A Case Report of Atopic Dermatitis with Otitis Media with Effusion and Chronic Rhinitis

Ju-Hyun Lee; Eun-Heui Jo; Ji-Eun Hong; Ji-Won Park; Min-Cheol Park; Lee, Ju-Hyun; Jo, Eun-Heui; Hong, Ji-Eun; Park, Ji-Won; Park, Min-Cheol

doi:10.13048/jkm.21008

JKM > Volume 42(1); 2021 > Article

Lee, Jo, Hong, Park, and Park: A Case Report of Atopic Dermatitis with Otitis Media with Effusion and Chronic Rhinitis

Case report

The Journal of Korean Medicine 2021; 42(1): 110-118.

Published online: March 01, 2021

DOI: https://doi.org/10.13048/jkm.21008

A Case Report of Atopic Dermatitis with Otitis Media with Effusion and Chronic Rhinitis

Ju-Hyun Lee¹

, Eun-Heui Jo²^{, 3}

, Ji-Eun Hong²

, Ji-Won Park²

, Min-Cheol Park¹^{, 3}^{, *}

¹Department of Ophthalmology, Otolaryngology & Dermatology, College of Korean Medicine, Wonkwang University

²Department of Korean Medicine Acupuncture and Moxibustion, College of Korean Medicine, Wonkwang University

³Research Center of Traditional Korean Medicine, Wonkwang University

Correspondence to: Min-Cheol Park, Department of Ophthalmology, Otolaryngology and Dermatology, Wonkwang University Korean Medicine Hospital, 895 Muwang-ro, Iksan-si, Jeollabuk-do, 54538, Republic of Korea, Tel: +82-63-859-2821, Fax: +82-63-841-0033, E-mail: spinx11@wonkwang.ac.kr

Received October 31, 2020 Revised February 8, 2021 Accepted February 18, 2021

Abstract

Objectives

This study aims to report a case of atopic dermatitis with otitis media with effusion and chronic rhinitis improved by oral administration of Galgeungabanha-tang.

Methods

The patient of this case had symptoms such as erythema, abrasions, scales, and itching. She also complained of rhinorrhea, nasal obstruction, cough, sputum, and ear fullness. Considering the fact that she was sensitive to heat, but did not sweat well, and respiratory symptoms often occurred, Galgeungabanha-tang was prescribed.

Results

After medication, the symptoms of atopic dermatitis significantly improved from 10 to 2 point. The subjective symptoms of chronic rhinitis and otitis media with effusion also improved considerably. In addition, nasal swelling and purulent exudate almost disappeared. The tympanic membrane, which was swollen due to amber exudate, also changed to a normal gray-white color.

Conclusions

Atopic dermatitis accompanied by chronic rhinitis and otitis media was improved after 45 days of medication.

Keywords: Atopic Dermatitis, Otitis Media with Effusion, Allergic Rhinitis, Galgeungabanha-tang, Case Report

Fig. 1

Treatment Timeline

Fig. 2

Clinical Progress of Atopic Dermatitis

Fig. 3

Clinical Progress of Otitis Media with Effusion and Chronic Rhinitis

Table 1

Prescription of Galgeungabanha-tang

Name of natural medicine (herbal medicine)	Weight(g)
Zingiber officinale Roscoe	3
Ziziphus jujuba var. inermis (Bunge) Rehder	4
Ephedra sinica Staph	3
Glycyrrhiza uralensis Fisch	3
Cinnamomum cassia (L.) J. Presi	2
Pinellia temata (Thunb.) Makino	6
Paeonia lactiflora Pall.	2
Pueraria lobata (Wild.) Ohwi	4
Total Amount	27

Table 2

Atopic Dermatitis Symptom Evaluation Index

	Evaluation	Score
Objective symptom	Erythema	0=Absence 1=Mild 2=Moderate 3=Severe
	Edema/Papule
	Oozing/Crusting
	Excoriations
	Lichenification
	Dryness

Subjective Symptom	Sleep Loss	0–10
Subjective Symptom	Pruritus	0–10

Table 3

Chronic Rhinitis Symptom Evaluation Index

	Evaluation	Score
Objective symptom	Nasal Swelling	0=Absence 1=Mild
Objective symptom	Purulent Exudate	2=Moderate 3=Severe

Subjective Symptom	Rhinorrhea	0–10
	Nasal Congestion
	Cough

Table 4

Otitis Media with Effusion Symptom Evaluation Index

	Evaluation	Score
Objective symptom	Tympanic Membrane Swelling	0=Absence 1=Mild 2=Moderate 3=Severe (Tympanic Membrane color)
Objective symptom	Tympanic Membrane Color
Subjective Symptom	Ear fullness	0–10

