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Pustulosis Palmaris et Plantaris (PPP)


 

Pustulosis Palmaris et Plantaris (PPP)

Pustulosis Palmaris et Plantaris (PPP) is a disease that can develop aseptic pustules on the palm of your hands and soles of the feet. In some countries dermatologists classify PPP as a kind of psoriasis. Therefore, treatment is done in a manner very similar to psoriasis.

In the ordinary dermatology department, the strongest steroidal ointments such as Dermovate (clobetasol propionate ), Diflal (diflorasone diacetate),Diacort (diflorasone diacetate), are prescribed. But, since the skin of the limbs is thick, even if you apply a strong steroidal ointment, you do not have to worry about side effects caused by steroids. The condition is however not often improved even with the strongest steroidal ointments.
Oral administration of vitamin A derivatives may be prescribed. However, oral administration of vitamin A derivatives may cause serious side effects over a long period of time. In addition, tonsillectomy or appendix excision may be performed. But, despite of these efforts, the treatment is not sosuccessful enough to cure the symptoms.

The protocol of the treatment at my clinic is rather different from ordinary treatments in other clinics. And if you follow this protocol, you can be free from PPP in a year. The success rate is more than 90% as far as you don't smoke and got to bed till 10 pm.


1) Amoxycillin

The first one week. Take Amoxycillin (https://en.wikipedia.org/wiki/Amoxicillin) for a week. But if you are allergic to penicillin, please don't take it.

Although PPP is said to be "aseptic" and it seems that antibiotics have no meaning, if you take antibiotics, Amoxycillin, especially at early stage, better healing can be achieved.

2) Erythromycin / Cepharanthine

From the second week, take Erythromycin (Erythrocin®) (https://en.wikipedia.org/wiki/Erythromycin) and Cepharanthine (Cepharanthin®) (https://en.wikipedia.org/wiki/Cepharanthine)

Erythromycin ( Erythrocin® 200 mg )

Erythromycin is an antibiotic useful for the treatment of a number of bacterial infections. I tried many kinds of antibiotics and found Erythromycin is really good medicine. Theoretically antibiotics is effective against bacteria, but not against virus. Against virus, only anti-viral medicine such as Tamiful against influenza should be effective. But Erythromycin seems to be effective against virus, too, actually. Theory is not reality. Many medicines are effective theoretically, but not effective in realty. Erythromycin is not effective against virus theoretically, but it is effective in realty. When I travel oversea by long international flight, I always take Erythromycin since 2 days prior to the flight to prevent bacterial and viral infections. And it does work.

We don't know why Erythromycin is important for the treatment of PPP, because theoretically PPP is aseptic. But as I wrote already, real disease is very much different from theory.

How to take ; 4 tablets/day --- Morning 2 tablets, Evening 2 tablets. But the way of taking is unusual. Please take them as follows. For 4 days take 4 tablets everyday. And the following 3 days, don't take any tablets. And the next 4 days take 4 tablets everyday, and don't take any tablets for the 3 days. For example, you begin 4 tablets on Sunday. Then on Monday, Tuesday, Wednesday, you should take 4 tablets everyday. And on Thursday, Friday, Saturday, you should not take any tablets. Then, the next Sunday to Wednesday, take 4 tablets everyday. And on Thursday, Friday, Saturday, you should not take any tablets. --- repeat this cycle for 12 weeks (almost 3 months). *If you are allergic to Macrolides, please don't take this antibiotic.

Cepharanthine ( Cepharanthin® 1 mg )

Cepharanthine is an alkaloid extracted from the plant "Stephania cepharantha Hayata". Cepharanthin® is a rather "obscure" medicine in Japan. It is used only for Alopecia areata and Leukopenia due to radiation therapy for cancers.
Because it is cheap, doctors are not so interested in prescribing it. (Doctors prefer expensive drugs for business!!). And Cepharanthine is getting been forgotten. But we find it is effective for various kinds of diseases. Not only for PPP and psoriasis, but also, for example, Multiple Sclerosis, Ulcerative Colitis, Hypothyroidism, Tuberculosis, etc. though we don't know its precise mechanism. Now only one Japanese company produces Cepharanthin. We do hope the company continues its production.

How to take : 3 to 4 tablets/day. Usually you must continue for 3 months. Its side effect is very few. Compared with biologics such as Stelara or immunosuppressants such as MTX, its side effects are almost zero.

 


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