One Condition, Seven Individuals: A Case Series on Individualized Homoeopathic Management of Cutaneous Warts

Warts (ICD-11: 1E80) are common benign proliferative lesions of the skin caused by infection with human papillomavirus (HPV). ^[1] They commonly occur on the hands, fingers, feet and periungual areas and may present as solitary or multiple, well-defined, hyperkeratotic and verrucous lesions.  ^[2] Although generally benign, warts may persist for prolonged periods and can cause pain, functional inconvenience and cosmetic concern. ^[2][3] Cutaneous warts are particularly common in children and young adults, with studies demonstrating a substantial prevalence in school-aged children. ^[4] The natural course is variable, and spontaneous resolution may occur; therefore, persistence, recurrence and the possibility of spontaneous regression are important considerations when assessing treatment outcomes. ^[5] Various treatment modalities, including keratolytic agents, cryotherapy and other destructive or immunotherapeutic approaches, are available, but treatment response may vary according to the type, site and duration of the wart. ^[3][6] Individualized homoeopathy considers the totality of characteristic symptoms of the patient in selecting the medicine rather than prescribing solely on the basis of the pathological diagnosis. Reporting such cases requires adequate documentation of the clinical presentation, individualized symptomatology, rationale for medicine selection, medicine details, follow-up and objective evidence of change. Evidence concerning individualized homoeopathic treatment of cutaneous warts remains limited. A randomized, double-blind, placebo-controlled pilot trial of 60 patients reported significant within-group changes but no statistically significant between-group differences in the primary or secondary outcomes, and concluded that the evidence was inconclusive. ^[7] An earlier randomized, double-blind trial in children with hand warts similarly found no statistically significant difference between individualized homoeopathic treatment and placebo. ^[8] These findings indicate the need for further systematic clinical research while emphasizing that case series are primarily descriptive and hypothesis-generating. The present case series describes seven patients with clinically diagnosed cutaneous warts who received individualized homoeopathic medicines. The cases document the clinical presentation, individualized symptomatology, repertorial analysis, prescribed medicines, follow-up findings and photographic changes observed during treatment.

CASE REPORTS

Case No. 1:

A 7-year-4-month-old male patient reported to the OPD of Mahesh Bhattacharya Homoeopathic Medical College & Hospital with the chief complaint of multiple wart-like growths on the hand for approximately 2–3 years. There was no associated abnormal sensation or any kind of discharge with warty growth.

On Local clinical Examination:

Site – left index finger, dorsum of hand, right palm near ring and middle finger

No. of lesion – 5

Size- 2-4 mm

Morphology- multiple discrete, well-defined, raised papular lesions with a rough and keratotic surface

Colour- variable brownish to skin-coloured appearance

Surrounding Skin- the surrounding skin appeared normal

Discharge- absent

Itching/ pain/ burning – not present

Diagnosis

The clinical presentation was suggestive of multiple viral warts involving upper extremities. The prolonged duration, multiplicity of lesions and distribution over the hands taken into consideration while evaluating the case.

Characteristic mental physical and particular symptoms:

1. Weakness of memory, weak in studies, can’t remember things taught in class.
2. Irritable
3. Desire – sour foods, sweet foods
4. Thirst – profuse, drinks more quantity at a time
5. Sleep – knee chest position
6. Wart on multiple spots

Repertorial Result:

On repertorial analysis using Hompath firefly software, Medorrhinum scored 26 and covers maximum rubrics of 7, followed by Lycopodium, Sulphur, Argentum Nitricum and others. The details of repertorial sheet given in figure 1.

Figure 1: Repertorial sheet of Case 1

Date	Clinical findings	Prescription
30.05.2025	Warts on left index finger, right dorsum of hand, palm near ring and middle finger	Medorrhinum 0/1, 16 doses followed by placebo
28.06.2025	Warts on left index finger, right dorsum of hand, palm near ring and middle finger disappeared	Placebo
23.08.2025	No new complaint and no reapperence of old symptoms	Placebo
04.10.2025	No new complaint and no reapperence of old symptoms	Placebo

Figure 2: Clinical figures showing before and after pictures of warts of Case 1

Figure 3: Repertorial sheet of Case 2

Date	Clinical findings	prescription
25.08.2025	warty like growth on dorsum of hand near middle finger joint and tip of ring finger and thumb of right hand	Sulphur 200, 2 doses
24.09.2025	All Warty growth disappeared	placebo
27.10.2025	No new symptoms	placebo

Figure 4: Clinical figures showing before and after pictures of warts of Case 2

Figure 5: Repertorial sheet of Case 3

Date	Clinical findings	Prescription
13.02.2026	Warty growth on right upper eyelid	Causticum 200, 2 doses
28.03.2026	Complaints same as before	Placebo was given
08.05.2026	Growth slightly reduced	Placebo was given
29.05.2026	No warts present	Placebo was given

Figure 6: Clinical figures showing before and after pictures of warts of Case 3

Figure 7: Repertorial sheet of Case 4

Date/visit	Clinical findings	Prescription
21/05/26	warty growth on lateral side of index finger of right hand with itching and soreness of the lesion	Ruta G 200/ 2 doses
04/06/26	Warty growth reduced in size, itching reduced, mild soreness was present	Placebo
18/06/26	Warty growth vanished, tenderness and soreness disappeared	Placebo

