Volume 3, Number 4 | Winter 2008

Kampo Dermatology – Clinical Studies

Treatment of Plaque Psoriasis
with Kampo (4)Fumino Ninomiya
Aoki Clinic

Epidermal cells are originally born in the basal celllayer. And while dividing, the new epidermal cells
form

theprickle

celllayer

andundergodifferentiation, and then move up to the stratum
corneum (keratinous layer) of the outermost layer.
Then dead cells are shed from the skin as dirt. This
normal process takes about four weeks. If there issomething abnormal in the basal cell layer, new cells

Figure 1-1

still possessing cell nuclei may move up to thekeratinous layer at a faster rate, taking only twoweeks. (The author considers the basal layer belong
to “kidney.”)
If cells undergo a faster renewal process, thekeratinous layer cannot be formed adequately andvarious disorders occur in the epidermis; old cells arepushed by new cells that are moving up fromunderneath and the pushed old cells become crusted
and desquamated, or cause rashes or eruptions
before they become dirt to be shed. This condition isplaque psoriasis, an intractable skin disorder. Its
cause is not known.

Figure 1-2
For the skin surface of scaly conditions, heat clearing

In plaque psoriasis, “corkscrew-like vessels” asseen in Fig. 1 bulge into the skin tissues where there
should essentially be no vessels, and they extend tojust before the skin surface. And only small amountsof stimulation or irritation causes bleeding very
easily. This is a major characteristic of plaquepsoriasis. So it is essential to keep smooth blood flow.

Kampo

medicines

suchasAngerica

Decoction-

Antipruritus, Wind Dispersing Powder, unseiin, andGentian Liver-Purging Decoction are used. The skinsurface especially intensely reddish is the condition that
damp and heat bind together, or that of blood and heatbind together. For this condition, Kampo medicines suchas Capillary Wormwood Decoction are used.
As above, the scaly skin surface is often accompaniedby blood stasis. For the condition, Kampo medicines forexpelling stasis (blood activating and stasis resolving
medicines) are used according to individuals’ demands,
such as keishibukuryogan, tokakujokito, tsudosan,daiobotampito, choyoto.

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The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 3, Number 4 | Winter 2008

Plaque psoriasis often becomes worse in autumn. It

Labo Data:is partly because autumn is a dry season, but mainly

T-Chol 98mg/dl↓

because it may be related with the fact that the basal

HDL-Chol 35 mg/dl↓

layer becomes active (kidney’s activity) in autumn andTG 234mg/dl↑

thereby the layer becomes strong enough to create cells

AST 102Iu/l↑

from underneath.

ALT 49Iu/l↑γ‐GPT 483Iu/l↑

If the kidney becomes active and the skin conditionis exacerbated, internal evil (pathogen) needs to be

LDH 367Iu/dl↑

dispelled by activating blood, clearing heat, andSerum protein :Total protein7.5

draining damp to recover the normal metabolism.

A/G 1.11
Case: Male of 69 years oldALB 52.6

Plaque psoriasis

Underwent surgery for colon

α 2 Globulin 4.4↓

polyps eight years ago. Veins in the esophagus ruptured

β Gulobulin 6.1↓

three years ago.

γ Globulin 35.0↑

Past medical history:

The patient had hepatic cirrhosis due to alcoholic

Leucocytes 2.9↓

hepatitis. He was taking various drugs prescribed

Erythrocytes 36.2↓

by other hospital for hepatitis, gastrointestinal

Hb 13.6g/dl

symptoms, and diuresis.
Present medical history: Plaque psoriasis occurred twoyears ago. It started affecting the scalp and spread allover the body. The patient had also been treated by otherhospital. Scales (++). In autumn it became worse and thepatient made the initial visit to our clinic in October.

Ht 40.1% Platelet 5.0↓
Therapy and course
tsudosan 5.0g, eppikajutsuto 5.0g, Epinastine
Hydrochloride 20mg one tablet/day for 6 weeks.
Changed to tsudosan 5.0g, unseiin 5.0g, andkeishibukuryogan 2.5. Biotin 4.5g was added.
tsudosan 5.0g, unseiin 5.0g, Biotin 4.5g were continued.
In June of the following year, the healed state wasbeing maintained.

Before treatment

After treatment

Before treatment

After treatment

Figure 2
The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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