• Title/Summary/Keyword: moderate-to-severe atopic dermatitis

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Relationship between serum 25-hydroxyvitamin D and interleukin-31 levels, and the severity of atopic dermatitis in children

  • Cheon, Bo Ram;Shin, Jeong Eun;Kim, Yun Ji;Shim, Jae Won;Kim, Deok Soo;Jung, Hye Lim;Park, Moon Soo;Shim, Jung Yeon
    • Clinical and Experimental Pediatrics
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    • v.58 no.3
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    • pp.96-101
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    • 2015
  • Purpose: Atopic dermatitis (AD) is a chronic inflammatory relapsing skin disorder. Vitamin D plays a pivotal role in the development of AD, and interleukin (IL) 31 is known to be related to pruritus in AD. The aim of our study was to determine whether 25-hydroxyvitamin D (25(OH)D) levels are related to IL-31 levels or to the severity of AD. Methods: We enrolled 91 children with AD and 32 control subjects without history or symptoms of allergic diseases. Blood was drawn to evaluate complete blood cell count, total eosinophil count (TEC), and total IgE, specific IgE to common allergens, 25(OH)D, and IL-31 levels. Serum 25(OH)D and IL-31 levels were measured using high-performance liquid chromatography and enzyme-linked immunosorbent assay, respectively. The scoring atopic dermatitis (SCORAD) index was used to evaluate the severity of AD. Results: The mean 25(OH)D level was significantly lower in the AD group than in the control group; 25(OH)D decreased greatly in the moderate and severe AD groups compared with the mild AD group. Children with atopic sensitization showed significantly lower 25(OH)D levels than nonatopic children. However, serum IL-31 levels were not related to AD group, SCORAD index, or 25(OH)D levels. The SCORAD index was inversely correlated with serum 25(OH)D level and positively correlated with TECs and total IgE levels. Children with moderate and severe AD had significantly higher TECs than children with mild AD. Conclusion: Vitamin D is related to the severity of AD independently of IL-31.

Retrospective Study about the Effectiveness of Topical Preparations Containing 12 Herbal Extracts on Atopic Dermatitis Patients (선태, 백지 외 10종 한약재 추출물 함유 외용한약의 아토피 피부염 치료효과에 대한 후향적 연구)

  • Choi, Ye-Yong;Choi, Yeon-Gil;Shin, Sang-Ho;Jo, Hyun-Jung;Lee, Eun-Ji;Park, Kyu-Jeong;Yun, Young-Hee
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.31 no.2
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    • pp.104-112
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    • 2018
  • Objectives : The purpose of this study is to examine whether the topical preparations containing 12 herbal extracts is effective for patients with atopic dermatitis. Methods : We retrospectively reviewed the medical records of 11 patients who were prescribed topical preparations containing 12 herbal extracts on the outpatient clinic of 4 hospitals; Noble Korean Medicine Clinic, Amar Korean Medicine Clinic, Chung-Yeon Korean Medical Hospital, Donggwangju Chung-Yeon Korean Medical Hospital. Results and Conclusions : A total of 11 patients were included in the selection and exclusion criteria. The OSI mean value before treatment and at the last treatment day decreased significantly from $37.03{\pm}16.75$ to $13.32{\pm}9.83$, and the mean value of EASI decreased from $13.33{\pm}12.85$ to $2.78{\pm}5.00$, which was statistically significant. No safety concerns were reported. The results of this study confirmed the possibility that the topical preparations can be effective in moderate to severe infants, adolescents, and adult atopic dermatitis patients.

Analysis of Atopic Dermatitis Patients according to the Sasang Constitution (아토피 피부염 환자의 체질분석)

