Medicine, Kampo ; Dermatitis, Atopic

We report a case of atopic dermatitis that was successfully treated with daiseiryuto. The patient was a 31-year-old Japanese female, who had atopic dermatitis and bronchial asthma since childhood. Recently, her itching, as well as her bronchial asthma, had simultaneously worsened. We diagnosed the patient with “exterior excess” (hyoujitsu), because she complained of anhidrosis. She also complained of being thirsty, suggestive of “interior heat” (rinetsu). Furthermore, her severe itching reminded us of “restlessness” (hansou). According to these Kampo observations, we prescribed daiseiryuto. After several weeks of taking the medication, the patient's asthma attacks had disappeared completely. The severe itching had also improved within a couple of months, and the skin eruptions disappeared in about 6 months. We think that daiseiryuto is a useful formulation for itching of the skin, and that it could be applied to many skin disorders besides atopic dermatitis, because severe itching of the skin can be interpreted as “restlessness” (hansou) in many cases. Daiseiryuto is safe for long-term use by comparatively young, strong patients, but a precaution must be taken in prescribing it to patients with a past history of ischemic heart disease, because daiseiryuto has a high Ephedrae herba content.
Pruritus ; Dermatitis, Atopic ; Integumentary system ; Patients ; Asthma

We analyzed the clinical features of 21 cases with drug-induced liver injury due to Kampo medicines between the years 2000 and 2009 in our institute. The mean age in these cases was 55.2 ± 13.4 years. Five of the cases were men, and 16 were women. In 17 of the 21 cases, drug-induced liver injury had occurred within 3 months after beginning Kampo medicines. There were no subjective symptoms in 11 cases. Nine cases of both hepatocellular injury, and of mixed-type injury were seen. Causative Kampo medicines included an Ogon (Scutellariae Radix) component in 19 cases. A drug-induced lymphocyte stimulation test (DLST) was performed in 5 cases. The test was positive for Kampo medicines in only one of the 5 cases. Liver injury improved or normalized in 18 cases (85.7%) after discontinuing causative Kampo medicines. In another 2 cases, liver injury normalized after changing a Kampo medicine to the same prescription without Ogon. These results suggest that even if patients complain of no symptoms we must perform blood tests to check liver function within 3 months of prescribing Kampo medicines, especially those including Ogon, to facilitate early diagnosis of drug-induced liver injury.

The patient with atopic dermatitis is often dissatisfied with the long-term nature of treatment for his/her disease. The aims of this study were to examine the effect of Kampo therapy on the skin manifestation of atopic dermatitis as well as the patient's mental state, and to evaluate the relation between severity of symptoms and satisfaction with the Kampo therapy. Kampo medicine was administered to 15 in-patients with atopic dermatitis for 6 months. Their clinical conditions, quality of life (QOL) assessments, and psychosomatic scores before and after treatment were observed and comparatively evaluated. We evaluated patients' symptom severity with the atopic dermatitis severity classifications of the Japanese Dermatological Association, and the European SCORAD (Scoring of Atopic Dermatitis). We evaluated QOL with the SF-36 and DLQI (Dermatology Life Quality Index), and mental state with the PSS-AD (Psychosomatic Scale for Atopic Dermatitis). Clinical conditions, QOL and mental states were improved after treatment with Kampo medicine. However, when we examined individual cases, severity of symptoms and satisfaction with treatment did not correlate. Patients' satisfaction ratings and the severity of their symptoms do not necessarily correspond in patients with atopic dermatitis, because evaluations vary with each individual. Therefore, clinicians treating patients for atopic dermatitis must make an effort to recognize each patient's psychological condition.

Kakkonkokato is a special formula used for the treatment of rosacea-like dermatitis lesions in the nasal region, but very few cases treated with this formulation have been reported so far. Here, we report three patients with refractory facial eruptions of rosacea-like dermatitis treated successfully with kakkonkokato. Case1was a 39-year-old man who presented with a 15-year history of rosacea-like dermatitis lesions in the nasal region. After 3 weeks' treatment with kakkonkokato, a marked improvement of his lesions was seen, with disappearance of the redness of his face. Case 2 was a 56-year-old woman who presented with a prolonged history of itchy eruptions around her mouth and nasal region. After 8 weeks' treatment with kakkonkokato, an almost complete disappearance of her eruptions was observed. Case 3 was a 26-year-old woman who presented with atopic dermatitis and intractable erythema under her nose, which was refractory to treatment with steroid ointments and antiallergic agents. After 2 months' treatment with kakkonkokato, her erythema completely resolved, along with improvement of the systemic lesions of atopic dermatitis. The observations in these three cases suggest that kakkonkokato may be a useful formula for the treatment of not only rosacea-like dermatitis in the nasal region, but also of refractory facial eruptions of other causes.
therapeutic aspects ; seconds ; Lesion, NOS ; Nasal ; Acne Rosacea

When the Kampo treatment is considered for skin diseases of infants, difficulties arise because of the medicine's smell and taste. One of the ways is to give Kampo medicine to their mothers with the expectation that Kampo medicine will be transfered to the infant through lactation. The results of this treatment of ten infants are reported here. One suffered from seborrheic eczema and nine from atopic dermatitis. Nine out of ten cases were cured by the treatment of Kampo medicine in periods ranging from one month to one year and four months. The other case had to continue Kampo medicine by himself for one year and seven months after discontinuance of breast feeding. This therapeutic way is also good for the mothers with atopic dermatitis. In cases of atopic dermatitis in both mothers and children, children improved in a rather short period compared to their mothers. As a result, for the treatment of the skin diseases of infants, administration of Kampo medicine to their mother should be considered.

A 60-year-old male patient visited the Oriental Medicine Research Institute of the Kitasato on ***** because of abdominal discomfort. Hangeshashin-to was administered to him and the abdominal discomfort was relieved. He continued to take Hangeshashin-to from June to August 1997. He had chills, high fever, and fatigue from ********. He stopped Hangeshashin-to and took Shosaiko-to for five days because of liver dysfunction. He was admitted to our hospital on ********. Antibiotics and stronger neo-minophagen C were administered to him. A chest roentgenogram revealed a ground-glass shadow on the left upper lung, and Shosaiko-to was discontinued. The patient began to complain of dyspnea and had fine crackles on the chest. A chest roentgenogram and chest CT showed interstitial pneumonitis. Oral predonisolone therapy was started for hypoxemia and the patient improved. A drug lymphocytes stimulation test revealed that lymphocytes were stimulated by Shosaiko-to and its components, Saiko and Ogon. A chest roentgenogram just before ingesting Hangeshashin-to revealed the interstitial change of the lung. Taken all together, this patient suffered from druginduced hepatitis and pneumonitis as a result of ingesting Hangeshashin-to and Shosaiko-to.