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CONTACT DERMATITIS (LACQUER DERMATITIS)

GENERAL

Clinical Manifestations	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
Treatment Principle
Herb Formulas	Topical: San Huang Xi Ji Qing Dai San Zao Shi Xi Yao Acute: Decoct Jie Du Xi Yao + Zhi Yang Xi Yao. Apply the cool decoction to the affected area(s). Then apply Huang Bai San or Shi Zhen San mixed with sesame oil to the affected area(s). Repeat two or three times daily. Chronic: Apply Hei Dou Liu You Ruan Gao to the affected area(s) 2-4 times daily.
Points	DU-14, HT-7, LI-11, SP-6, SP-10, ST-36 For severe itching: + HT-8 For pronounced Dampness: + SP-9 For Blood Deficiency: + UB-17

TAI YANG SHANG HAN WITH INTERIOR HEAT

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	Da Qing Long Tang
Points	DU-14, DU-16, GB-20, LI-4, LI-11, LU-7, LU-9, LU-10, SJ-5, SP-1, SP-2, ST-44, UB-12, UB-13

WIND-HEAT

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	Zhi Tou Chuang Yi Fang Jing Fang Bai Du San Xiao Feng San Topical: Qing Dai San Topical #2
Points	DU-14, DU-16, GB-20, LI-4 + LU-7 or LI-4 + SJ-5, LU-5, LU-10, LU-11, UB-12, UB-13

WIND-DAMP

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	Jing Fang Bai Du San Shi Wei Bai Du San Xiao Feng San Due to Yin and Blood Deficiency: Di Huang Yin Topical: Dermatitis Compress #1 Dermatitis Paste #1 San Huang Xi Ji Qing Dai Gao
Points

BLOOD HEAT

Clinical Manifestations	Allergy to lacquer Rash affects: Face Head Neck Wrist Back of the hand Fingers Red papules Large vesicles with ulcerations and suppuration Face and eyelids puffy May not be able to open the eyes Redness Heat Swelling Pain Aversion to Cold Fever Headache Constipation Mental confusion Insomnia
Treatment Principle	Cool the Blood Clear Heat
Herb Formulas	Sheng Di Yin Hua Tang Topical: Qing Dai Gao Dermatitis Compress #2
Points

BLOOD DRYNESS

Clinical Manifestations	Contact dermatitis or chronic eczema with thick, dry, dark flaky skin May show lichenification Protracted course Anemia Severe itching which is worse at night Swelling Abscesses Ulceration T: Pale C: Thin and white P: Thready, floating and rapid or Thin and wiry
Treatment Principle	Nourish and invigorate the Blood Moisten Dryness Clear Heat Expel Wind Stop itching
Herb Formulas	Dang Gui Yin Zi modified Chinese Patent Medicines: Qin Jiu Wan Run Fu Wan
Points

DAMP-HEAT

Clinical Manifestations	Skin lesions after contact with a foreign substance Abrupt onset The lesions have well defined borders Short course Main sites involved: Antecubital and popliteal fossa Lesions: Pinpoint papules Papulovesicles Vesicles, some of which coalesce Slight infiltration and severe, painful itching is likely Maybe necrosis Water blisters The skin is rough and itchy Local skin flushing Skin erosion 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 or white or Sticky and yellow P: Soggy and rapid or Floating
Treatment Principle	Clear Heat Dispel Dampness Support Zheng Qi Alleviate itching
Herb Formulas	Chu Shi Wei Ling Tangmodified Xiao Feng Dao Chi Tang + Long Dan Xie Gan Tang Dang Gui Nian Tong Tang Bei Xie Shen Shi Tang modified Dermatitis Medicamentosa #1 Wu Wei Xiao Du Yin Pu Ji Xiao Du Yin Qing Jie Pian If Heat has entered the Ying Stage: Qing Ying Tang Damp-Heat in the Lower Jiao: Er Miao San Topical: Hei Dou Liu You Ruan Gao Apply 2 times/day Fu Fang Ku Shen Tang Dermatitis Compress #1 Qing Dai Gao Dermatitis Compress #3 Di Yu Er Cang Hu Gao For dryness and fissuring: Run Ji Gao For relatively severe itching without exudation: Di Yu Er Cang Hu Gao For recurrent severe itching without weeping: Bu Mian Ca Ji Chinese Patent Medicines: Long Dan Xie Gan Wan Fang Feng Tong Sheng Wan
Points

TOXIC HEAT

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	Wu Wei Xiao Du Yin Pu Ji Xiao Du Yin Qing Jie Pian Topical: Topical #2 Di Yu Er Cang Hu Gao Jin Huang San (Gao) For simple redness of the skin and/or papules: San Huang Xi Ji For vesicles that weep or ulcerate: Qing Dai Gao Yu Lu San Older children: Hei You Gao E Huang San For recurrent severe itching without weeping: Bu Mian Ca Ji
Points	LI-4, LI-11, LU-5, PC-3, UB-40