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
  • Contact Dermatitis (Lacquer Dermatitis): An acute or chronic inflammation caused by contact with substances
    The lesions range from transient redness to severe swelling with bulla formation
    Itching
    Vesiculation
    Severe cases:
    Wheals develop almost immediately at the site of contact
    The lesions may spread to other areas
    If the cause is removed:
    Redness and swelling disappears in a few days
    Blisters dry up in a few days
    Vesicles and bullae may rupture, weep and crust
    Scaling and temporary thickening of the skin occur
    Continued exposure may cause infection
    Dry skin and bleeding may occur
  • 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
  • Neurodermatitis (Lichen Simplex Chronicus) see Neurodermatitis: A chronic, superficial, pruritic inflammation of the skin characterized by dry, scaling, localized patches of thickened and often hyperpigmented skin. Which is thought to have a strong psychogenic component. Women are more affected than men and many patients have obsessive personalities and focus most of their attention on the itching lesions. Onset is usually between the ages of twenty and fifty.
    An area of the skin seems to itch recurrently from a prior irritation (scratch, cur, burn, pimple or contact dermatitis)
    The nape of the neck is the principle site is the nape of the neck
    May also appear on:
    The exterior surface of the elbows
    Flexor surfaces of the wrist
    Ankles
    Anal and genital region
    Palms and soles
    Nervous tension, heat and cold increase the itching
    Scratching gives relief temporarily but becomes habitual and perpetrates skin changes
    May be single lesions or multiple and well demarcated oval or irregular lichenfied plaques
    Often purple in color
  • Seborrheic Dermatitis:
    A scaling disease of the scalp and face, and sometimes other parts of the body
    It is thought to be genetically determined
    It is frequently seen in people with AIDS and Parkinson's disease
    The onset is gradual:
    The main symptom is a diffuse dry or greasy dandruff of the scalp
    Some itching
    As it progresses:
    Yellow-red scaling papules appear:
    Along the hairline
    Behind the ears
    In the external ear canals
    On the eyebrows
    On the bridge of the nose
    On the nasolabial folds
    Other areas are:
    Back
    Sternal area
    Axillae
    Groin
    Perineum
    Obese patients:
    Under the pendulud abdomen
    Women:
    Under the breasts
    Infants:
    In the first month of life may develop a thick, yellow, crusted scalp lesion called "cradle cap"
    Red facial papules may appear
    A stubborn diaper rash
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Severe chills
  • Mild or no fever
  • Headache
  • Generalized discomfort
  • Stiff neck and shoulders
  • Body aches
  • Joint ache
  • Nausea
  • Vomiting
  • Hiccups
  • Anhidrosis
  • Gasping
  • Stabbing joint pain
  • Itchy throat
  • Cough
  • Asthma
  • Aversion to Wind and Cold
  • Maybe low back pain
  • Maybe frozen shoulder
  • Maybe dyspnea
  • Maybe epistaxis (severe)
  • T: Normal
  • C: Thin and white
  • P: Floating and tight
Treatment Principle
  • Relieve the Exterior
  • Expel Cold
  • Disperse the Lungs
  • Stop asthma
Herb Formulas
Points
Clinical Manifestations
  • Itching or tickling in the throat
  • Wheezing
  • Sneezing
  • Gasping
  • Cough with expectoration of thin, watery or frothy white sputum
  • General body aches
  • No thirst
  • Dyspnea
  • Headache
