JAANET(Japan Allergy&Asthma Network ) Japanese Allergy Association

What kind of illness the Atopic dermatitis is ?

1) Atopic dermatitis is the eczema with strong itch which is easy to continue for a long time repeating improve or worsen. Eczema is at the inflammation of atopic dermatitis, although it is one of the skin inflammations. The lymphocyte called Th2 is considered to have an important role. This has led also to an IgE antibody being easy to be made. In allergic bronchial asthma, allergic rhinitis and etc., it was thought that mechanism are the same way. These diseases are collectively called atopic disease.

2) From such sick nature, atopic dermatitis often merges other atopic diseases such as asthma and allergic rhinitis. Moreover, the probability of development of symptoms in a family is high, and the tendency for the ease of symptoms developing to be transmitted from parents to a child can be seen. Investigation result is reported that when one of the parents experienced atopic dermatitis in the past, if one of parents experienced, children may have 56% possibility on the average, if both parents experienced, children may have 75% possibility and if friend experienced, children may have 49% possibility, if both of parents not experienced, children may have 21% possibility.

3) In atopic dermatitis, abnormalities appear in work of the skin that the capability which maintains the moisture of the skin tends to keep low, easy of itch, and infection tends to occur and the barrier ability of the skin is lowered.

4) It is thought that an environmental factor may affect to human constitutional factor, then atopic dermatitis symptoms developing.

Current state of atopic dermatitis is ? (Epidemiology)

1) The patient of atopic dermatitis were investigated in terms of what rate per population(probability) by a medical specialist's medical checkup from year 2000 to year 2002. Consequently, national average probability were 12.8% of four-month children, 9.8% of one and half year-old children, 13.2% of 3 years-old children, 11.8% of first graders in an elementary school, 10.6% of sixth graders in an elementary school and 8.2% of first grade in a university.

2) About 75% - 85% of the person diagnosed as atopic dermatitis had light illness. However, the tendency for symptom to get worse of later childhood rather than an infant stage is found.

What is the basic medical treatment of atopic dermatitis? (medical treatment guideline)

1) 　Let's explain the foundations of medical treatment according to the "atopic dermatitis medical treatment guideline 2002" created by the welfare labor science research group. This medical treatment guideline is widely created as an object for the doctor who perform medical examination of atopic dermatitis. In order to treat atopic dermatitis correctly, it is recommended that the skilled doctor who have much experience of medical examination of atopic dermatitis, correctly diagnosis and this judgment of the grade (the degree of seriousness) of symptom shall be made.
They are three points of search and the measure of the fundamental medical treatment of atopic dermatitis. 1) cause / deterioration factor research and measure, 2) skin care, and 3) medication (Fig. 1) . Although these three points are equally important, it combines appropriately according to the patient's condition and/or other situations. In order to fully acquire the medical treatment effect, it is important to fully exchange information between the patient and a doctor or medical staff, and to build good partnership and a confident relationship.

1) Although atopic dermatitis develops and gets worse by various factors, the typical items are shown in Fig. 2. Although other various cause /deterioration factors are known besides these factors, the importance of each factor varies depend on each patients. It cannot be decided only from inspection results such as a blood test and a skin test. It is very important to frequently consult with your family doctor and to create the measure to cause / deterioration factor.

2) Although as stated above, there are some functional abnormalities at the skin of atopic dermatitis, the skin care is important in order to rectify it. The skin care fundamental is the cleanliness of the skin by daily bathing and shower and moisturizing by moisturizer . Moreover, avoiding the injury of the skin by itch and scratching are important.

3) Even if situation does not improve by caution of an deterioration factor and takes care about skin care, the medical treatment by the medicine is required. The fundamental course is an external application treatment and an internal use treatment. The subjects of an external application treatment is steroid and Takurorimus medicine for external application. the main course of an internal use treatment are antihistaminic agent and anti-allergy medicine.

(1) Steroid medicine for external application

Previously, the use of the steroid medicine for external application to atopic dermatitis had the tendency to refused just because it worries about the side effects. Although it is a fact that side effects exist in a steroid medicine for external application, but steroid is a very effective medicine for controlling dermatitis. If you can get good directions of doctors such as a kind, an application point, quantity, the number of times and etc. of a steroid medicine for external application, it is never a dangerous medicine. And it is also important to surely consult once at one - two weeks interval and to check the state of the skin by the doctor.

(2) Takurorimus ointment

Now, the medicine for external application of Takurorimus which is a non-steroid system immuno-suppressive drug at the age of two or more can be used (from more than 2 years old to less than 16 years old years old: 0.03% ointment, 16 or more years old : 0.1% ointment). The clinical effect is estimated about the same as the steroid medicine of external application. Up to now, side effects like a III steroid medicine for external application are not experienced. Therefore, it is highly useful for the person whose face and the cervix in which side effects is easy to occur by the steroid medicine of external application.
However, it is important for not to use instead of steroid medicine for external application. The use of non-steroid system immuno-suppressive drug shall be followed the instruction of the doctor.

(3) Anti-histaminic agent - anti-allergy medicine

These medicines are mainly used in order to stop itch. Eczema condition cannot be suppressed, although the medicine with these anti-histamine actions controls it when hives merges. Therefore, do not take aimlessly, but it is important to use confirming the effectiveness of the medicine.

・Other caution to be taken.

1) Since it is easy to merge infection illness such as a scabby mouth, Kpoji chicken pox eruption and infectious mastitis, so that, the cautions are required.

2) Since a cataract, detachment of the retina and etc. will tend to occur if an eye is rubbed or struck because of itch, so that, the cautions are required.

3) Since "rash" may arise by the medicine of external application currently used and condition may getting worse, so that, the cautions are required.

4) It is the basic medical treatment which was described above. Although other medical treatment may be added if needed by the judgment of your family doctor.

5) Even it continues the medical treatment for about one month, if not improving come out, it is required to consult the medical doctor who have more professional level technology and medical facility.


Above mentioned are the fundamental medical treatment of atopic dermatitis with the latest information. It is my pleasure if these description help you for understanding the medical treatment of atopic dermatitis.

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