Severe Hair Loss of the Scalp due to a Hair Dye Containing Para phenylenediamine

We report the case of a 41-year-old female showing severe hair loss approximately 90% after the use of a hair dye. These symptoms developed six days after the use of a hair dye containing PPD. A patch test showed a (++) reaction at 48 h to 1% PPD in petrolatum, whereas all metals and white petrolatum were negative. She was therefore diagnosed with contact dermatitis due to PPD, resulting in hair loss. The skin lesions gradually improved after starting treatment with the systemic corticosteroids. The possibility that allergic contact dermatitis from hair dyes may be responsible for telogen effluvium should always be considered in a patient with increased hair loss

Jumihaidokuto (Shi-Wei-Ba-Du-Tang), a Kampo Formula, Decreases the Disease Activity of Palmoplantar Pustulosis

Palmoplantar pustulosis (PPP) is a chronic skin disease characterized by sterile intraepidermal pustules associated with erythematous scaling on the palms and soles. Jumihaidokuto is a traditional herbal medicine composed of ten medical plants and has been given to patients with suppurative skin disease in Japan. This study investigated the effect of jumihaidokuto on the disease activity in PPP patients (n=10). PPP patients were given jumihaidokuto (EKT-6; 6.0 g per day) for 4 to 8 weeks in addition to their prescribed medications. The results showed that the palmoplantar pustular psoriasis area and severity index (PPPASI) was decreased after the administration of jumihaidokuto (p<0.05). Therefore, Jumihaidokuto is seemingly effective against PPP

The Traditional Japanese Formula Keishibukuryogan Inhibits the Production of Inflammatory Cytokines by Dermal Endothelial Cells

Keishibukuryogan (KBG) is one of the traditional herbal formulations widely administered to patients with blood stagnation for improving blood circulation; currently, it is the most frequently prescribed medicine in Japan. KBG has been reported to improve conjunctional microcirculation. The aim of this study was to evaluate the role of KBG and paeoniflorin, a bioactive compound of KBG, in inhibiting the production of inflammatory cytokines using human dermal microvessel endothelial cells (HDMECs). The authors observed that lipopolysaccharide (LPS; 1 μg/mL) stimulated the secretion of proinflammatory cytokines in HDMECs. KBG treatment (10 mg/mL) significantly suppressed the mRNA levels of migration inhibitory factor (MIF), interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α in LPS-stimulated cultured HDMECs. Similarly, paeoniflorin significantly suppressed the mRNA levels of these cytokines in LPS-stimulated cultured HDMECs. ELISA showed that KBG and paeoniflorin suppressed the production of MIF, IL-6, IL-8, and TNF-α in LPS-stimulated HDMECs. Moreover, KBG and paeoniflorin decreased the expression of cyclooxygenase-2 and inducible nitric oxide synthase (iNOS) in these cells. These results suggest that KBG may be useful for improving microvascular inflammation in patients with skin diseases

Mugwort-Mustard Allergy Syndrome due to Broccoli Consumption

Pollen-food allergy syndrome (PFAS) is a relatively rare form of food allergy which develops in individuals who are sensitized to pollen. Tree pollens, especially birch pollen, frequently induce PFAS; however, the incidence of PFAS due to grass or weed pollens such as ragweed or mugwort is relatively rare. Mugwort-mustard allergy syndrome (MMAS) is an example of a PFAS in which individuals sensitized to mugwort may develop an allergy to mustard and experience severe reactions. We herein describe a case of MMAS due to broccoli consumption

Keishibukuryogan (Gui-Zhi-Fu-Ling-Wan), a Kampo formula decreases the disease activity and the level of serum thymus and activation-regulated chemokine (TARC) in patients with atopic dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin disorder with pruritic and eczematous lesions. AD is characterized by the predominant infiltration of Th2-type cells in the acute phase of skin lesions. Thymus and activation-regulated chemokine (TARC), a member of the CC chemokine superfamily was identified as a selective chemoattractant for Th2-type cells. The serum TARC level is significantly increased in patients with AD and is correlated with the severity of AD. Keishibukuryogan (KBG) is a Kampo formula composed of five kind of crude drugs and has been administered to patients with blood stagnation in Japan. This study investigated the effect of KBG on disease activity and TARC production in AD patients. AD patients were administered KBG for 4 to 6 weeks in addition to their prescribed medications. The SCORAD index and VAS score were decreased by the administration of KBG. The serum TARC level of the AD patients was much higher than that of normal controls. This elevated serum TARC level was significantly decreased by administration of KBG. These results suggest that KBG may improve AD by the inhibitory effect on Th2-type chemokine production. アトピー性皮膚炎は痒みと湿疹病変を伴う慢性炎症性疾患であり,その急性期には皮膚病変内に多くのTh2細胞の浸潤がみられる。TARCはCCケモカインのひとつで,このTh2細胞に対して選択的な遊走活性を持つ。また,アトピー性皮膚炎患者では血清TARC値が正常と比較し有意に上昇しており,さらに重症度と相関することが知られている。一方,駆瘀血剤のひとつである桂枝茯苓丸は,これまで主に血栓症や動脈硬化症の患者の治療に用いられてきた。今回我々はアトピー性皮膚炎患者における疾患活動性とTARC産生に対する桂枝茯苓丸の作用について検討した。36名のアトピー性皮膚炎患者に4～6週間桂枝茯苓丸を投与し,投与前後でSCORAD index,VAS scoreを計測しその効果を評価した。また同時に血清TARC値も測定した。その結果,桂枝茯苓丸内服前に高値であったSCORAD index,VAS scoreは,内服後には有意に低下していた。また血清TARC値も投与前は高値であったが,内服後は有意に低下していた。以上の結果より,桂枝茯苓丸はこれまで知られていた作用に加えTARC産生を抑制する可能性が示唆され,アトピー性皮膚炎などTh2ケモカインが関与する炎症性疾患に対して有用な治療法になりうることが期待された