ABSTRACT
Disorder of venous circulation is a common cause of skin ulcers in the lower leg. Increased vascular permeability inhibits normal healing of the skin and often prolongs the course. We observed a 75 year-old woman who developed intractable leg ulcer caused by traumatic injury. In spite of the routine medical therapy of Western medicine, the ulcer got worse. She came to us when her doctor recommended surgical intervention. After initial treatment with boiogito extract with shiunko ointment for 2 weeks, no improvement was observed. Then the prescription was changed to eppikajutsuto extract and bushi powder with shiunko ointment, which resulted in increased urine volume and healing of the ulcer after 2 months. Although we usually use hozai such as ogikenchuto for the treatment of skin ulcers, eppikajutsuto might be a choice for the difficult cases like this caused by circulation disorder.
ABSTRACT
We report a case of a 57-year-old woman with radiation proctitis (RP) treated by shiunko (SK) enema with promising outcomes. The patient underwent interstitial brachytherapy for anterior vaginal vault recurrence of uterine cancer. Nine months after the treatment, she had anal pain and was diagnosed with RP by clinical course and colonoscopy. The rectal ulcer was so severe that a surgeon proposed permanent stoma formation as one option, given eventual risk of rectovaginal fistula. The patient rejected stoma formation and opted for Kampo medicine. Though she took keishibukuryogankayokuinin for blood stasis at first, her anal pain and rectal bleeding gradually worsened. Thereafter, she mainly used SK enema, kyukikyogaito and magnesium oxide. Anal pain and rectal bleeding decreased after applying SK to the rectal wall per rectum. Magnetic resonance imaging (MRI) and colonoscopy findings of the rectal ulcer also improved. SK effectively reduced anal pain and rectal bleeding as well as stimulated tissue repair in our patient, and therefore SK is worth considering in the treatment of RP.
ABSTRACT
Since a skin infiltration of breast cancer may increase hemorrhage and malodorous exudates, it significantly reduces the quality of life. Local treatment is usually performed with zinc oxide starch, Mohs paste or its alternatives. However, the Mohs paste causes pain due to necrobiosis of normal tissues, while the topical therapy with zinc oxide starch ineffectively suppresses hemostasis and odor. We hereby report a case of an 86-year old woman with skin infiltration by breast cancer. The patient’s symptoms including bleeding, infection signs, odor, exudates, necrotic tissue objectively improved with Shiunko ointment, Zinc oxide starch, and Metronidazole (MNZ) combination therapy. The gauze was exchanged once a day and this treatment was simple and easy. The combination therapy with Shiunko ointment, Zinc oxide starch, and MNZ may become an effective new regimen for bleeding and odor from skin involvement in breast cancer.
ABSTRACT
Shiunko, topical herbal ointment, has been used in Japan for hemorrhoid and skin wound such as scratch, incision and burn. We report two cases of radiation dermatitis with erosion, which have a good outcome after treatment with shiunko. Case 1 was 72-year-old man with radiation dermatitis of bilateral inguinal region caused by postoperative irradiation for bilateral inguinal lymph node metastases from penile cancer. Re-epithelization was observed in erosion on the 10th day after applying shiunko. It showed earlier recovery from radiation dermatitis than the cases treated with topical external medicine of azulene and/or steroid. Case 2 was 60-year-old man with the perianal radiation dermatitis with pain caused by pelvic radiotherapy for recurrence of advanced rectal cancer after chemotherapy. Shiunko gave rapid relief from anal pain and the patients felt no pain on the day subsequent to applying shiunko. Shiunko hastens analgesic effectiveness and improvement of wound caused by radiotherapy.
ABSTRACT
Molecularly-targeted agents such as cetuximab, an anti-EGFR (epidermal growth factor receptor) monoclonal antibody have been used for the treatment of head and neck cancer. However, these agents frequently induce adverse skin reactions including acne-like rash and paronychia. For these problems, minocycline oral and heparinoid or steroid ointments, are commonly used. Some patients, however, cannot be controlled just by using these drugs. This case report shows a man in his 50s, who was treated for recurrence of nasal cancer. He received a long-term cetuximab therapy for 1 year and a half, and had severe paronychia and skin rash. Medication of unseiin and shiunko ointment decreased these adverse skin reactions, especially, paronychia on his first toes didn't need to be treated by steroid ointment anymore. When the common skin therapies are not effective, these Kampo therapies are possibly one of the options for the supportive care for the patients using cetuximab.
ABSTRACT
PURPOSE: Radiation-induced scalp dermatitis is a type of burn caused by radiotherapy for brain tumors, and often impairs patients' quality-of-life (QOL). In this study, we evaluated the efficacy of shiunko for the treatment of radiation-induced scalp dermatitis. Shiunko is an ointment invented by Sheishu Hanaoka in the early 19th century and is known to treat burns more effectively than steroids.METHODS: Twenty-two patients (12 men and 10 women; age range between 51 to 74 years-old, mean 63.1) with malignant brain tumors were involved in this study. The histological diagnoses were malignant glioma (13 cases), malignant lymphoma (6 cases), and metastasis (3 cases). Performed radiotherapies were as follows: whole brain in 9 cases and local in 13 cases. Symptoms were as follows: redness in 18 cases, burning pain in 13 cases, itching in 13 cases, and erosion in 3 cases. Shiunko was applied in the same manner as when treating with standard ointment. Efficacy was evaluated according to symptom improvement rates: excellent (more than 80%), good (more than 50%), fair (less than 50%), and no effect (less than 30%).RESULTS: Favorable therapeutic effects were observed in all patients (16 excellent cases, 6 good cases). The efficacy was confirmed within a few hours in patients who showed quick response to this treatment.CONCLUSION: Shiunko can be expected to be an effective ointment for treating radiation-induced scalp dermatitis.
ABSTRACT
A 50-year-old female developed severe dermatitis on her face during topical therapy with Shiun-ko and Taitsu-ko. The skin lesions almost disappeared in two weeks with oral steroid therapy and did not recur. Patch testing showed positive reactions to Shiun-ko, Taitsu-ko and Lithospermi radix, and beeswax, which were constituents of Shiun-ko and Taitsu-ko. The result suggests that the patient was sensitized with these topical medicaments and developed allergic contact dermatitis.