  • Kim Hae-jeong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.16 no.3
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    • pp.200-209
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    • 2003
  • Objectives : The aim of this study was to investigate the relationship between atopic dermatitis and the Sasang constitution. Methods : I examined 64 patients with moderate to severe atopic dermatitis for a long time who visited Department of Dermatology in Kangnam Korean Hospital, Kyunghee University and classified them into 4 types according to Sasang constitution under consulting a Sasang specialist. 1. The Sasang specialist classified the patients using the Questionnaire for the Sasang Constitution Classification Ⅱ(QSCCⅡ), body components examination, facial morphology measurement and Meridian function examination. 2. I analyzed the distribution of sex and age, first onset age, history period, digestion condition, existences of past history and family history, basal material volume, immunoglobulin E and eosinophil. Results and Conclusions : 1. As the distribution of sex and age, 28 patients(pts) were male and 36 pts were female. 20's female group was the most common. 2. As the distribution of Sasang constitution types, Soeumin were 28(43.7$\%$) pts, Taeumin were 24(37.5$\%$) pts, Soyangin were 11(17.2$\%$) pts, and Taeyangin was 1(1.6$\%$) pI. 3. As the mean age at first visit, Soeumin's was 20yrs, Taeumin's and Soyangin's were 27yrs, and Taeyangin's was 15yrs. 4. As the mean onset age, Soeumin's was 7yrs the lowest, Taeumin's was 15.7yrs, Soyangin's was 10.54yrs and Taeyangin's was 15yrs. 5. As the history period. Soeumin's was 13.8yrs. Taeumin's was 11.8yrs. Soyangin's was 16.5yrs. Tae yangin's was 13yrs. 6. As the existence of past history of atopic diseases, Soeumin were 12(43$\%$) pts, Taeumin were 7(29$\%$) pts and Soyangin were 5(45$\%$) pts. 7. As immunoglobulin E, 21(75$\%$) pts of Soeumin were normal, 7(25$\%$) pts were abnormal.. 22(92$\%$) pts of Taeumin were normal, 2(8$\%$) pts were abnormal. 8(73$\%$) pts of Soyangin were normal, 3(27$\%$) pts were abnormal. As the defecation condition, 19(68$\%$) pts of Soeumin were normal, 9(32$\%$) pts were abnormal. 14(58$\%$) pts of Taeumin were normal, 10(42$\%$) pts were abnormal, 8(73$\%$) pts of Soyangin were normal, 3(27$\%$) pts were abnormal. 8. The mean value of immunoglobulin E of Soeumin was 1236, Taeeumin was 442, Soyangin was 2010, the mean value of eosinophil of Soeumin was 3.5, Taeeumin was 2.47, Soyangin was 4.28.

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Clinical Study for Herbal Medicine Therapeutic Effect on the Pediatric Chronic Sinusitis using Plain Radiography and Computed Tomography (소아(小兒) 축농증(蓄膿症)의 한방(韓方) 치료효과(治療效果)에 대한 단순촬영(單純撮影) 및 CT(전산화단층촬영(電算化斷層撮影))를 이용한 임상적(臨床的) 연구(硏究))

  • Lee Hai-Ja;Park Eun-Junng;Jin Gong-Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.13 no.2
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    • pp.187-224
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    • 1999
  • Background: In recent years, pediatric chronic sinusitis patients who don't respond with antibiotics are increasing, but there are a few reports on the herbal medicine therapy treating pediatric chronic sinusitis, so this report was studied. Objective: To demonstrate the effect of herbal medicine therapy in the chronic sinusitis before and after treatment using computed tomograpy (CT) and plain radiograpy. Materials and methods: Ninty patients (45 mail and 45 femail) treated in our hospital between February 1998 and August 1999 were studied. Ages ranged from 3 to 13 years (mean age :6.5 years). Sixty two patients had a underlyiing family history (allergy or sinusitis of parents or brothers), In the past history, 68 patients had asthma, allergy of milk, atopic dermatitis, bronchiollitis and irritable bowel syndrom. Illness period was from 10 days to 96 months (mean period:12.4 month). Duration of treatment were from 25 days to 200days (mean:96 days). To ascertain the efficacy of treatment, CT in the 42 and plain radiopgrapy in the 48 patients were checked out. In the CT, three images were obtained 2cm interval on the coronal and axial plan. CT findings of the chronic sinusitis were analyzed for mucoperiostal thickening before and after treatment using 4 grades;(normal, mild, moderate, severe). Normal was defined as below 3mm thickening of mucoperiosteum; mild was 3-5mm thickening; moderate was 5mm-1cm thickening; severe was above 1cm thickening. Plain radiograpy using Water's view provided maxillary sinus, anterior ethmoid sinus, frontal sinus. Normal was defined as simillar to density between sinus and oronasal cavity; mild was defined as generally increased density with no significant mucoperiosteal thickning; moderate was partial mucosal thickening without bony hypertropy; severe was total haziness with mucoperiosteal thickening. Gamihyunggyeyungyo-tang was administered mainly. Gamigwaghyangjeungki-san, Gamizwakwi-eum and Gamihyangso-san were administered for through oral route additional symptoms Results: Of the 90 patients, 84 patients showed complete recovery (93%), 4 patients showed no significant interval change(4%) and 2 patients were aggrevated (2%). Sixty patients were severe(67%) and 26 patients were moderate (29%), 4 patients were mild(4%) The duration of treatment was varied with patient conditions (91 days in average); severe were 101.7 days, moderate were 70 days and mild were 63 days. Fifty three patients with maxillary and ethmoid sinusitis were 114 days, 35 patients with maxillary sinusitis only were 71.5 days. Fifty eight patients with both maxillary sinusitis were 94.6 days, 26 patients with either maxillary sinusitis were 65 days. The symtoms of chronic sinusitis were nasal obstruction(75%), cough(69%), purulunt or mucosal discharge(62%), lymphoid follicle(54%), postnasal dripping(49%), headache(23%) and nose bleeding(22%). Conclusion: We know that herbal medicine therapy is the effective treatment of pediatric chronic sinusitis using plain radiograpy and CT. The duration of treatment may be significant assosiation with the location and degree of chronic sinusitis.

