1999 Volume 62 Issue 2 Pages 71-79
From June 1990 to October 1998, 100 patients with adult-type atopic dermatitis (59 males and 41 females, 25±8 years) were admitted to our hospital to receive balneotherapy using Kusatsu hot-spring water. The atopic dermatitis in all but 9 cases occurred while the patients were still under 20 and had been refractory to various treatments including steroid ointment therapy over a long period of time. The patients took a 10-minute 40-42°C hot-spring bath followed by immediate application of white petrolatum 1-2 times daily for 75±46 days. The main components of the hot-spring water are aluminium, sulphates and chlorides, and its pH is 2.0. The skin symptoms of 79 of 100 cases (79%) were improved through the balneotherapy and furthermore pruritus was improved in 55 of the 79 cases (70%). The improvement of skin manifestations was supported by a significant decrease in serum LDH levels. In contrast, pruritus was not improved in the remaining 21 cases who showed no changes in skin symptoms and serum LDH levels. Moreover, changes in the number of Staphylococcus aureus on the skin surface were examined before and after balneotherapy. In the 69 cases examined whose skin symptoms were improved, many Staphylococci aureus were detected in 52 of the cases but not in the other 17 cases before starting balneotherapy. They disappeared in 24 cases and decreased in 18 cases of the 52 cases, but were not changed in the remaining 10 cases through the balneotherapy. On the other hand, the number of Staphylococcus aureus on the skin surface was not changed in 11 of the 14 cases examined whose skin symptoms were not improved. Our previous study reported that bactericidal activity against Staphylococcus aureus is expressed by the co-existence of manganese and iodide ions contained in the hot-spring water under an acidic (pH 2.0-3.0) condition. Thus, the mechanisms of the improvement of skin manifestations through the balneotherapy may be explained by considering bactericidal activity of Kusatsu hot-spring water against Staphylococcus aureus inducing acute flares of skin manifestations. Therefore, balneotherapy at Kusatsu can be useful for the treatment of refractory cases of adult-type atopic dermatitis as a suitable method of skin care.
