ATOPIC DERMATITIS

Etiology
  • This condition is due to constitutional insufficiency and deficiency of the Lungs and Spleen complicated by external contraction of Wind, Dampness and Heat, which are obstructed in the skin and flesh. An enduring condition will cause damage to Yin and Body Fluids resulting in Yin Deficiency and Blood-Dryness
  • The mothers preference for fatty, sweet, spicy, or fried food or overindulgence in fish and seafood during pregnancy or lactation will result in impairment of the Spleen's transportation function and the generation of damp-heat in the interior. The mother will pass on the Heat Toxins and turbid substances in the Blood to the baby through breast-feeding. If this is complicated by improper feeding and nursing after birth, Damp-Heat may move to the skin and flesh to cause the disease. Dampness tends to predominate in plump babies, heat in thin and weak babies.
  • Constitutional weakness plus the child's preference for an inappropriate diet of fish, seafood and spicy food will damage the Spleen and Stomach and result in the generation of damp-heat. Where this damp-heat moves outward to accumulate in the skin and flesh and is complicated by invasion of pathogenic wind, Dampness or Heat, or toxic substances such as dust mites or pollen, red papules and vesicles may appear suddenly. Where impairment of the Spleen's transformation function results in Damp-Heat accumulating in the Interior, this Damp-Heat may be retained over a long period, resulting in a chronic disease with repeated occurrence.
  • Congenital insufficiency leads to Liver and Kidney Deficiency. Lack of proper care after birth results in damage to the Spleen and Lungs. Damage to the Spleen leads to Deficiency of the source for generating transformation of Qi and Blood; damage to the Lungs causes weakness of Wei Qi. As a result, it is easy for External pathogenic factors to invade. At the initial stage, these factors are obstructed in the skin and interstices, causing dryness and itching; at the later stage, Yin is damaged and Blood is consumed, making the skin rough and leathery.
Clinical Manifestations
  • Chronic itching
  • Superficial inflammation of the skin
  • Redness
  • Weepy, crusted lesions
  • May all begin in first few months of life
  • Worsened by stress, environmental changes and wool
  • Associated with genetic factors and is also known as hereditary allergic dermatitis.
    Family history of susceptibility to asthma, hay fever, urticaria, and eczema
    -Allergy to heterologous protein
    -High serum immunoglobulin (IgE) levels
    -An increase in the number of eosinophil leukocytes in the blood
  • Infantile Stage (1 month - 2 years):
    Main sites involved:
    Cheeks
    Forehead
    Scalp
    It may spread to the trunk and limbs
    * Fat babies who tend to sweat are more likely to suffer from an    exudative-type condition.
      -Lesions manifest as erythema and a dense distribution of   pinpoint papules, papulovesicles and vesicles with exudation.
      -Thick or thin yellow crusts form when the exudate dries up.
      -A moist, bright red erosive base will often show once crusts fall    off due to rubbing or scratching provoked by itching.
    *Thin, weak babies are more likely to suffer from a dry-type    condition.
      Lesions are characterized by pale red or dark red erythematous   patches
      A dense distribution of small papules without vesicles
      Dryness without obvious exudation
      Grayish-white bran-like scales on the surface of the lesions
      Slight infiltration, lichenification, fissuring scratch marks, or   bloody crusting will be present in a persistent condition
  • Childhood Phase (3-12 years):
    Main sites involved:
    Antecubital and popliteal fossae
    Neck
    Wrists and
    Ankles
    Lichenification, excoriations and dry skin are frequent
    Sleep may be affected
    In some, small, firm papules are found on back and extensor aspects of the limbs; excoriation may lead to blood crusting and pigmentation
  • Adolescent and Adult Phase (12 years - early 20's):
    Main sites involved:
    Antecubital and popliteal fossae
    Anterior and lateral aspects of the neck
    Circumscribed dry lesions appear with infiltration, thickening and lichenification, and pigmentation as a sequel
    Hands may also be involved after contact with irritants
  • Atopic Dermatitis: A chronic, superficial inflammation of the skin, characterized by itching inside of the elbows and behind the knees
    May have a history of allergies
    May begin in infancy with red, weeping, crusted lesions on the cheeks and scalp then moves to the extremities
    Usually abates by age three but reappears frequently throughout one's life
    The itching is triggered by scratchy surfaces, humidity and environmental or psychological stress
    Repeated scratching leads to lichenification of the skin
    Secondary bacterial infections, dry skin and bleeding may occur with possible changes in color
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Particularly in thin, weak, undernourished babies with a yellow complexion
  • Main sites involved:
    Scalp
    Face
    Neck
    May spread to the trunk and limbs
  • Lesions:
    Papules
    Large pale red or dark red erythematous patches covered by oily scales or crusts
    Often small lesions covered with lichens form thin white scales
    The skin is rough and itchy, disturbing sleep
    No clear boundaries
    Scratching will cause slight bleeding or result in the formation of bloody crusts
  • Additional Symptoms:
    Indigestion
    Vomiting of milk shortly after feeding
    Loose stools possibly with undigested food
    Itching
    Insomnia
    These babies are pale
    Poor appetite.