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A study of the frequency and characteristics of minor clinical manifestations in children with atopic dermatitis (소아 아토피피부염 환자의 부증상 빈도 및 특징에 대한 연구)

  • Cho, Ji Eun;Jeon, You Hoon;Yang, Hyeon Jong;Pyun, Bok Yang
    • Clinical and Experimental Pediatrics
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    • v.52 no.7
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    • pp.818-823
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    • 2009
  • Purpose : We aimed to evaluate the frequency and characteristics of minor clinical manifestations of atopic dermatitis (AD) in Korean children to aid the diagnosis and treatment of AD. Methods : From April 2007 to December 2007, we enrolled 106 children (aged 1 month [infants] to 15 years) diagnosed with AD at the Pediatric Allergy Respiratory Center in Soonchunhyang University Hospital. Clinical manifestations were examined and laboratory findings (total and specific immunoglobulin E [IgE] levels and peripheral blood eosinophil count) were analyzed and compared. Results : Minor symptoms, in order of frequency, included xerosis (78.3%), aggravation due to environmental or emotional stress (43.4%), lichenification (35.8%), orbital darkening (34.0%), periauricular eczema (33.0%), and cutaneous infection (31.1%). Older children (${\geq}2$ years) showed more orbital darkening (P=0.01), horizontal crease (P=0.01), and lichenification (P=0.001) than infants. Patients with severe AD (scoring atopic dermatitis [SCORAD] score, ${\geq}40$) showed higher frequencies of xerosis (P= 0.04), cutaneous infection (P=0.03), ichthyosis (P=0.18), keratosis pilaris (P=0.02), pityriasis alba (P=0.07), recurrent conjunctivitis (P=0.02), orbital darkening (P=0.001), aggravation due to environmental or emotional stress (P=0.05), facial eczema (P=0.001), lichenification (P=0.001), and hand/foot eczema (P=0.04) than those with mild-to-moderate AD. Children with atopic eczema showed more facial eczema (P=0.01) and lichenification (P=0.04) than those with non-atopic eczema. Conclusion : The clinical manifestations of AD were similar to those established by Hanifin and Rajka. However, we need to develop our own diagnostic criteria for AD, because the frequencies shown by our subjects differed from those observed in other countries.

Improvement Effect of the HyungGae-Water on Quality of Life in Children and Adolescents with Pruritus (한방입욕제(형개수) 사용을 통한 소양증을 호소 소아청소년의 삶의 질 개선효과)

  • Jeong, Kyung Sik;Baek, Young Hwa;Yoo, Jong Hyang;Hwang, Man Ki;Choi, Young Jin;Kim, Yun Hee;Lee, Si Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.32 no.3
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    • pp.178-183
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    • 2018
  • Pruritus is the most prominent symptom of atopic dermatitis and other skin diseases. It is not easily improved and is a major factor that threatens the quality of life of patients and their families. The purpose of this study was to evaluate the effect of HyungGae-Water, which was bath preparation made from Korean medicine herbs, for children and adolescents suffering pruritus. The participants were 50 boys and girls aged from 2 to 15 years old. The HyungGae-Water was used once a day for 6 weeks, and we were followed up three times every two weeks. Of 50 participants enrolled, 47 completed the study. The outcome variables were dermatology quality of life scales in children, pruritus VAS, and investigator global assessment (IGA). The results of the study show that the dermatology quality of life is significantly improved and the VAS of pruritus has meaningful changes. In the IGA, moderate or severe improvement was observed in 48.9% and slight improvement in 17%. There were seven suspected or less relevant adverse events using HyungGae-Water. The present results suggest that the HyungGae-Water has alleviating effect for the pruritus in children and adolescents.

