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      Kaposi's Varicelliform Eruption in Atopic Dermatitis treated with Korean medicine

      case-report

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          Abstract

          Objectives:

          This case report is to present a complete recovery from Kaposi’s varicelliform eruption (KVE) that occurred in a patient with atopic dermatitis by applying Korean Medicine therapies.

          Methods:

          Hwangyeonhaedoktang pharmacopuncture (HP), 0.3 mL, and 25% bee venom pharmacopuncture (BVP), 0.1 mL, were injected, 0.2 mL each, at both BL13 acupoints once a day in the morning. Acupuncture was applied at Sama Upper, Middle and Lower of the Master Tung acupuncture points and at ST44 on the left lateral for 30 minutes twice a day. The affected face was gauze dressed with mixture of 2.0 mL HP and 1.0 mL 25% BVP with 20 mL of normal saline twice a day. Herbal Medicine, Seungmagalgeuntang, was administered three times a day after each meal.

          Results:

          Rashes and papules on the face were completely cleared after 10 days of treatments.

          Conclusion:

          KVE, an acute and urgent dermatitis, can be effectively treated with Korean medicine.

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          Most cited references26

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          Interleukin-18 regulates both Th1 and Th2 responses.

          Although interleukin-18 is structurally homologous to IL-1 and its receptor belongs to the IL-1R/Toll-like receptor (TLR) superfamily, its function is quite different from that of IL-1. IL-18 is produced not only by types of immune cells but also by non-immune cells. In collaboration with IL-12, IL-18 stimulates Th1-mediated immune responses, which play a critical role in the host defense against infection with intracellular microbes through the induction of IFN-gamma. However, the overproduction of IL-12 and IL-18 induces severe inflammatory disorders, suggesting that IL-18 is a potent proinflammatory cytokine that has pathophysiological roles in several inflammatory conditions. IL-18 mRNA is expressed in a wide range of cells including Kupffer cells, macrophages, T cells, B cells, dendritic cells, osteoblasts, keratinocytes, astrocytes, and microglia. Thus, the pathophysiological role of IL-18 has been extensively tested in the organs that contain these cells. Somewhat surprisingly, IL-18 alone can stimulate Th2 cytokine production as well as allergic inflammation. Therefore, the functions of IL-18 in vivo are very heterogeneous and complicated. In principle, IL-18 enhances the IL-12-driven Th1 immune responses, but it can also stimulate Th2 immune responses in the absence of IL-12.
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            Huang-Lian-Jie-Du-Tang exerts anti-inflammatory effects in rats through inhibition of nitric oxide production and eicosanoid biosynthesis via the lipoxygenase pathway.

            Huang-Lian-Jie-Du-Tang (HLJDT) is a traditional Chinese medicine with a long history of anti-inflammatory use, but its pharmacological effects have not been thoroughly investigated. This study aimed to evaluate the anti-inflammatory activity of HLJDT in vivo and in vitro. The carrageenan rat air pouch model was used to investigate the anti-inflammatory action of HLJDT after oral administration. Moreover, we exploited a modified method based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) technique to assay the effects of HLJDT on arachidonic acid metabolites. Our data demonstrate that oral administration of HLJDT significantly inhibited the inflammatory responses in carrageenan-injected rat air pouches, and also significantly reduced the production of nitric oxide (NO) and leukotriene B(4) (LTB(4)) in vivo, without any influence on biosynthesis of cyclooxygenase (COX)-derived eicosanoids. Similar behaviour of HLJDT was also observed by using calcium ionophore A23187-stimulated peritoneal macrophages, where HLJDT markedly inhibited eicosanoids derived from different lipoxygenases. The NO production and the mRNA expression of inducible nitric oxide synthase (iNOS) and chemotactic factors (CCL3, CCL4, CCL5 and CXCL2) were also inhibited by HLJDT in RAW 264.7 macrophages stimulated by lipopolysaccharide. Our data revealed, for the first time, that HLJDT could inhibit biosynthesis of eicosanoids derived from different lipoxygenases. Also, HLJDT may exert its anti-inflammatory effects by its suppression on eicosanoid generation, NO production and gene transcription of chemotactic factors, which supports its effectiveness in the treatment of inflammatory diseases.
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              Recurrent viral infections in patients with past or present atopic dermatitis.

              Histories of recurrent infections were obtained from 955 adults with past or present atopic dermatitis (AD) and from 199 controls. Patients who had previously been hospitalized in childhood because of severe AD had a significantly higher incidence of recurrent (greater than 5 episodes per year) cold sores and upper respiratory tract infections as well as a higher incidence of herpes zoster, than non-atopic controls. Patients with milder AD in childhood (never hospitalized) had lower incidence of these diseases, but as regards cold sores, the frequency of recurrent infections was still significantly higher than that of the controls. AD patients with past or present respiratory allergy had a slight but not statistically significant increased incidence of recurrent infections, as compared to AD patients without concomitant respiratory allergy. The factors predisposing to frequent infections appeared to be those related to severity of the atopic condition, i.e. ongoing AD, need for hospitalization in childhood and extent of dermatitis. The increased susceptibility to recurrent viral infections in AD patients is most probably related to dysfunctioning cell-mediated immunity.
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                Author and article information

                Journal
                J Pharmacopuncture
                J Pharmacopuncture
                J Pharmacopunct
                Journal of Pharmacopuncture
                KOREAN PHARMACOPUNCTURE INSTITUTE
                2093-6966
                2234-6856
                June 2014
                : 17
                : 2
                : 80-83
                Affiliations
                [1 ] Department of Ophthalmology, Otolaryngology and Dermatology, Korean Medicine Hospital, Pusan National University, Yangsan, Korea
                [2 ] Department of Internal Medicine, Korean Medicine Hospital, Sangji University, Wonju, Korea
                Author notes
                * Corresponding Author Hyung-Sik Seo. Department of Ophthalmology, Otolaryngology and Dermatology. School of Korean Medicine, Pusan National University, Yangsan, Kyungnam 626-770, Korea Tel: +82-55-360-5630 Fax: +82-55-360-5689 E-mail: aran99@ 123456pusan.ac.kr
                Article
                10.3831/KPI.2014.17.020
                4331992
                9c9929a4-92aa-427b-acc6-d0643619c02e
                Copyright ©2014, KOREAN PHARMACOPUNCTURE INSTITUTE

                This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 January 2014
                : 12 February 2014
                Categories
                Case Report

                atopic dermatitis,bee venom pharmacopuncture,eczema herpeticum,herbal medicine,hwangyeonhaedoktang pharmacopuncture,kaposi’s varicelliform eruption

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