FOLLOW-UP OF ADULT PATIENTS WITH ATOPIC ECZEMA TREATED WITH CHINESE HERBAL THERAPY FOR 1-YEAR

Adult patients with severe atopic eczema who had completed a double-bl ind placebo-controlled crossover trial of a specific formulation of Ch inese herbal therapy were offered continued therapy for 1 year. Of 31 patients who completed the original placebo-controlled study and after a washout period and 2 months of further treatment, 17 continued trea tment (group 1), 11 chose not to continue treatment (group 2), one was lost to follow-up and two patients originally in group 1 decided to s top treatment and became pregnant. At the end of the year, 12 of the p atients in group 1 had greater than 90% reduction and the remaining fi ve had greater than 60% reduction in clinical scores compared with bas eline values. Clinical scores of patients in group 2 gradually deterio rated so that by the end of the year the difference between groups 1 a nd 2 was highly significant (P=0.005 and P=0.002 for erythema and surf ace damage, respectively).At the end of the year no patient in group 1 felt able to discontinue treatment permanently, but eight patients we re on an alternate-day regimen by 6 months and remained on this regime n until the end of the year, and seven were able to control their ecze ma with a 1 in every 3 day treatment by the end of the year. The remai ning two patients continued on daily treatments. Toxicology screening revealed no abnormalities in either full blood counts or biochemical p arameters in any patient on continued treatment. Improvement in diseas e was not associated with any significant change in serum IgE level or peripheral blood lymphocyte subsets. This study has shown that Chines e herbal therapy produces a sustained remission of disease activity in patients whose atopic eczema had been unresponsive to a variety of co nventional treatments. Furthermore it has suggested that withdrawal of treatment in patients whose eczema had responsed to treatment, produc es a gradual relapse of the disease but to a severity less than pretre atment levels. No evidence of toxicity was observed in any patient rec eiving this specific formulation of Chinese herbal therapy, but we adv ise continued surveillance of patients receiving such therapy.