An Alternative Approach to Atopic Dermatitis: Part I-Case-Series Presentation

Atopic dermatitis (AD) is a complex disease of obscure pathogenesis.A substantial portion of AD patients treated with conventionaltherapy become intractable after several cycles of recurrence.Over the last 20 years we have developed an alternative approachto treat many of these patients by diet and Kampo herbal medicine.However, as our approach is highly individualized and the Kampoformulae sometimes complicated, it is not easy to provide evidenceto establish usefulness of this approach. In this Review, todemonstrate the effectiveness of the method of individualizedKampo therapy, results are presented for a series of patientswho had failed with conventional therapy but were treated afterwardsin our institution. Based on these data, we contend that thereexist a definite subgroup of AD patients in whom conventionaltherapy fails, but the ‘Diet and Kampo’ approachsucceeds, to heal. Therefore, this approach should be consideredseriously as a second-line treatment for AD patients. In theDiscussion, we review the evidential status of the current conventionalstrategies for AD treatment in general, and then specificallydiscuss the possibility of integrating Kampo regimens into it,taking our case-series presented here as evidential basis. Weemphasize that Kampo therapy for AD is more ‘art’than technology, for which expertise is an essential pre-requisite.