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.

Psoriasis vulgaris is a chronic disease in which demarcated erythema and rashes with silvery-white scales occur at various sites, and it is sometimes intractable. We report that Kampo medicines are effective in the treatment of psoriasis vulgaris. An 83-year-old woman suffered from erythema with pruritus and strong redness on the trunk and upper limbs and she visited the dermatology department. She was diagnosed with psoriasis vulgaris and started treatment with betamethasone ointment. However, her symptoms did not improved, and she requested Kampo medicine treatment. After the administration of maorenshoshakushozuto, erythema gradually improved. Maorenshoshakushozuto is effective for the dermatological diseases with pruritus and strong redness like psoriasis vulgaris.

[Background]Functional abdominal pain syndrome (FAPS) represents a chronic pain disorder localized in the abdomen and the symptoms largely are unrelated to food intake and defecation, which differ from other painful functional gastrointestinal disorders.
We report a case of FAPS whose symptom was successfully improved by acupuncture.
[Case Report]A 75-year-old female had been hospitalized at Meiji University of Integrative Medicine Hospital because of left lower abdominal pain from which she had repeatedly suffered for more than 2 years. Despite strict medication, her symptom had not been improved. After admission to the hospital, according to recommendation by her physician, acupuncture treatment was started. The patient received TCM-based acupuncture treatments five times a week over 13weeks. Primary acupuncture points used for the patient were LV3(Taichong), SP6 (Sanyinjiao), ST36 (Zusanli) and PC6 (Neiguan). Evaluation of the left lower abdominal pain was carried out with a Visual Analogue Scale (VAS). The Gastrointestinal Symptom Rating Scale (GSRS) was used to evaluate QOL related to the digestive symptoms. VAS for the left lower abdominal pain showed a remarkable decrease immediately after the initial acupuncture session. The symptom disappeared within 4 weeks after commencement of the treatment and never appeared during her hospitalization. GSRS was also improved and it was maintained during hospitalization.
[Conclusion]We suggested that acupuncture treatment might be one of the useful, non-pharmacological alternatives for symptoms of FAPS.