    T: Pale red or Red or A red tip
    C: Scant or Thin and white
    P: Moderate or Rapid
Treatment Principle
  • Clear Heat from the Heart
  • Guide out reddish urine
  • Support the Spleen
  • Nourish Yin
  • Remove moisture
  • Reduce itching
Herb Formulas
Points
Clinical Manifestations
  • Particularly in fat babies
  • Main sites involved:
    Face
    Head
    Neck
    May spread to other areas
  • Lesions:
    Erythema
    Papules and
    Vesicles
    Thick exudation
  • As the disease develops, crusts appear and itching becomes increasingly pronounced, leading to disturbance of sleeping patterns.
  • The body is leaner and weaker.
  • The lesions, usually dark red, are on the face, neck and often the hands and feet, with no clear boundaries.
  • Often small lesions covered with lichens form thin white scales, with signs of itching and can create a little bleeding, but no discharge
  • Itching
  • Insomnia
  • These babies are pale looking, with poor appetite
  • Additional Symptoms:
    Constipation
    Short yellow urine
    T: Pale red or Red or Red tip
    C: Thin white or yellow
    P: Rapid or Slippery and rapid
Treatment Principle
  • Clear Heat
  • Transform Dampness
  • Alleviate itching
Herb Formulas
Points
Clinical Manifestations
  • Common in heavyset babies with a tendency to obesity
  • Rash usually appears on the face, scalp and neck, and can also spread to other areas.
  • Lesions are red with blisters and fluid
  • Lichens may also merging
  • Sometimes the layers are simplified Below are scabs
  • Itching is strong and disturbing for the baby
  • sometimes urination is a little shorter than normal
  • Dark yellow urine
  • T: Red
  • C: Thin, yellow and sometimes greasy,
  • P: Rolling
Treatment Principle
  • Strengthen the Spleen
  • Remove Damp-Heat
  • Reduce itching
Herb Formulas
Points
Clinical Manifestations
  • More often in children and adults with a weak constitution
  • Main sites involved:
    Antecubital and popliteal fossae
  • Lesions:
    Papules and vesicles with erosion and exudation
    Skin is dry and rough with some scaling and localized itching
  • Additional Symptoms:
    Pale complexion
    Lassitude
    Poor appetite
    Abdominal distention
    Diarrhea
  • T: Pale
  • C: Greasy
  • P:Thready and weak or Deep and slippery
Treatment Principle
  • Fortify the Spleen
  • Eliminate Dampness
Herb Formulas
Points
Clinical Manifestations
  • More often in adult phase
  • Main sites involved:
    Elbow
    Knee and
    Neck
  • Lesions: Thickening and lichenification with ill-defined borders
  • Dry and cracked skin is likely
  • Slight bleeding or exudation after scratching
  • Itching is severe, especially at night
  • Skin is dry and rough with some scaling and localized itching
  • T: Pale
  • C: Little
  • P: Thready and rapid
Treatment Principle
  • Enrich Yin
  • Eliminate Dampness
  • Moisten Dryness
  • Alleviate itching
Herb Formulas
Points
Clinical Manifestations
  • Skin lesions after contact with a foreign substance
  • The lesions have well defined borders (contact)
  • Main sites involved:
    Antecubital and popliteal fossae
  • Lesions:
    Pinpoint papules
    Papulovesicles
    Vesicles, some of which coalesce
  • Slight infiltration and severe itching are likely
  • Maybe necrosis
  • Water blisters
  • The skin is rough and itchy
  • Bleeding or exudation follows Rupture of skin after scratching
  • Erythema
  • Disturbing sleep
  • Scratching will cause slight bleeding or result in the formation of bloody crusts
  • Severe cases:
    Burning
    Itching
    Pain
  • T: Red
  • C: Thin and yellow
  • P: Soggy and rapid
Treatment Principle
  • Clear Heat
  • Dispel Dampness
  • Support Zheng Qi
  • Alleviate itching
Herb Formulas
Points

Clinical Manifestations
  • Dermatitis
  • High fever
  • Irritability
  • Fidgeting
  • Dry mouth
  • Dry throat
  • Incoherent speech
  • Insomnia
  • Dark urine
  • Deep-rooted boils
  • Maculae
  • Carbuncles
  • Hematemesis
  • Hemoptysis
  • Palpitations
  • Furuncles
  • Tinnitus
  • Purpura
  • Red face
  • Rashes
  • Deep-rooted boils
  • Red eyes
  • Itchy skin
  • Fidgeting
  • Dry lips
  • Delirium
  • Dysentery with fever
  • Jaundice
  • Epistaxis
  • Hematuria
  • Cloudy mind
  • Diarrhea
  • T: Red
  • C: Yellow
  • P: Rapid and forceful
Treatment Principle
  • Clear Heat
  • Drain Fire
  • Relieve toxicity from all three Jiaos
  • Relieve inflammation
  • Stop bleeding
  • Purge Damp-Heat
  • Purge the Gallbladder
Herb Formulas
Points