Atopic dermatitis and obesity in a teenage boy -A case report of fecal microflora transplantation
Case presentation: Teenage boy, atopic dermatitis and obesity (under observation)
summary
He had atopic dermatitis since he was a child and continued steroid treatment. Later, he also developed allergic rhinitis. He was treated with medication at a dermatologist and an otolaryngologist. Her entire body was covered with pruritic skin rash, and she was constantly wearing bandages on her extremities, which were itchy. She also had difficulty concentrating and was distracted by the itching. He tended to be obese. After transplantation, her obesity was resolved and her pruritic skin condition improved.
Basic Information
| Patients : | Teenage boy |
| Attending physician : | Haruna Clinic |
| Medical institution in charge of transplantation : | Haruna Clinic |
Information at the time of initial medical examination
| Disease name : | Atopic dermatitis, obesity |
| Time of onset : | infancy |
| Transplant Purpose: To | Allergies, skin problems, diet, other (atopic dermatitis) |
| Chief complaint : | Eczema and itching, obesity tendency |
| Medications being taken : | Allelock, Biosly, Chinese herbal medicine |
| Medical history : | Nothing |
| Background, family history, lifestyle, supplement use, etc : | Brother has a food allergy. |
Transplant Information
| Transplantation period: from | April 6, 2018 – November 30, 2019 |
| Number of transplants : | 13 times |
| Change from first transplant to end of transplant : |
| After the first transplant, his bowel movements improved a little, but the skin rash and itching did not get better until the 6th transplant. However, his tendency to obesity improved and he became slimmer.After the 6th transplant, the skin rash calmed down with additional transplants and remained calm without worsening in the summer of 2019. The skin rash and itching have calmed down since the fall of 2019. However, he does not take the bandages off the extremities due to psychological effects. 【1st transplantation questionnaire】 The patient was constantly scratching his body and was restless during the examination. He is always blowing his nose due to allergic rhinitis and is obese. 【2nd transplantation questionnaire】 The symptoms of atopy have not changed since the last time, and the itching is still severe. The whole body is pruritic and some areas are bleeding. ⇒Suggestion: Stop eating snacks. 【3rd transplantation questionnaire】 Skin rash remains the same, itching is severe. The patient’s diet at home is gluten-free, casein-free, and free of sugar, chemical seasonings, and snacks. He is becoming more aware of his condition. He feels a little slimmer. 【4th transplantation questionnaire】 Skin itching has improved a little, but the skin rash remains the same. The skin rash remained the same, but the use of steroids had calmed it down a little at the time of the visit. He was able to follow the basic dietary restrictions. 【5th transplantation questionnaire】 Itching is still present. Eczema is pruritic and controlled with steroids. Her diet is improving. Her weight has not changed, but she has grown taller and a little slimmer. 【6th transplantation questionnaire】 Skin is a little better. Steroids and anti-allergic drugs are being used. 【7th transplantation questionnaire】 Eczema is getting better all over his body. Started prescribing Chinese herbal medicine. Weight loss has been steady and slim, and obesity has been eliminated. Her diet is also improving. 【8th transplantation questionnaire】 The prurigo has flattened out and is scattered, and the pigmentation has almost completely cleared up. The itchiness has been significantly reduced. Her weight has been steadily decreasing and she is now slimmer. 【9th and 10th transplantation questionnaire】 Aggravated due to lack of skin care during the summer. Using steroids. 【11th transplantation questionnaire】 The itchiness subsided in the cooler weather. Skin is clearing up. 【12th transplantation questionnaire】 No itching, but skin rash sometimes appears on her back. She is concerned about the remaining pigmentation of the rash and always wears bandages on her hands and feet. Her skin is moist and not dry. 【13th transplantation questionnaire】 The skin rash has improved considerably and has calmed down. She always wears bandages because she is concerned about being seen, but there is almost no skin rash on her body or extremities. |
| Changes after completion of transplant : |
| Skin rashes are occasionally treated with steroids. He maintains a slim figure. Psychologically still unable to take bandages off extremities. |
Evaluation and Discussion
| Transplant Evaluation : | Moderate improvement of symptoms |
| Pre- and post-transplant flora balance test changes:. | The proportion of lactobacilli and bifidobacteria is decreasing, but clostridium diversity is emerging. |
| Blood test changes:. | Not implemented |
| POMS2 SCORE CHANGE:. | Not implemented |
＜Intestinal flora balance before and after transplantation＞
| His/her experience (from the questionnaire) : |
| The obesity has resolved and the degree of allergy is getting better. He has had a transplant and the itching has calmed down. |
| Adverse events: No |
| Nothing |
| Transplant General Comments and Discussion : |
| He has been transplanting after the 9th transplant at his request. He said he feels better after each transplant. 13 transplants have been done and the transplanted bacteria seem to be growing well. His skin is also recovering faster. Rhinitis is still not improving well, so we would like to continue to grow the fungal solution while also working on his diet to improve his condition. |
… and upwards
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