A Case of Recalcitrant Acute Eczematous Dermatitis Resolving with Customized Herbal Medicinal Formula 对抗生素和激素治疗无效的急性湿疹一例
Clinical Presentation
The patient presented with a five-month history of blistering lesions on her arms and lower legs, accompanied by mild pruritus. Initial treatment at a family clinic with oral antibiotics yielded no improvement. Subsequent consultation with a dermatologist led to a diagnosis of eczema, and the patient was prescribed a topical steroid cream. However, the dermatitis remained unresponsive to this treatment approach. The patient also experimented with health supplements, including turmeric extract tablets and multivitamin pills, without observing any resolution of her skin condition. Seeking a third opinion and alternative treatment, she presented at our clinic.
Medical History and Comorbidities
The patient’s medical history revealed a complex profile of comorbidities, including hyperglycemia, arthritis, and thalassemia. Notably, these conditions were not deemed causative factors for her dermatological symptoms. The patient also recalled a childhood diagnosis of erythromelalgia, a condition characterized by redness and burning pain in extremities, which had spontaneously resolved without intervention.
Laboratory tests conducted upon the patient’s visit to our clinic revealed a positive Hepatitis A infection. Furthermore, the patient exhibited elevated levels of Rheumatoid Factor (40 IU/mL, with a normal range <30 IU/mL) and LDL Cholesterol (168 mg/dL, with a normal range <100 mg/dL).
Treatment and Clinical Course
The patient was prescribed a customized herbal medicinal formula tailored to her unique clinical presentation. Concurrently, the use of topical steroids was discontinued. Within the first three months of treatment, the patient experienced a flare-up of eczematous lesions, which was attributed to a rebound effect following steroid withdrawal. However, over time, the lesions gradually subsided, ultimately achieving full clearance at the thirteen-month mark. The full reovery image can be obtained from our video channel.
Discussion
This case report highlights the successful management of a recalcitrant eczematous dermatitis in a patient with a complex medical history. The utilization of a customized herbal medicinal formula, coupled with the cessation of topical steroids, resulted in a prolonged but ultimately favorable outcome. The case underscores the importance of a thorough evaluation of comorbidities and individualized treatment strategies in addressing challenging dermatological conditions. Further exploration of the relationship between Hepatitis A infection, elevated Rheumatoid Factor, childhood erythromelalgia, and dermatological manifestations may provide valuable insights into the pathophysiology of similar cases.
Privacy
In situations where the disease information had already been made publicly available (as evidenced by prior articles), genuine names of individuals have been utilized. Conversely, in instances where there was no pre-existing public disclosure or at the explicit request of patients for privacy, pseudonyms have been employed. Furthermore, identities have been deliberately obscured, and certain contextual details and diagnoses have been modified to hinder any attempts at identification. It is essential to emphasize that the patients and encounters described in this work are authentic, and their consent for publication was duly obtained. As responsible authors, we earnestly implore all our readers to honor the privacy and confidentiality of these individuals. Additionally, certain scenarios, assessments, and clinical interventions have been altered to safeguard the anonymity of both patients and healthcare providers.
