Abstract
A 32-year-old man with refractory atopic dermatitis visited our hospital in the hope of receiving treatment with Kampo medicine. He had had diffuse pruritic erythema with scale and lichenificated plaques almost all over the body in spite of standard therapy using topical steroid and antihistamines over 20 years. We listened attentively to his complaints from the psychosomatic standpoint. Besides having intractable eruptions, he suffered from insomnia and physical and mental fatigue. Hochuekkito and orengedokuto were added to the standard therapy. After confirming that these preparations succeded to improve his symptoms, we also used goreisan, shofusan, and unseiin for other symptoms according to his conditions during the long-term treatment course.
In addition, we recommended him to convert to a better-balanced diet consisting mainly of traditional Japanese food and to keep a diet diary. Five months later, his eruptions almost completely disappeared, and no new treatment was required for the following ten years. After ten years, a mild recurrence of skin symptoms occurred but hochuekkito and goreisan with standard therapy effectively cured them soon. Although stress sometimes caused recurence for the following 3 years, remission for more than a year and half has been achieved with dietary care alone. This report represents the long-term outcome of diet-and-Kampo therapy conducted by the same dermatologist over 16 years for a patient with recalcitrant atopic dermatitis.
