Case：31 29 years old female Hospital stay Aug-Nov 2016
Suffering for 6 years after steroid-free was solved
Atopic dermatitis develops from childhood. The skin rash was confined to the flexion part of the limb from the school childhood to the high school days, and she was occasionally receiving external steroid treatment in the near dermatology clinic.
She got a job after her high school graduation, but dermatitis worsened in her workplace with a lot of machine oil. She began to use steroid topical / antiallergic drugs every day, but the effect gradually fell off in 5 years, she could not control her dermatitis and she started steriod-free at the age of 24. Although the rebound occurred, it was serious but she endured while sometimes she was absent.
Even after that, chronic systemic dermatitis persisted. Alternative therapies such as acupuncture and light therapy started two years ago were somewhat effective, and the joints which could not be bent by pain could be bent. However, as the range of dermatitis gradually expanded, the state of inflammation including the face was chronic, itchiness also became chronic and she was not able to know whether it was itch or not so she decided to start therapy in our hospital.
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Progress after hospitalization
Upon admission, systemic dry dermatitis, especially limbs, had erythema and bilan (strong inflammation with epidermis defect) all over. Looking at inflammatory markers, IgE is as high as 70,000s, but TARC via Th2 system IL4 · IL13 is not high, eosinophils via IL5 are abnormally high, 46%. It is not a typical Th2 dominance, it seems to be a type involving Th1.
However, the effect of BSC (Bacillus spa care), which induces innate immunity, was remarkable, and all markers including subjective symptoms (POEM) declined clearly.
She was also released from pruritus after years and even no humectant other than BSC was needed.