Individualized Homoeopathic Management of Stable Generalized Vitiligo with Coexisting Lichen Planus in an Elderly Female: A Case Report

Abstract

Vitiligo is a chronic autoimmune pigmentary disorder characterized by selective destruction of melanocytes, resulting in depigmented macules that significantly affect cosmetic appearance and quality of life. The coexistence of vitiligo with other autoimmune dermatological disorders such as lichen planus suggests a common immunological basis and often presents therapeutic challenges, particularly in elderly patients with multiple comorbidities.

This case report describes a 69-year-old female with a three-year history of generalized vitiligo, previously treated with topical corticosteroids, who presented with stable depigmented patches without the development of new lesions. She also had a history of facial and cervical lichen planus treated intermittently over the preceding ten years and borderline diabetes mellitus for seven years. Constitutional assessment revealed prolonged grief following the death of her husband during the COVID-19 pandemic, chronic stress, anxiety regarding her disease, disturbed sleep, religious inclination, courageous disposition, and episodes of sudden anger. Repertorial analysis indicated Arsenicum album as the constitutional remedy, while Wiesbaden Aqua was prescribed as an organ-supportive medicine.

Following individualized homoeopathic treatment combined with depigmentation therapy, the patient demonstrated stabilization of disease activity, absence of new lesions, progressive perifollicular repigmentation, reduction in itching, and improvement in emotional well-being. This case illustrates the potential role of individualized homoeopathic treatment in the long-term management of stable vitiligo associated with autoimmune comorbidity.