-By MATHUR K.N