We recently showed that multicomponent traditional Chinese medicine (TCM) therapy had steroid-sparing effects in moderate-to-severe eczema. We sought to evaluate TCM effects in severe eczema in a 7-year-old male with refractory disease and corticosteroid withdrawal syndrome. Prior to referral, the patient had been treated since infancy with increasingly intensive standard of care, including high-dose topical and systemic corticosteroid and antibiotic therapy and was unable to tolerate further steroid treatment. The patient was administered a combination of oral and topical TCM for 17 months following discontinuation of his steroid regimen. His overall medical condition was assessed by SCORAD criteria and laboratory evaluations of serum IgE, absolute eosinophil count, and liver and kidney function tests. The patient showed rapid improvement of clinical measures of disease after starting TCM therapy, with marked improvement of sleep quality within the first week, complete resolution of itching, oozing, and erythema at 2 weeks, and a 79% and 99% decrease in his SCORAD values after one month and 3–6 months of TCM, respectively. Serum total IgE decreased by 75% (from 19,000 to 4630 (kIU/L), and absolute eosinophil counts decreased by 60% (from 1000 to 427 cells/μL) after 12 months of treatment. The patient did not require oral or topical steroids during the 17-month trial of TCM. TCM was tapered without complications. His dermatologic manifestations continued to be well-controlled 3 months after discontinuation. This case study suggests TCM should be further evaluated in controlled clinical studies of patients with severe, refractory eczema and steroid withdrawal syndrome.

中文翻译：

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多组分中药治疗改善皮质类固醇停药相关重度湿疹皮损

我们最近表明，多成分中药 (TCM) 疗法对中度至重度湿疹具有减少类固醇的作用。我们试图评估中医对一名患有难治性疾病和皮质类固醇戒断综合征的 7 岁男性严重湿疹的疗效。在转诊之前，患者从婴儿时期就接受了越来越严格的标准护理，包括大剂量局部和全身皮质类固醇和抗生素治疗，并且无法耐受进一步的类固醇治疗。该患者在停止类固醇治疗后接受了 17 个月的口服和局部中药组合治疗。他的整体医疗状况通过 SCORAD 标准和血清 IgE 的实验室评估、绝对嗜酸性粒细胞计数以及肝肾功能测试进行评估。患者开始中医药治疗后临床症状迅速改善，第一周睡眠质量明显改善，2周瘙痒、渗液、红斑完全消退，SCORAD分别下降79%和99%分别在中药治疗 1 个月和 3-6 个月后的值。治疗 12 个月后，血清总 IgE 下降 75%（从 19,000 至 4630 (kIU/L)，绝对嗜酸性粒细胞计数下降 60%（从 1000 至 427 个细胞/μL）。患者不需要口服或外用类固醇在 17 个月的中医药试验期间，中医药逐渐减量，无并发症，停药 3 个月后皮肤表现继续得到良好控制。