Topical steroid application is widely used in the treatment of discoid lupus erythematosus (DLE), but response is usually poor. A 39-year-old woman was given the Kampo (Japanese herbal) formulas Hochu-ekki-to and Keishi-bukuryo-gan according to the principles of Kampo diagnosis. Topical steroids were not employed. The erythema associated with DLE had visibly decreased by the third week of administration, and disappeared completely after seven months of treatment.
For maximum effectiveness, Kampo formulas should usually be selected through the Kampo diagnostic process.

I report on three rebound cases caused by topical steroids, which were successfully treated by Japanese herbal medicine. A drug for clearing away the heat was selected, because I thought skin erythema and hotness was due to the heat. A herbal drug that nourishes Yin and is anti-inflamatory was also selected, because I thought erythematosquamous eruption was due to asthenic heat syndrome. I selected a drug to promote diuresis, because the tendency of edema, exudation, and lichenification was due to disorders of the body's fluid metabolism. One of the cases with constitutional symptoms such as sensitivity to the cold and general malaise received Kampo treatment following diagnosis from the tongue, pulse and abdominal diagnosis by pulsation and skilled questioning of the patient.
Case 1 was a 19-year-old female with sensitivity to the cold and malaise. She improved after one week of treatment with Juzen-taiho-to, Sanmotsu-ogon-to and Chorei-to. Case 2 was a 19-year-old male with hyperfunctioning condition. He was almost cured after a month of treatment with Gorin-san, Sanmotsu-ogon-to and Chorei-to. Case 3 was a 25-year-old male with disorders of the body's fluid metabolism in skin and Yindeficiency in the body. He improved after one month of treatment with Rokumi-gan, Sanmotsu-ogon-to and Chorei-to.

We administered Ryutan-shakan-to to a case of pyoderma chronica which failed to respond to antibiotics alone. After two weeks, erythema disappeared and the nodules reduced significantly. As histological examination revealed organic changes which indicated fistulation, surgery was performed. Our observation showed the value of this formulation in the pre- and post-operative management of such lesions. To the best of our knowledge, no such case has been reported before.

We report on a case of Hailey-Hailey disease successfully treated with Sokeikakketsuto. This case was a 70-year-old woman. Her mother, grandmother and elder sister had the same symptoms. From 2004 August, she noticed erythematous exudative lesions with itching on both sides of her inguinal area. By September, she was diagnosed with Hailey-Hailey disease histologically. We treated using a topical corticosteroid at first. This had little effect, so we considered treatment using Kampo medicines. We diagnosed a kidney Yin-deficiency from a fissure of her tongue, thirstiness, numbness in the region below the umbilicus and night sweat, thus and selected Rokumigan. We then diagnosed deficiency of Qi from her general malaise, so chose Hochuekkito. The pathology of Hailey-Hailey disease exists mainly in the epidermis which covers most of the body's surface area. And this indicates the presence of pathogenic wind factor. We considered the presence of dampness as a disease-inducing factor because of her exudation, and the presence of the heat from her erythema. So we also selected Eppikajutsuto as an anti wind-wetness-heat drug. Her general condition was very much improved with these administrations, but her skin lesions improved very little. So we stopped Eppikajutsuto, and Sokeikakketsuto administration was started instead. After this change of drug, her skin lesions were improved remarkably.