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There is enough accumulated evidence to conclude that house dust mites (HDM) are the most significant causes of atopic dermatitis (AD). HDMs are known to increase serum IgE and RAST scores for Dps and Dfs, and will often show positive results among AD patients when a patch test using three crushed HDMs or many HDMs in a petrolatum-base is performed. However, HDMs are invisible to the naked eye as they measure less than 0.3 mm, and therefore even when thousands of HDMs are present in the interior of the patients’ homes, they live quietly without causing any noise, and therefore their presence cannot be detected by the patients. The newly developed Methylene Blue Agar method (MBA) can reveal how many HDMs are present in each interior object, and through this method, they can be reduced to less than 50/m2/20seconds aspiration for all interiors, dramatically improving severe symptoms of AD for patients who have even suffered for more than ten years. Therefore, it is critical that the mite fauna of the patients’ home is examined so that effective measures can be taken to cure the patient. Consequently, AD considered as a unique form of allergic contact dermatitis due to the fact that HDMs involve both type I and type IV allergies. Please note that the rare exceptions are AD caused by reactions towards metals and the malassezia group fungi. Correspondence to: Hideo Nakayama, Meguro Chen Dermatology Clinic Shinyo-CK Building 6F 3-3-5, Kami-Ohsaki, Shinagawa-ku, Tokyo 141-0021, Japan, Tel: +81-3-3786-1678; E-mail: nakayamadermatology@eos.ocn.ne.jp

Mite Fauna Investigation Followed by Environmental Improvement Is Essential In Treating Intractable Atopic Dermatitis