A Clinical Study of Hypersensitive rhinitis including Allergic rhinitis (알레르기성 비염을 포함하는 과민성 비염 환자에 관한 임상적 연구)

  • Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.2
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    • pp.169-182
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    • 2002
  • Background: Allergic rhinitis(AR) is a heterogeneous disorder that despite its high prevalence is often undiagnosed. It is characterized by one or more symptoms including sneezing, itching, nasal congestion, and rhinorrhea. And it is frequently accompanied by symptoms involving the eyes, ears, and throat, including postnasal drainage. There are many different causes of rhinitis in children and adults. Approximately 50$\%$ of all cases of rhinitis are caused by allergy. In the case of rhinitis caused by allergens, symptoms arise as a result of inflammation induced by a gamma globulin E-mediated immune response to specific allergens such as pollens, molds, animal dander, and dust mites. The immune response involves the release of inflammatory mediators and the activation and recruitment of cells to the nasal mucosa. AR is similar to 鼻?, hypersensitive rhinitis in Oriental Medicine. I think hypersensitive rhinitis is including of AR, vasomotor rhinitis and non-allergic rhinitis related with eosinophil increased and so on. Purpose: To perform a clinical analysis of hypersensitive rhinitis including allergic rhinitis and estimate the efficacy of Oriental Medical treatment. Objective: We studied 96 patients who had visited our hospital with complaints of nasal symptoms from March 2000 to February 2002; they had the signs more than 2 - nasal obstruction, watery discharge, sneezing and eye or nasal itching. Parameters Observed & Methods: We treated them with acupuncture & herb-medication. Sometime they used aroma oil or external medicine. 1) the distribution of sex & age groups 2) the clinical type based on duration & the severity of symptom 3) the breakdown of complication & pasl history of Otolaryngologic or allergic disease 4) the clinical assessment and classification of rhinitis(sneezers and runners & blockers) 5) the associated symptoms and signs 6) the classification of Byeonjeung 7) the classification of prescriptions and 8) the efficacy of treatment. Result: 1. In the clinical type of based on duration, the intermittent type was 42.7$\%$ and the persistent was 57.3$\%$. 2. We observed the severity of symptoms based on the quality of life. The mild type was 24.0$\%$ and the moderate-severe was 76.0$\%$. 3. In the clinical assessment and classification of rhinitis, the sneezers and runners type was 69.8$\%$ and the blockers was 30.2$\%$. 4. The most common family history with otolaryngologic or allergic disease were allergic rhinitis(17.7$\%$), urticaria, paranasal sinusitis and T.B.(3.1$\%$). 5. The most common past history with otolaryngologic or allergic disease were paranasal sinusitis(14.6$\%$), atopic dermatitis and asthma(8.3$\%$). It was 31.3$\%$ they had a family history and 44.8$\%$, past history. 6. The most common complication was paranasal sinusitis(15.6$\%$). In decreasing order the others were otitis media with effusion(9.4$\%$), GERD and headache(6.3$\%$), asthma, bronchitis, nasal bleeding and allergic dermatitis(5.2$\%$). 7. Classification through Byeonjeung : ⅰ) 39 cases(34.9$\%$) were classified as showing Deficiency syndrome. The insuffficiency of Qi was 17.7$\%$, deficiency of Kidney-Yang, 12.5$\%$ and Lung-Cold, 10.4$\%$. ⅱ) 57 cases(59.4$\%$) were classified as showing Excess syndrome. The Fever of YangMing-meridian was 35.4$\%$, Lung-Fever, 24.0$\%$. 8. The efficacy of treatments showed: an improvement in 22cases(22.9$\%$); an improvement partly in 24 cases(25.0$\%$); no real improvement or changes in 16 cases(16.7$\%$); and couldn't check the results 18cases(18.6$\%$). Conclusion: We suggest that this study could be utilized as a standard of clinical Oriental Medical treatment when we treat hypersensitive rhinitis including allergic rhinitis.

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