Case：39 40 years old female Hospital stay May-August 2018
Worked hard to the limit as a housewife and job, finally healed by natural treatment
She had undergone corticosteroid topical treatment for atopic dermatitis since childhood. Although it was a lesion only in the limb flexion part in the school childhood, it improved from when she was in the upper grade and the symptom was just dry. After that, I experienced employment / marriage / childbirth, but in the meantime I have gradually applied steroids and protopic coatings. Eczema occurred chronically in the arm from 10 years before hospitalization in the arm, and although the steroid topical was used, the effect gradually diminished, and antibiotic oral administration had some effect.
Since 2014, steroid topical use has further decreased in effect and the amount of steroid has increased, so isodin coat therapy was used in combination with aiming for amount loss, but only temporary effects were obtained, so we began protopic application to the whole body. Since the effect of steroid protopic has been lost since 2016, we began to take Kampo since April of the same year. However, there was no effect, severe atopic dermatitis occurred with strong itching on the whole body again. She tried hard to continue housework and job for two years with occasional break.After eating a cake in February 2018, the symptoms deteriorated further, the vigor also declined, scratching, itching, leaching, and desquamation occurred to the whole body. She received prescriptions for sleep induction medicine at nearby doctors because of general malaise and insomnia. Feeling the physical and mental limit and taking a leave from the end of April. Immediately after taking a leave she found our hospital and took a hospital treatment.
Progress after hospitalization
There is atopic dermatitis of the most severe type all over the body, and edema, redness, chills of the whole body are strong, “In the workplace the surroundings had the impression that she was a zomby .” she said. Although she had a positive personality, she seemed to have a trouble in walking at the beginning of hospitalization. There is also a change in exudation of the whole body, at first glance it is not surprising even if TARC exceeds 10000. She lives with her children who are 2nd year college student and 3rd year middle school student and my husband, but she was hospitalized with her mother supporting housework. Inflammation began to improve in 1 month after hospitalization, and physical fitness also recovered. Her family was delighted with that as well. TARC improved to normal value after 3 months from hospitalization.
At the first outpatient visit after discharge in September, the temperature was still high and the climate was sweaty, but the skin kept good as the BSC was continued at home and the subjective symptoms improved greatly. With the effect of diet therapy, she became slim and returned to work, but her colleagues seemed not to notice her because of the change of her appearance. The fact that the effect of steroid protopic has disappeared indicates that immunosuppressive therapy induces infection with pathogenic bacteria and the limit has come. In that case it is necessary to change immunity to natural direction.
Recently, Dupillumab injection medicine was adopted as a health insurance as an immunotherapy drug. IL-4 and IL-13 block monoclonal antibody injected subcutaneously every two weeks, the drug price is 163,280 yen a month. Even with 30% burden, it will be a patient burden of about 50,000 yen a month. However, because it is not causal therapy, you need to continue forever, and there are many side effects. Human immunity is complicated and blocking two cytokines has various obstacles in the long term. IL-4 and IL-13 are not simply involved only in allergy, but some problems always happen to the immune system such as cancer, infection, and autoimmune.
The history of the development of human skin immunity began in the amphibian era 400 million years ago, soil bacteria and skin immunity co-evolved over the years. The conversion to the original immunity can be achieved only by returning to the position at which a person is part of nature.