Case 1 was a 40-year-old woman who used a facial treatment machine and felt burning facial pain at night.She then felt unpleasantness in her facial skin all day long and was too uncomfortable to leave her home. We prescribed kamikihito. Ten days later, she felt the positive effects of treatment. Forty-five days later, she did not feel the unpleasantness on her facial skin, and she was able to go out again. Case 2 was a 36-year-old woman who had intense inflammation of her face, because she had stopped treatment with a steroid ointment.After 6 months, her face still felt hot and strange, which decreased her quality of life. We prescribed yokukan sankachinpihange. Four weeks later, she felt the positive effects of the treatment, and 14 weeks later, she was able to restart her part-time job. Because both of these cases had received various types of conventional medi cal therapy in the beginning that were not effective, their Kampo therapy was begun a long after the start of their abnormal facial sensation symptoms. Kampo therapy demonstrated a positive effect after approximately one month in both of these refractory cases. Thus we recommend Kampo medicines for the treatment of abnor mal facial sensations.

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

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.