Psoriasis vulgaris is a chronic intractable disease characterized by systemic demarcated erythema and rashes with silvery-white scales. Tumor necrosis factor (TNF) α inhibitors, one of the biological agents, are new therapeutic options for psoriasis vulgaris. However, the number of cases of paradoxical reactions has been increasing in psoriasis patients treated with TNF α inhibitors. Here, we show a successful case indicating the efficacy of Kampo formulas for treating an infliximab-associated paradoxical reaction. The patient was an 83-year-old man. He was diagnosed with psoriasis vulgaris at the age of 69. While receiving infliximab injection and topical steroids, he presented and was admitted to our hospital after painful erythema appeared on his trunk and limbs. He was diagnosed with a paradoxical reaction related to infliximab. We identified the patient’s painful edematous erythema and systemic coldness. Therefore, we stopped infliximab and started to administer eppikajutsubutokadaio. His erythema and other symptoms gradually improved, and he was discharged on the 11th day of hospitalization. Eppikajutsubutokadaio has potential efficacy for psoriasis vulgaris with TNF α inhibitor-associated paradoxical reaction.

Introduction : Japanese elderly men tend to refuse social network even if they need to use them. The objective is to explore Japanese elderly men's perceptions of social network including daycare services.
Methods : Qualitative studies using focused group and semi-structured interviews for elderly men more than seventy-five years old who live in Nagi-cho, Okayama, Japan were conducted.. All interviews were recorded and transcribed. Data analysis was done with modified grounded theory approach.
Results : Three categories were made as internal factors (role seeking, adapt aging), relationship factor (female attendance, staff communication), and external factor (transportation, economy).
Conclusion : By conducting intervention focusing on causes of relationships and external factors inclusive of day care services , it may be possible to improve social involvement of elderly men. 10 proposals were made to government.