A Case of “Cystic Acne ” Cured by Individualized Medicine

Acne is a disorder of the pilosebaceous complex that predominantly affects the peripubertal population and clinically manifests as comedones (open/closed), papules, nodules, pustules, and cyst, and heals with scar.[1] It is a disorder in which hair follicles develop obstructing horny plugs (comedones), as a result of which inflammation develops later around the obstructed follicles, causing tissue destruction and scar formation. Nodulocystic or cystic acne is a severe form of acne affecting the chest, back, and face. Cystic acne is characterized by multiple inflamed and uninflamed nodules, frequently forming scars. It is more common in males. The name implies there are nodules (firm lumps) and cysts.[2]

A 28-year-old male patient reported suffering from acne on the face especially right cheek. There were red pustular bleeding eruptions ([Fig. 1]) accompanied by intense itching for the past 6 months. The case was clinically diagnosed as acne vulgaris by a dermatologist and treated with several oral medications and topical steroids without any significant relief.

Fig. 1 Eruptions on the right cheek.

Diagnosis: Acne cystic (ICD code: L70.0). Following a thorough case history recording on a structured proforma, an analysis and evaluation of the symptoms was done, the totality of the symptoms was constructed, and synthesis repertory[3] was used for repertorization. The patient was forgetful and weak minded. He used to laugh and weep without any cause. He could not remember faces, names, books, and places. He had a craving for sugar. Syphilinum was selected after consultation with Boericke's Materia Medica.[4]

Prescription: Two doses of Syphilinum 200 (once daily in the morning for 2 days) followed by placebo for 14 days.

After 14 days: Eruptions on the face, decreased significantly along with reduced itching ([Fig. 2]). Placebo was continued for 14 days, which was further continued for 3 months. After 3 months, there was marked improvement in the eruptions ([Fig. 3]). The patient had a new energy and vitality. Improvement in mental symptoms was also seen. The minimum dose of Syphilinum 200C was found to be effective for acne with bleeding hard nodular acne with scarring and the condition is resistant to conventional treatments.

Fig. 2 After 14 days.

Fig. 3 After 3 months.

Patients' Consent

The authors certify that they have obtained consent from the patient and his legal guardians (given his mental state) for his images and other clinical information to be reported in the journal. The patient and the legal guardians understand that due efforts will be made to conceal his identity though anonymity can not be guaranteed.

Publication History

Article published online:
21 March 2025

• References

• 1 Khanna N. Illustrated Synopsis of Dermatology and Sexually Transmitted Diseases. 5th ed.. New Delhi: Reed Elsevier India Pvt. Ltd; 2016
• 2 Marks R. Roxburgh's Common Skin Diseases. 1st ed.. London: Arnold; 2003
• 3 Schroyens F. Synthesis 9.1: English. 1st ed.. Cambridge, UK: RSC Publishing; 2023
• 4 Boericke W. Pocket Manual of Homoeopathic Materia Medica. 9th ed.. New Delhi: IBPP; 2015