SKIN/DERMATOLOGY RESEARCH (© JCM Ltd)

CHINESE HERBS AND ACUPUNCTURE FOR ATOPIC DERMATITIS
A Canadian study has assessed the effectiveness of combining Chinese herbal medicine and acupuncture for the treatment of atopic dermatitis. Twenty patients (aged 13-48) who had mild-to-severe atopic dermatitis were given a combined treatment of acupuncture twice a week plus a Chinese herbal formula three times daily for a total of 12 weeks. Assessments were performed before treatment, and at weeks 3, 6, 9 and 12 of treatment. Primary outcomes were defined as the changes in the Eczema Area and Severity Index (EASI), Dermatology Life Quality Index (DLQI), and patient assessment of itch measured on a visual analogue scale (VAS). After 12 weeks of treatment, an improvement in EASI was noted in 100% of patients, when compared with baseline. The mean EASI fell from 4.99 to 1.81; the median percentage of decrease was 63.5%. In addition, 78.8% of patients experienced a reduction in DLQI and VAS, compared with baseline. Mean DLQI decreased from 12.5 to 7.6 at the end of treatment, with 39.1% improvement. Mean VAS decreased from 6.8 to 3.7, with 44.7% improvement. (The effectiveness of combined Chinese herbal medicine and acupuncture in the treatment of atopic dermatitis. J Altern Complement Med. 2008 Oct;14(8):1043-8).

CHINESE HERBS FOR ECZEMA
A Chinese herbal formula had been found to reduce the production of inflammatory proteins linked with causing eczema. A Hong Kong team assessed the effects of the ‘Pentaherbs formulation’ (PHF, containing honeysuckle flower (jin yin hua), peppermint (bo he), peony root bark (mu dan pi), atractylodes rhizome (cang zu), and phellodendron bark (huang bai)) on immune cell cultures and patients with atopic eczema. In the in vitro study, the researchers isolated peripheral blood mononuclear cells from randomly chosen transfusion blood samples. Cell cultures were then exposed to PHF and the effects on cell growth and production of inflammatory mediators were analysed. PHF reduced production of four inflammatory mediators: brain-derived neurotrophic factor (BDNF), interferon (IFN)-gamma, tumour necrosis factor (TNF)-alpha and thymus and activation-regulated chemokine (TARC), following stimulation of the cells with microbial toxins. In the second part of the experiment, 28 Chinese patients (5-21 years old) with moderate to severe eczema were treated with PHF for three months. Most continued to take steroid medication. Blood samples were taken at the beginning and end of this period. Although there was no change in the amount of steroids used by the patients, they found that levels BDNF and TARC reduced over the three months. (In vitro and clinical immunomodulatory effects of a novel Pentaherbs concoction for atopic dermatitis. Br J Dermatol. 2008 Mar 13 [Epub ahead of print]).

ACUPUNCTURE AND PSORIASIS
Having become interested in the results of an acupuncturist treating psoriasis, members of a University Dermatology department in Sweden set up this clinical trial. The acupuncturist had treated with traditional Chinese medicine, acupuncture (an average of 24 sessions), topical needling, ear acupuncture and Chinese herbal remedies. This trial drew a sample of 56 chronic but stable psoriasis sufferers, mostly from a newspaper advertisement, and randomly allocated to 'active' or 'placebo' treatment. They were given treatment twice weekly for 10 weeks and the severity of skin lesions was scored before, during and 3 months after treatment. No significant differences were found between the 2 groups and neither reached the normal placebo change of 30% expected by researchers. In the trial, treatment was given by a qualified acupuncturist and active treatment consisted of the use of 20 points (how these were used is not specified), needled deeply and with electrostimulation applied. Ear points were also used. Placebo treatment consisted of shallow needling close to the same body points and with some ear points. As the discussion section admits, such placebo approaches are increasingly suspect, but it is interesting that neither group reached the non-treatment effects expected. It is also interesting that the acupuncturist originally agreed to the methodology but subsequently declined to appear as a co-author and apparently has not furnished full details of the style of treatment given. The results of this study do not bear out the earlier, retrospective findings of success in treating psoriasis with TCM. This may reflect differences in the sample of patients or in the practice and styles of the two practitioners, or even more so the relative importance of the use of herbal remedies. The nature of this study does not however seem to justify the sweeping conclusion that "classical acupuncture with electrostimulation and ear acupuncture has no effect on psoriasis  vulgaris". (A controlled trial of acupuncture in psoriasis : no convincing effect. Jerner B, Skogh M, Vahlquist A. Acta Derm Venereol (Stockh) 1997; 77: 154-156).

CHINESE HERBS AND HERPES SIMPLEX
The combination of various Chinese herbs with proven antiherpes simplex virus type 1 (HSV-1) action combined with acyclovir has been found to have a stronger anti-HSV-1 action than either the herbs or acyclovir alone. They reduced virus yields in the brain and skin more strongly than acyclovir alone, and exhibited stronger anti-HSV-1 activity in the brain than in the skin, in contrast to acyclovir treatment by itself. (Antiviral Research.  1995 ;27(1-2):19-37).

CHINESE HERBS AND ECZEMA
A study has followed up a group of 31 patients with severe atopic eczema who initially took part in a double-blind placebo-controlled crossover trial of a specific formulation of Chinese herbal therapy. All were offered continued therapy for one year after the trial was completed. Of 17 patients who took up the offer, 12 had a greater than 90% reduction of symptoms and the other 5 had a greater than 60% reduction. 11 patients who decided not to continue treatment reported a gradual deterioration of symptoms, resulting in a significant difference (both erythema and surface damage) between the two groups. Toxicology screening revealed no abnormalities in either full blood counts or biochemical parameters in any patient on continued treatment. Improvement in disease was not associated with any significant change in serum IgE level or peripheral blood lymphocyte subsets (Clinical & Experimental Dermatology.  1995 ;20(2):136-40).