Anti-histamine evidence level in the allergic rhinitis treatment of Japan was not high. It is because in addition, there is not making in English public of it is hardly and not the use of the placebo to it by the examination from which only the development clinical trial is made randomized. Recently, after it is marketed, a lot of evidences are collected, and therefore, the result is made public in English, and the level has improved to the development clinical trial. As for the treatment strategy of the allergic rhinitis, the effect assumes the sneezing and the rhinorrhea type to be the adjustment for anti-histamine, and using with high effect and low side effect one on an actual clinical site as described in the guideline. On the other hand, it is necessary to prescribe LTRA and the steroid drug chiefly in the blockage type. It exists with a personal variation in the effect, it is necessary to know the anti-histamine cannot be selected only by compared agents though the effect of various ant-histamine is examined by the field examination and the exposure test, etc.

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We experienced 4 cases of intractable recurrent oropharyngeal ulceration (erosion and aphthous ulcer), diagnosed other diseases by these later course. Two cases were pemphigoid, and the others were Behcet's Disease. At first all cases were not diagnosed by the clinical test, biopsy and blood test. Some of the systematic diseases are complicated firstly with such oropharyngeal symptoms. In such cases, it takes times to reveal other organ complication or positive immunology histological test, which would be helped to be correctly diagnosed. We should confirm other symptoms than oropharyngeal region, and request meticulous examinations to the related clinics when we experience intractable recurrent oropharyngeal ulceration, especially in recrudescence.

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