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How to view cases

2019.08.09

How to view cases

We record blood marker tests and check skin transition by photos from almost all of the patients suffering from atopic dermatitis.

By making immunological change occurring in body visible, our treatment stands out among others in which only the change of appearance of skin is followed.

BSC is a method to care skin by effective bacteria. We are thinking of growing up this as new medical field. We believe BSC with scientific evidences and clear clinical results spreads all over the world and become the Gospel to patients of severe atopic dermatitis suffering from excessive dose of steroid.

Posted cases are carried out by obtaining informed consent in all patients.

Blood marker of Atopic dermatitis

Atopic Dermatitis is not rapid reaction that happens in 20 min after antigen contact but slow reaction that happens several hours after that.
Acute phase lesion is the reaction of type th2 and in the chronic phase, Type th1 is said to be added.

 

TARC ( Cytokine to stimulate Th2 cell)

TARC is chemical substance stimulating lymphocytes that cause allergy ( one of the cytokines). It can be the most incisive index to show the severity of atopic dermatitis
Normal value is under 450 for adults, over 2598±409 is judged as moderate level, and over 8009±995 is thought to be severe level.
*Each number’s unit is pg/ml
As for children, normal value is under 1367 for age of 6~12 months, under 998 for 1~2 years and under 743 for over 2 years old.

LDH normal value is under 245

An enzyme secreted by cells. In dermatitis, destruction of cells cause its secretion and the value change shows the degree of dermatitis.

Eosino  normal value is under 7%

The ratio of Eosino in all leukocytes shows the degree of allergies. The IL-5 produced by Th2 cell increases Eosino and it shows acute allergic dermatitis by cause edema erythema, etc. The change of Eosino level is inversely proportional to the that of IgE.

IgE especially connected to the immediate reactions like hives and hay fever normal value is under 170.

This value shows the amount of allergic antibody that causes Type1 allergic reaction. This value often starts to decrease about half an year after treatment initiation. This decrease is not sharp but this shows the degree of allergy in the long term.
But specific antigen “RAST” often increases without antigen contact and shows the present condition of dermatitis. Originally atopic dermatitis is not Type1 immediate reaction of allergy so the value of IgE does not directly show the condition of dermatitis.

RAST Quantitative inspection of specific IgE antibody

Allergen inspections are scratch, intradermal, evoked, food load test,etc but RAST can be blood test.
It is useful to assume antigen because it reflects 50~70% of allergic reaction.
From clinical perspective, RAST is known to decrease from 3 months to half a year after decrease of antigen and it is assessed by 6 stages.
The feature of adult atopic dermatitis is massive infection of Yeast-like fungus like Malassetia, Candida and Staphylococcus aureus.

Th1/Th2 the ratio of Th1 cell and Th2 cell

T-cell is a lymphocyte that regulates immune system but helper T-cell activates immunity.
One type of Helper T-cell is Th1( a kind of natural immunity born in an old age of evolution), which secretes IFN-γand IL-2 and activates cellular immunity like NK and TCL Macrophage.
The other is Th2( born in new age of evolution), which stimulates B lymphocytes thorough IL4 and IL10 and produced IgE antibody. It also activates Eosinophil thorough IL-5 and runs humoral immunity.
In atopic dermatitis, Th2 is said to be dominant against Th1.

 

Indication of severity including subjective symptoms of atopic dermatitis

POEM

It is a method that can also self-score by questionnaire method. It is convenient, but it correlates with the severity of dermatitis, it is severe at 10 to 20 points out of 28 scores, the most severe is about 20 to 28 points as a guide.

Biological spa care (BSC) requires to be continued

Human immune system is formed by 3 years old.
If you are an adult patient of atopic dermatitis, unfortunately the immune system is formed biased towards allergies, so please think that your allergy lasts a lifetime. BSC is a method to control rather than cure.
Even though you think that the symptoms improve and heal, it is thought that atopic dermatitis will come out again if you quit.

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