INDIVIDUALIZED HOMEOPATHIC MANAGEMENT OF GRANULOMA ANNULARE IN A YOUNG WOMAN: A CASE REPORT AT DR BATRA'S

Abstract

Background: Granuloma annulare is a benign inflammatory dermatosis characterized clinically by annular or arc-shaped papules and plaques. The present case describes a 27-year-old woman with biopsy-confirmed granuloma annulare, associated endocrine and respiratory comorbidities, and a prolonged course of skin eruptions.

Case presentation: A 27-year-old homemaker from Jalgaon, who had shifted to Pune approximately three years earlier, presented with raised reddish, skin-coloured eruptions arranged in arc and ring-like patterns for approximately six months. The lesions gradually increased in extent and subsequently involved the knee, leg and upper arm. Moderate-to-severe itching was initially reported. She had a past history of treated leprosy in 2004 and was a known case of hypothyroidism, for which she was receiving thyroxine. She also had polycystic ovarian syndrome and allergic bronchitis. Skin biopsy performed on 27 June 2025 was reported as granuloma annulare.

The case was evaluated using physical generals, mental and emotional characteristics, past history, associated complaints and repertorial analysis. The constitutional assessment included characteristics such as introversion, irritability expressed by shouting, desire for personal space, health-related concern and cautious/fastidious behaviour. Pulsatilla was considered in relation to the patient's emotional sensitivity, yielding nature, need for reassurance and subsequent improvement in confidence. Arsenicum album was also considered based on cautiousness, fastidiousness, concern regarding health, irritability and desire for control/personal space.

Intervention and outcome: During follow-up, the patient reported progressive reduction in itching and gradual improvement in the thickness and appearance of the lesions. Periodic photographic assessment documented the clinical course. At several follow-ups, the eruptions were described as stable or reducing, with itching becoming minimal or absent. However, recurrence of skin complaints was subsequently reported in July 2026, coinciding with an increase in thyroid medication dosage. The case therefore demonstrates improvement with periods of recurrence rather than a uniformly sustained response.

Conclusion: This case illustrates an individualized homeopathic case-taking approach in a patient with biopsy-confirmed granuloma annulare and multiple associated conditions. The clinical course included periods of improvement in itching and lesion characteristics, followed by recurrence. As this is a single uncontrolled case, the observed changes cannot establish treatment efficacy or causality.