Skin Diseases (Dermatitis)

WESTERN MEDICINE: Dermatitis is an acute or chronic superficial inflammation of the skin, characterized by erythema, oozing, crusting, scaling, and sometimes by vesicles. 

Various types of dermatitis and eczema constitute one-half of all clinical dermatologic conditions. The term eczema has become synonymous with chronic dermatitis. Recognition of certain clear-out types often simplifies the selection of proper treatment and permits a reasonably accurate prognosis. 

SYMPTOMS AND SIGNS: In Chinese medicine, the symptoms and signs of skin diseases are usually categorized as Yin Zhen, Shi Zhen, Feng Zhen or Ban. Its symptoms are sudden onset of red or white rash, or erythema, itching without pain, disappears suddenly; or chronic skin eruptions, accompanied with Qi, blood, or kidney deficiency symptoms and signs. 

ETIOLOGY AND PATHOLOGY: Skin diseases are the disease of the skin, but it is connected with Qi and blood, as well as some internal organs, such as heart, lung, spleen and stomach, intestines, liver and kidney. In the late stage of skin problems, the pathogenic factors always combine with stagnated blood, so as to make it harder to treat and lasts a long time.

• Exogenous factors, such as wind, cold, dampness or heat, attack skin and obstruct the pores causing the obstruction of lung Qi and disharmony of nourishing Qi and defending Qi. 
• The stagnated heat of stomach and intestines due to fatty food intake, alcohol, or too much seafood will produce interior damp heat in the stomach and intestines. This damp heat goes upward to attack lung and obstruct lung Qi. Lung is the organ which control skin and pores. The obstruction of lung Qi easily causes skin problems 
• The stagnated heat of stomach and intestines due to fatty food intake, alcohol, or too much seafood will produce interior damp heat in the stomach and intestines. This damp heat goes upward to attack lung and obstruct lung Qi. Lung is the organ which control skin and pores. The obstruction of lung Qi easily causes skin problems 
• The deficiency of Qi and blood makes skin lose its normal nourishment causing skin problems.

DIFFERENTIATIONS: 

1. Wind Attacking Skin Type:

Indications: Skin eruptions of pale or light colors, occurs when in wind or coldness, accompanied with fever, aversion to cold, white thin tongue coating, floating slow or floating tight pulse, are symptoms to the wind cold type. Skin eruptions all over the body or some exposing part of the body, such as face and hands, itching, red skin, hot feeling of skin, edema of face or lips, or accompanied with restlessness, thirst, fever, sweating, yellow thin tongue coating, slippery and rapid pulse, are symptoms to the wind heat type; Skin rash over the whole body, erythema, oozing, vesicles, red and swollen skin, itching, especially at night, thin and greasy tongue coating, floating, or floating slow pulse, mostly occurs among children.

Treatment & Formulas: Dispel wind factors, harmonize the relationship of nourishing and defending Qi. 

Products:

• Jing Fang Bai Du San (Schizonepeta and Siler Decoction, Item No. 2166): This is a very effective formula to treat skin problems due to wind cold factors. 
• Xiao Feng Sang (Dang Gui and Arctium Decoction, Item No. 2148): This is a formula to treat skin diseases due to wind heat attacking with interior stomach heat. 
• Jing Jie Lian Qiao Tang (Schizonepeta and Forsythis Decoction, Item No. 2167): This treats skin problems due to wind heat factors.
• Yue Pi Jia Zhu Tang (Atractylodes Decoction): It treats skin disease due to lung obstruction with interior heat. 

2. Damp Heat at Stomach and Intestines:

Indications: Skin eruptions are accompanied with strong abdominal pain, poor appetite, constipation, or loose stool, or nausea, vomiting, yellow and greasy tongue coating, slippery and rapid pulse. 

Treatment & Formulas: Eliminate the damp heat and dispel wind factor. 

Products:

• Dang Gui Nian Tong Tang (Dang Gui and Anemarrhena Decoction, Item No. 2234): A very good formula to eliminate the internal damp heat and dispel the external wind so as to treat the skin problem due to interior damp heat and exterior wind factors. 

3. Stagnated Heat of Heart and Lung:

Indications: Skin eruptions of red color, burning sensation, and strong itching, skin rash comes out along scratching areas, feels worse during the evening, insomnia, palpitation, or erosion of mucous membranes in the oral cavity or tongue, full sensation of chest, restlessness, shortness of breath. The tip of tongue is red, thready and rapid pulse or slippery and rapid pulse. 

Treatment & Formulas: Tonify the heart Yin so as to clear the heat, eliminate the damp-phlegm of lung; tranquilize the spirit. 

Products:

• Tian Wang Bu Xin Dan (Ginseng and Zizyphus Decoction, Item No. 2055): It tonifies the heart soas to clear the deficient heat and tranquilize the spirit. 
• Wen Qing Yin (Dong Gui and Gardenia Decoction, Item No. 2226): This is a strong formula to eliminate the interior damp heat and tonify the blood at the same time. 

4. Interior Heat due to Kidney Yin Deficiency:

Indications: Chronic skin eruptions, itching, and recurs easily, tidal fever, flushed complexion, worse at night, or accompanied with soreness of lumbar region and knees, hot sensation of the palms and souls, nocturnal emission or involuntary emission, red tongue, thin coating, or dry and no coating, thready and rapid pulse; in women, the skin eruption occurs during or before menstruation, disappears afterwards, or accompanied with irregular menstruation or dysmenorrhea. 

Treatment & Formulas: Tonifies the kidney's and clears the deficient fire. 

Products:

• Zhi Bai Di Huang Wan (Anemarrhena, Phellodendron and Rehmannia Decoction, Item No. 2123): This is a typical kidney Yin tonic formula.
  Si Wu Tang (Four Substance Decoction, Item No. 2060): This can be combined with Ba Wei Di Huang Wan (Rehmannia Eight Decoction, Item No. 2011) to treat women's skin disease connected with menstruation. 

5. Liver Flaming Fire:

Indications: Skin eruptions occur when strong emotions flare up, red skin, restlessness, easily angered, or flush face and irritated eyes, dry and bitter mouth, headache, constipation, scanty urination. Yellow or greasy tongue coating, wiry and rapid pulse. 

Treatment & Formulas: Sedate the liver fire so as to dispel the interior wind and coot blood. 

Products:

• Long Dan Xie Gan Tang (Gentiana Decoction Item No. 2267): A strong formula to sedate the liver fire and eliminate the damp-heat. 
• Jia Wei Xiao Yao San (Bupleurum and Peony Decoction, Item No. 2068): This treats the liver fire due to prolonged unhealthy emotions. 
• Hu Ma San (Sesame Seed Decoction, Item No. 2134): Clears both the interior and external wind factors. 

6. Qi and Blood Deficiency:

Indications: Chronic skin eruptions for many months or years, occuring when feeling exhaustion due to work or any other activities, accompanied with dizziness, fatigue, pale complexion, shortness of breath, palpitation, insomnia, or spontaneous sweating, pale or enlarged tongue, thin coating, thready and slow pulse. 

Treatment & Formulas: Tonifies the Qi and blood. 

Products:

• Ba Zhen Tang (Eight Treasue Decoction, Item No. 2010): This is a typical formula for Qi and blood tonics.
• Shi Quan Da Bu Tang (Ginseng and Dang Gui Ten Decoction, Item No. 2015): Also a popular Qi and blood tonic. 
• Ren Shen Yang Rong Tang (Ginseng and Rehmannia Decoction, Item No. 2007): Treats skin diseases of the weak type, especially with insomnia or dizziness.