  • Body aches
  • A sensation of heaviness
  • Chills with low grade fever
  • Maybe asthma
  • Intolerance of Cold
  • Anhidrosis
  • Blocked and/or runny nose with watery nasal discharge
  • Chest discomfort
  • Neck stiffness
  • Irritability
  • T: Pink
  • C: Thin, white and moist
  • P: Superficial and tight
Treatment Principle
  • Disperse Wind-Cold
  • Induce diaphoresis
  • Dispel Dampness
Herb Formulas
Points
Clinical Manifestations
  • Fever and chills
  • Maybe fever only
  • Achiness
  • Anhidrosis
  • Headache
  • Cough
  • Asthma
  • Aversion to Cold
  • Edema
  • Thirst
  • Restlessness
  • Irritability
  • Fidgeting
  • Constipation
  • Sometimes dry achy eyes
  • T: Normal or red
  • C: Yellow or white
  • P: Floating and tight or rapid
Treatment Principle
  • Expel Wind
  • Disperse Cold
  • Cool Heat
Herb Formulas
Points
Clinical Manifestations
  • Dizziness
  • Red, sore eyes
  • Difficulty swallowing
  • Nasal congestion and infection
  • Thick, sticky nasal discharge and saliva
  • Bitter taste in the mouth
  • Dry mouth
  • Focal distention in the chest and diaphragm
  • Stifling sensation in the chest and diaphragm
  • Manic behavior
  • Carbuncles
  • Heat rash
  • Headache
  • Acne
  • Chills
  • High fever
  • Restlessness
  • Urticaria
  • Sore throat
  • Swelling of the throat
  • Coughing
  • Reddish urine
  • Dyspnea
  • Vertigo
  • Severe aversion to Cold
  • Skin rashes
  • Skin ruptures or ulcers
  • Tense abdomen
  • Shoulder stiffness
  • Numb extremities
  • Fatigue
  • Constipation
  • Dysuria with reddish urine
  • Dark, rough urination
  • Obesity
  • Fullness of the abdomen
  • Fullness of the epigastrium
  • Heaviness in the head
  • T: Red
  • C: White or Yellow and greasy
  • P: Flooding and rapid or Wiry and slippery or Floating, smooth and rapid or Floating, slippery, rapid and wiry or Floating, slippery, rapid and overflowing
Treatment Principle
  • Disperse Wind
  • Release the Exterior
  • Drain Heat
  • Unblock the bowels
Herb Formulas
Points
Clinical Manifestations
  • High fever
  • Profuse perspiration
  • Great thirst with a desire to drink
  • Abdominal pain
  • Dryness
  • Irritability
  • Restlessness
  • Feverish body parts
  • Red face
  • Dry stools
  • No constipation
  • No aversion to Cold
  • T: Red, dry
  • C: Dry yellow
  • P: Rolling and rapid (gigantic)
Treatment Principle
  • Clear Heat
  • Reduce fever
  • Moisten and replenish fluids
Herb Formulas
Points
Clinical Manifestations
  • High fever
  • Profuse sweat
  • Generalized weakness
  • Severe chills
  • Aversion to Heat
  • Red face
  • Severe thirst
  • Thirst may be unquenchable
  • Irritability
  • Anxiety
  • Pruritis
  • Headache
  • Toothache
  • Gum bleeding
  • Epistaxis
  • Dry lips
  • Dry tongue
  • Dry mouth
  • May be sensitive to Cold in the upper back
  • Polyuria
  • Delusions
  • Eye congestion
  • Burning sensation on the skin
  • Itching skin
  • Abdominal fullness without resistance
  • Dry, course skin
  • Listlessness
  • May be heavy labored breathing
  • Delirious speech (serious cases)
  • Mania (serious cases)
  • T: Red tip and sides
  • C: Yellow, dry or white
  • P: Large and forceless
Treatment Principle
  • Clear Heat
  • Harmonize the Stomach
  • Strengthen Qi
  • Promote Body Fluids
Herb Formulas
Points
Clinical Manifestations
  • Lesions on the head, face, neck, gluteal area
  • Secretion of pus
  • Scabs
  • Itching
  • Desquamation
  • Inflammation
  • Swelling
  • Pain
  • Suppuration
  • Constipation
  • Muscle spasms
  • Cough with thick, sticky, yellow sputum