Table 5

Clinical Symptom Evaluation Progress of Atopic Dermatitis

	2020.05.04	2020.05.27	2020.06.03	2020.07.08	2020.07.25
Objective Symptom	3	2	1	1	1
Subjective Symptom	7	5	4	2	1
Total	10	7	5	3	2

Table 6

Clinical Symptoms Evaluation Progress of Chronic Rhinitis

	2020.05.04	2020.05.27	2020.06.03	2020.07.08	2020.07.25
Objective Symptom	3	2	2	1	1
Subjective Symptom	8	5	3	2	1
Total	11	7	5	3	2

Table 7

Clinical Symptoms Evaluation Progress of Otitis Media with Effusion

	2020.05.04	2020.05.27	2020.06.03	2020.07.08	2020.07.25
Objective Symptom	3 (Amber)	2 (Yellow)	2 (Grey-White)	1 (Grey-White)	0 (Grey-White)
Subjective Symptom	5	3	2	1	0
Total	8	5	4	2	0

참고문헌

1. Kim, KH, & Jung, HA. Clinical study for the efficacy of external preparation containing Sophorae Radix, Aurantii Immaturus Fructus, Schizonepetae Spica, Forsythia fructus and Portulacea Herba extract on atopic dermatitis. J Korean Med Ophthalmol Otolaryngol Dermatol, (2014). 27(1), 17-36.

2. Lifschitz, C. The impact of atopic dermatitis on quality of life. Ann Nutr Metab, (2015). 66(1), 34-40.

3. Park, HS, & Kim, KH. Characteristics of atopic dermatitis associated with severe ocular complications. Ko J Invest Dermatol, (2006). 13(3), 67-71.

4. Bantz, SK, Zhu, Z, & Zheng, T. The atopic march: progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol, (2014). 5(2), 202.

5. Jang, CH. Characterization of cytokines present in pediatric recurrent otitis media with effusion: Comparison of allergy and nonallergy. Korean J Otolaryngol, (2000). 43(8), 808-812.

6. Kim, LS, & Han, CS. Pathophysiology of otitis media with effusion. J Clinical Otolaryngol, (2000). 11, 197-205.

7. Mogi, G, & Suzuki, M. The role of IgE-mediated immunity in otitis media: Fact or fiction? Ann N Y Acad Sci, (1997). 830, 61-69.

8. Choi, JH. Allergic rhinitis and comorbidities. Korean J Med, (2013). 85(5), 457-462.

9. Rah, YH. Allergic rhinitis. Clin Exp Pediatr, (1998). 41(1), 1-11.

10. Seo, MS, Hur, IH, Sim, SY, & Kim, KJ. A case of atopic dermatitis treated with Sihogeji-tang. J Korean Med Ophthalmol Otolaryngol Dermatol, (2008). 21(3), 215-225.

11. Cho, SH, Jee, SY, & Lee, SG. A clinical report for treatment 2 cases on Takrisodokyeum of otitis media. J Korean Med Ophthalmol Otolaryngol Dermatol, (2002). 15(1), 301-307.

12. Sin, KS, & Roh, SS. Clinical study on 100 cases of allergic rhinitis. Journal of Haehwa Medicine, (1994). 3(1), 185-196.

13. Kim, YJ, Kim, OS, Lim, HS, Yoo, SR, Jeon, WY, Jin, SE, Shin, IS, Kim, JH, Shin, NR, Kim, SS, Lee, MY, Jeong, SJ, Ha, HK, & Shin, HK. Study on comparison of ingredient quantities and biological activities of Galgeun-tang according to extraction solvent. J Physiol & Pathol Korean Med, (2012). 26(6), 908-914.

14. Jeong, DH, Kim, JH, Park, SY, & Choi, JH. Effects of Pinelliae Rizoma (PR) on asthma induced intra-nasal instillation of ovalbumin in mice. J Korean Med Ophthalmol Otolaryngol Dermatol, (2008). 21(1), 38-54.

15. Mang WJ. Sanghanron commentary. 1st edition. Iksan. Wonkwang University Press Office;(1996). 10:p. 55

16. Yin, JA, Dai, Y, & An, SP. Pharmacological and clinical researches of gegentang. Chinese Archives of Traditional Chinese Medicine, (2007). 25(6), 1275-1278.

17. Kim, CW. Current update on allergic rhinitis. Korean J Med, (2012). 82(3), 298-303.

18. Hanifin, JM, & Rajk, G. Diagnostic features of atopic dermatitis. Acta Derm Venereol, (1980). 92, 44-47.