Figure 8: Clinical figures showing before and after pictures of warts of Case 4

Figure 9: Repertorial sheet of Case 5

Date	Clinical findings	Prescription
03.04.2026	Warty growth on thumb of right hand with cracks and fissures on hand.	Sarsaparilla 200, 2 Doses
15.05.2026	Warty growth remained same size, crack and fissures on hand slight reduced	Placebo was given
12.06.2026	Wart reduced in size along with no fissure on hand	Placebo was given
03.07.2026	Wart completely reduced no more new complaint.	Placebo was given

Figure 10: Clinical figures showing before and after pictures of warts of Case 5

Figure 11: Repertorial sheet of Case 6

Date	Clinical findings	Prescription
13.06.2026	Warty growth on both hands (specifically involving the fingers, thumb, and periungual areas)	Ruta Graveolens 200, 2 Doses
24.07.2026	Warty reduced in size	Placebo was given
21.08.2026	Wart completely disappeared no more new complaint.	Placebo was given

Figure 12: Clinical figures showing before and after pictures of warts of Case 6

Figure 13: Repertorial sheet of Case 7

Figure 14: Clinical figures showing before and after pictures of warts of Case 7

DISCUSSION

Cutaneous warts are common benign lesions associated with human papillomavirus infection and may occur as solitary or multiple lesions at different anatomical sites. Their clinical course is variable, and spontaneous regression is well recognised. Consequently, when evaluating outcomes in individual cases, the possibility of spontaneous resolution and variation in the natural history of warts should be considered. The present case series describes seven patients with clinically diagnosed cutaneous warts who received individualized homoeopathic treatment based on their individual symptomatology rather than solely on the pathological diagnosis. The cases demonstrated variation in age, duration, number, morphology and anatomical distribution of lesions. Most lesions involved the hands and fingers, while one involved the eyelid. The duration of the lesions ranged from approximately 6 months to 4 years. Individualized prescribing was based on characteristic mental, physical, general and particular symptoms, followed by repertorial analysis and consultation with Homoeopathic Materia Medica. The medicines prescribed were Medorrhinum, Sulphur, Causticum, Ruta graveolens, Sarsaparilla and Silicea. In Case 1, Medorrhinum was selected following repertorial analysis and Materia Medica consultation, with disappearance of the documented warts by the subsequent follow-up. In Case 2, Sulphur was selected and disappearance of the lesions was documented at follow-up. Similarly, Causticum was selected in Case 3 for a solitary eyelid lesion, while Ruta graveolens was prescribed in Cases 4 and 6 despite differences in clinical presentation. Sarsaparilla was selected in Case 5 after repertorial analysis and Materia Medica consideration, and Silicea was selected in Case 7. Progressive reduction followed by disappearance of the lesions was documented in the respective follow-ups. This variation in prescriptions illustrates the individualized nature of the therapeutic approach: the same diagnosis of a wart did not lead to selection of a single medicine across all cases. The repertorial results were also not used in isolation; the final prescription was based on repertorial findings together with consideration of the individual symptom picture and Materia Medica. The findings should be considered in the context of the existing evidence concerning homoeopathic treatment of cutaneous warts. A randomized, double-blind, placebo-controlled pilot trial of individualized homoeopathic medicines for cutaneous warts reported significant within-group changes but did not demonstrate statistically significant between-group differences in the principal outcomes, leading the authors to consider the evidence inconclusive. ^[7] Another randomized, double-blind clinical trial in children with hand warts similarly did not demonstrate a statistically significant difference between individualized homoeopathic treatment and placebo. ^[8] Therefore, the clinical improvements observed in the present cases should not be interpreted as confirmation of efficacy. Rather, these cases add detailed clinical observations concerning individualized prescribing, follow-up and photographic documentation. The descriptive nature of a case series makes it useful for documenting clinical experiences and generating hypotheses, but it does not provide the controlled comparison necessary to determine whether the observed changes were attributable to the intervention. A strength of this case series is the detailed documentation of individual clinical presentations, characteristic symptoms, repertorial analysis, medicine selection, dosage and follow-up. The inclusion of clinical photographs provides additional visual documentation of changes in lesion appearance. The cases also demonstrate individualized prescribing across patients with the same broad clinical condition rather than the routine use of a single medicine for all cases. Several limitations should nevertheless be acknowledged. The sample consisted of only seven cases and there was no control or comparison group. The lesions were clinically diagnosed without reported histopathological or laboratory confirmation. The possibility of spontaneous regression, particularly in lesions of relatively shorter duration, cannot therefore be excluded. The present observations may be useful for future research, which should employ prospective designs with predefined outcome measures, standardized photographic documentation, longer follow-up and appropriate comparison groups. Randomized controlled studies would be particularly important for distinguishing treatment-associated changes from the natural course of cutaneous warts.

CONCLUSION

This case series describes seven patients with cutaneous warts managed through individualized homoeopathic prescribing based on their characteristic symptomatology, repertorial analysis and Materia Medica consultation. Progressive reduction and eventual disappearance of the wart lesions were documented clinically and photographically during follow-up. The findings provide useful descriptive clinical observations on individualized prescribing in cutaneous warts. However, the small sample size, absence of a control group and possibility of spontaneous regression limit causal interpretation. Therefore, these observations should be considered hypothesis-generating rather than evidence of treatment efficacy. Further well-designed controlled studies with objective outcome measures and longer follow-up are required.

ACKNOWLEDGEMENT:

The authors are thankful to the patients for their co-operation and giving consent for publication of the cases

Source of Funding: None

Conflict of Interest:  The authors declare no conflict of interest.

REFERENCES

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