Stagnation of Steroid Hormones in Patients with Atopic Dermatitis and Unique Variation of Leukocyte Pattern during the Withdraival Syndrome after Cessation of Steroid Ointment

Abstract

Patients with severe atopic dermatitis are sometimes seen even after 15-20 years of age, despite tl1e fact that this is age when atopic dermatitis subsides in usual cases. We consider the possibility that steroid hormones administered as ointment stagnate in the skin and become oxidized cholesterols. Such substances may induce circulation failure and granulocyte-associated inflammation. We herein report the withdrawal of the above ointment in such patients, resulting in successful treatment within several months. Since they suffered from the withdrawal syndrome for the first two or three weeks, acupuncture was performed. Before therapy, these patients showed elevated levels of granulocytes and eosinophils, and an inverse decreased level of lymphocytes in the blood. The number and proportion of granulocytes are known to increase by sympathetic nerve stimulation.This, therefore, indicated that these patients were in a dominant state of the sympathetic nervous system. During the therapy, this leukocyte pattern became much worse due to the withdrawal syndrome. However, in parallel with the amelioration of inflammation, normalization of the leukocyte pattern was observed. These results revealed that, by some yet-undetermined reasons, patients with atopic dermatitis who had been treated by steroid ointment for long time, showed an unusual pattern of leukocytes (i.e., granulocytosis) and that this leukocyte pattern was normalized by the withdrawal of steroid hormones in parallel with the amelioration of the disease.The onset of atopic dermatitis usually begins at infancy or childhood and some cases experience spontaneous cure before adolescence (3, 12). Primarily, people in childhood show a predominant state of the immune system (i.e., a high level of lymphocytes) (5). However", adults gradually show a decreased level of the immune system (9). The level of granulocytes surpasses that of lymphocytes at l5~20 years old in Japan (our unpublished observation). We speculate that this age-associated change of the Correspondence to: Dr. T. Abo, Department of Immunology, Niigata University School of Medicine, Asahimachi-dori 1, Niigata 951-8510, Japan Fax: + 81-25-227-0766 E-mail: immunol2@med.niigata-u.ac.jp immune system might be responsible for the spontaneous cnre of atopic dermatitis. In other words, many cases of atopic dermatitis naturally subside due to an age-dependent decrease in the number of T cells.

“Senobi” Stretch Ameliorates Asthma Symptoms by Restoring Autonomic Nervous System Balance

“…6 In Japan, air pollution is no longer as serious as in the past, but children's lifestyles have changed, with less exercise and a high-energy diet. It has been speculated that the predominance of parasympathetic nerves in asthmatic patients increases the onset of bronchial asthma.…”

Does East Meet West?—The Association between Oriental Tongue Inspection and Western Clinical Assays of White Blood Cell Subsets

“…be involved in the onset of various diseases [10]. Because the ANS controls the distribution of WBCs, the status of ANS can be assessed by investigating WBC subsets [1]- [3].…”

“…The autonomic nervous system (ANS) modulates the number and ratio of white blood cells (WBC) to maintain their balance [1] [2]. Abo and Fukuda advocated that WBC subsets provide useful information for patients and doctors [3]. They also reported that patients of dermatological diseases, such as atopic dermatitis, showed abnormal WBC subsets [3].…”

“…Abo and Fukuda advocated that WBC subsets provide useful information for patients and doctors [3]. They also reported that patients of dermatological diseases, such as atopic dermatitis, showed abnormal WBC subsets [3]. However, to examine WBC subsets, blood must be sampled, which is invasive to patients and requires time, cost, and training.…”

“…The aim of the current study was to obtain evidence of the tongue inspection and then we investigated the association between oriental tongue inspection and western clinical assays of WBC subsets. We compared two types of patients: those with alopecia areata totalis (AT) and alopecia areata multiplex (AM), because we have previous experience of investigating the association between dermatological diseases and WBC subsets [3]. This study might indicate the validity of the tongue test versus WBC analysis to determine the status of the ANS.…”