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Fig 2.28 Phototherapy

NB: Not suitable for all

vulnerable cells associated with the immune response: lymphocytes, macrophages, neutrophils and eosinophils. Hence there is a reduction in the inflammatory process, and an improvement in atopic skin disease. Therapeutic UV lights aims to simulate the benefits of sunshine. The UVA lights used in tanning parlours, gyms and health clubs exert however little benefit in eczema. UVA combined with psoralens either orally or in a bath (PUVA treatment) can be helpful, as can narrow-band UVB treatment. The treatment produces a temporary remission in selected patients who can tolerate phototherapy (Fig 2.28). Provided only in specialist centres, the disadvantages of phototherapy include premature photo-ageing and skin malignancy, as well as both expense and inconvenience.

n o 2

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Chinese herbs

Fig 2.29 Chinese Herbs

An effective traditional remedy

Unpalatable, and potentially toxic

Teas made by prolonged boiling of combinations of selected dried plant material have been used for centuries by traditional Chinese healers (Fig 2.29). The success of such remedies for atopic skin disease has been investigated by western dermatologists in recent years and the beneficial effect of the treatment has been confirmed, with acceptable short-term toxicity margins. Liver function tests should however be carried out, both before and after treatment. The decoctions are however unpalatable, although encapsulated forms are being developed. During longterm therapy, toxicity, especially in children, remains a worrying factor. The only non-steroidal western drug to similarly suppress atopic eczema is Cyclosporin A, and the late emergence of malignancy is its recognised occasional side-effect.

Hypnotherapy Stage hypnotherapists have led to hypnosis being discredited in the public and medical eye as a valid medical treatment. However, in skilful hands, the technique has been reported to improve atopic eczema in the long and short term, in adults and children. Several sessions are required and the techniques for inducing adult trance need considerable modification for use in children. Suggestions are aimed at curtailing scratching, decreasing sleeplessness

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Profile for Christopher Bridgett

Atopic Skin Disease - A Manual For Practitioners  

An account of a new behavioural approach to the treatment of atopic eczema, written for practitioners, but also for patients

Atopic Skin Disease - A Manual For Practitioners  

An account of a new behavioural approach to the treatment of atopic eczema, written for practitioners, but also for patients