  • Sore, red, swollen throat
  • Thirst with a desire to drink cold liquids
  • Runny or blocked nose with thick, yellow discharge
  • Fever with perspiration
  • Slight chills
  • Aversion to Wind
  • Headache
  • Maybe dyspnea with flared nostrils
  • Maybe chest pain
  • T: Red tip
  • C: Thin and yellow
  • P: Superficial and rapid
Treatment Principle
  • Expel Wind
  • Clear Heat
  • Ventilate the Lungs
Herb Formulas
Points
Clinical Manifestations
  • Fever and chills, fever more pronounced or
  • Tidal fever
  • Abdominal distention
  • Thirst
  • Sweat
  • Stifling sensation in the chest
  • Restlessness
  • Gastric disturbances:
    Heaviness
    Nausea
    Severe diarrhea
  • Scanty urine
  • T: Red tip and edges
  • C: Greasy white or yellow
  • P: Rapid and soft
Treatment Principle
  • Disperse Wind
  • Clear Heat
  • Resolve Damp
Herb Formulas
Points
Clinical Manifestations
  • Hot toxic sores
  • The lesions have defined margins
  • They suddenly appear after contact
  • Papules
  • Erythema
  • Water blisters
  • Maybe necrosis
  • Maybe severe itching
  • Maybe severe burning
  • Maybe pain in severe cases
  • Fever
  • Chills
  • Anhidrosis
  • Pain and stiffness of the head and neck
  • Stuffy nose
  • Blood shot eyes
  • Sores that are red, swollen and painful
  • Generalized body aches and pain
  • Headache
  • Swollen eyes
  • Thirst or no thirst
  • T: Normal
  • C: Thin white
  • P: Floating or Floating and rapid
Treatment Principle
  • Induce sweat
  • Release the Exterior
  • Dispel Wind
  • Invigorate the Blood
  • Alleviate pain
  • Dispel Dampness
Herb Formulas
Points
Clinical Manifestations
  • Dry cough with little sputum
  • Dry throat
  • Hemoptysis
  • Muscle wasting
  • Shortness of breath
  • Emaciation
  • Dizziness
  • Tinnitus
  • Weakness
  • Shortness of breath
  • Malar flush
  • Spontaneous sweating
  • Weak lower extremities
  • T: Red or Crimson and dry
  • C: Little
  • P: Thready and rapid or Small and weak
Treatment Principle
  • Enrich Yin
  • Moisten the Lungs
  • Augment Qi
  • Tonify the Spleen

Herb Formulas
Points
Clinical Manifestations
  • Extremely itchy patches with scales
  • Thickened skin with scratch lines
  • Hyperpigmentation
  • T: Pale
  • C: White
  • P: Thready and weak
Treatment Principle
  • Strengthen the Spleen
  • Moisten the skin
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
  • Body cold
  • Limbs icy
  • Complexion white and shiny
  • Low back, knees and abdomen feel cold and painful
  • Lower abdomen feels cold and painful
  • Loose stools containing undigested food
  • “Cock-crow” diarrhea (occurs at about 5 am)
  • Edema of face and limbs
  • Dysuria
  • Severe:
    Abdominal ascites
  • T: Pale, moist and swollen
  • C: Thin and white or White and greasy
  • P: Deep, thready, weak and maybe slow
Treatment Principle
  • Warm and Reinforce the Spleen and Kidneys
Herb Formulas
Points
Clinical Manifestations
  • Lower abdominal pain and Cold
  • Abdomen feels chilled
  • Aching bones and joints
  • Muscle ache
  • Whole body pain
  • Aversion to Cold, especially at the back
  • Cold limbs
  • No Thirst
  • Lower abdominal pain and Cold
  • Abdomen feels chilled
  • Maybe fever
  • No thirst
  • T: Normal
  • C: White and slippery
  • P: Deep and faint or Forceless or Choppy and slow or Wiry
Treatment Principle
  • Dispel Cold
  • Warm the channels
  • Assist Yang
  • Dispel Dampness
  • Relieve pain
Herb Formulas
Points
Clinical Manifestations
  • Pain that is fixed, stabbing and /or severe or
  • Pains that move around
  • Distention
  • Depression
