A case of small intestinal perforation and peritonitis after tumescent liposuction performed in an ambulatory setting elsewhere is presented. Only four other cases were reported earlier. In all cases, the diagnosis had been missed initially. Unique problems in diagnosis, preventive steps, and risk reduction are discussed.

Case seriesPatient: —Final Diagnosis: —Symptoms: Skin lesionsMedication: —Clinical Procedure: —Specialty: DermatologyObjective:Unusual or unexpected effect of treatmentBackground:Vitiligo, also known as leukoderma, is an autoimmune skin condition that results in the loss of melanin pigment. Vitiligo is not a rare condition but is difficult to treat and is associated with psychological distress.Case Reports:A series of 14 cases of vitiligo are presented that were treated with individualized homeopathic remedies that were based on plant, animal, or mineral compounds. There were 13 women and one man in the case series, with a mean age 29.8 years, and a mean follow-up from treatment of 58 months. The mean time between the onset of the appearance of vitiligo and the first consultation at our clinic was 96 months. Homeopathic treatment for patients is holistic and was performed on an individualized basis as described in this case series. Photographic images of the skin are presented before and after treatment.Conclusions:In 14 patients with vitiligo treated with individualized homeopathy, the best results were achieved in the patients who were treated in the early stages of the disease. We believe that homeopathy may be effective in the early stages of vitiligo, but large controlled clinical studies are needed in this area.

The Continuum theory and the Levels of Health theory propound the idea that return of efficient acute inflammation (high fever) heralds true improvement in chronic inflammatory states. We present 6 cases of atopic dermatitis (AD), which had stability in their improvement for 1 year or more, under classical homeopathy. The cases were retrospectively assessed with selected based on the Hanifin Rajka atopic dermatitis diagnostic criteria and the follow ups evaluated according to changes on SCORing Atopic Dermatitis scale (SCORAD) scale. The pictures are presented as evidence. Modified Naranjo Criteria for assessing causal attribution of clinical outcome to homeopathic intervention was used to assess the effect of homeopathy in these cases. All the cases improved and stabilised with complete skin clearance (those that relapsed within 1 year were not included). These patients had not suffered high fevers/acute inflammatory diseases since onset/aggravation of AD. Five of the 6 cases developed acute inflammatory diseases as the chronic condition improved. The last case showed return of an old, lesser pathology. The control cases – which were selected for non-improvement under classical homeopathy also showed remarkable skin clearance when there was appearance of acute inflammatory states. In this study, there is a mutually exclusive relationship between efficient acute inflammation and chronic inflammation, which is in accordance with the 2 theories considered here. Further scientific studies are necessary to establish the phenomenon at tissue level.

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