  • Irritability
  • Pan is worse with pressure
  • Dark complexion
  • Fixed, palpable masses
  • Bleeding with clots
  • Purple lips
  • Purple nails
  • Dry skin
  • Blue, dark or purplish discoloration of skin in small or large areas,
  • Varicose and spider veins
  • Cold hands and feet
  • Tendency to hemorrhage dark blood or clots
  • T: Purple, possible purple or red spots
    Red purple if there is Heat
    Blue purple if there is Cold
  • C: White
  • P: Choppy or Wiry and choppy
Treatment Principle
  • Invigorate the Blood
  • Break up Stagnation
Herb Formulas
Points
Clinical Manifestations
  • Decreased urination or
  • Interrupted urination or
  • Constant urination or
  • Anuria
  • Lower abdominal fullness
  • Lower abdominal pain which may radiate to the genitals
  • Maybe hematuria
  • Tumor formation
  • Purple urine with blood clots
  • Abdominal spasms and tension
  • Headache
  • Sinus congestion
  • Constipation
  • Lower back ache
  • Nervousness
  • Fatigue
  • Skin eruptions
  • Scaly, dry skin
  • Headache
  • Shoulder stiffness
  • Vertigo
  • Cold low body and feet
  • Flushed face
  • T: Dark purple or with echymoses or petechiae or pale with purplish spots
  • C: White
  • P: Choppy or Tense, deep and slow or Thin or Deep and choppy or Slow and choppy
Treatment Principle
  • Invigorate the Blood
  • Transform Blood Stasis
  • Soften lumps
  • Reduce fixed abdominal pain
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
  • Dizziness
  • Palpitations
  • Insomnia
  • Dry skin
  • Dry hair
  • Poor memory
  • Paleness
  • Fatigue
  • Scanty periods
  • T: Pale
  • C: Thin, white and dry
  • P: Thready and rapid or Weak
Treatment Principle
  • Nourish Blood
  • Tonify the Spleen
Herb Formulas
Points
Clinical Manifestations
  • Chronic, continuous uterine bleeding
  • A pale complexion
  • Stabbing pain in the abdomen
  • Alternating chills and fever
  • Irregular menstruation with profuse bleeding
  • Abdominal pain
  • Fever
  • Thirst
  • Itchy skin
  • Heat in the upper body with Cold in the lower body
  • Irritability and restlessness despite fatigue and exhaustion
  • Mood swings
  • A sallow complexion
  • Emaciation
  • T: Dry with a red tip
  • C: Thin white
  • P: Deep and rapid
Treatment Principle
  • Drain Fire
  • Resolve toxicity
  • Tonify the Blood
  • Stop Bleeding
  • Warm the menses
  • Cool the Blood
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
Clinical Manifestations
  • Chronic, severe itch
  • Rough, thickened skin
  • Lichenification
  • Desquamation
  • Pigment sedimentation with a distinct border
  • May occur on any part of the body
Treatment Principle
  • Nourish the Blood
  • Moisten Dryness
Herb Formulas
Points

Clinical Manifestations
  • Mild persistent uterine bleeding
  • Irregular menstruation (either early or late)
  • Prolonged menstruation
  • Skipped period
  • Metrorrhagia
  • Extended or continuous menstrual flow
  • Pain
  • Lower abdominal distention
  • Lower abdominal Cold
  • Lower abdominal pain
  • Infertility
  • Dry lips
  • Dry mouth
  • Spermatorrhea
  • Pale complexion
  • Leukorrhea
  • Amenorrhea
  • Bleeding between periods
  • Low grade fever at dusk
  • Irritability
  • Five sole Heat
  • No desire to drink
  • Distending breast pain
  • Low back coldness and pain
  • Loose stools
  • Cold limbs
  • Aversion to Cold
  • T: Purple with petechiae
  • P: Thready and choppy
Treatment Principle
  • Warm the menses
  • Regulate menstruation
  • Dispel Cold
  • Warm the channels
  • Nourish the Blood
  • Dispel Blood Stasis
Herb Formulas
Points