Male, 18 years old, student, with “recurrent mouth ulcers for 8 years, scrotal ulcers for 2 years, recurrent swelling of both calves for 1.5 years, and skin ulcers on both calves for 1 month.” In March 2009, he was hospitalized. The patient had oral ulcers in the summer of 2001 with no obvious triggers, with the tip of the tongue and the inner edge of the lips, about 2 to 3, stinging pain, healed in about ten days, with monthly episodes, without consultation.In August 2007, scrotal skin ulcers of about 1×12.5px2 size appeared with severe pain, accompanied by progressively aggravating swelling of the right calf, which interfered with walking. She was diagnosed with segmental thrombosis of the veins of both lower limbs and formation of the right traffic branch, and thrombosis of the right common iliac vein in the local hospital. After treatment with urokinase, low molecular heparin and warfarin (dosage unknown), the swelling and scrotal ulcers improved, and then he insisted on oral warfarin 2.5 mg/d. In January 2008, the oral ulcers worsened after stopping the use of warfarin, accompanied by fever and malignant chills, and the scrotal ulcers and swelling of the left calf reappeared in March, and ultrasound at the local hospital indicated thrombosis of the right common iliac vein and bilateral N veins. She was treated with low molecular heparin, urokinase and warfarin (dosage unknown) again, and the swelling subsided. in April 2008, she was admitted to the PLA General Hospital for diagnosis of leukoaraiosis due to oral ulcers, vulvar ulcers with painful nodular erythema on the whole body skin, and painful soybean-sized red nodules with small pustules in the center of the pinprick, She was admitted to the General Hospital of the People’s Liberation Army (PLA) and diagnosed as “leukoaraiosis” and “venous thrombosis of the lower limbs”, and was given prednisone, leflunomide, warfarin and other treatments. After that, in May and November 2008, he suffered from venous thrombosis of both lower limbs. She was relieved by thrombolysis and anticoagulation, and was admitted to our clinic one month ago with worsening of oral and vulvar ulcers, accompanied by multiple skin ulcers on both calves, in order to seek Chinese and western medical treatment. Admission symptoms: oral cavity, vulva, both thighs, both calves, multiple skin ulcers, pain, with pus, left calf swelling and pain, poor diet, sleep, normal urination and defecation. No past history of major diseases, allergic to sulfa drugs, honey, milk. Physical examination: young male, poor spirit, dark face. Multiple red papules of rice grain size on the back of both hands, and one pustular herpes at the IV. Scattered flaky hyperpigmentation on both upper limbs and back. Two mouth ulcers, one vulvar ulcer, about 0.5×12.5px2, scattered dark brown erythematous nodules on both thighs, five ulcers on the left calf, 1-75px in diameter, the larger one about 37.5px deep and draining pus, and two ulcers on the right calf. The tongue was dark red, the moss was thin and white with slightly yellowish greasy roots, there was peeling, and the pulse was fine and astringent. After admission: ESR 95mm/h↑, CRP 83mg/L↑. Coagulation tests: D-DI/3 0.77μg/ml↑, PT-INR 1.43↑, PT-sec 17.6↑, PT-% 61↓, PT-Ratio 1.34↑, APTT-sec 62.9↑, Fib 2.84g/L, TT 16.0, Fib-sec 17.3, TT-Ratio 0.94. Other tests were performed. RF, ASO, ANA, dsCDNA, Sm/RNP, SSA/B, Jo-1, Scl-70, IgG, IgA, IgM, C3, C4, blood, urine and stool routines, and blood biochemistry were all normal. Venous ultrasound of both lower limbs suggested thrombosis of the left external iliac and common femoral vein (acute stage). Left superficial femoral vein and calf deep vein thrombosis (old), partially recanalized. Right femoral and N vein thrombosis (old), partially recanalized. Western medicine diagnosis: 1. Leukosis 2. Venous thrombosis of both lower limbs. Chinese medicine diagnosis: fox confusion. The evidence belongs to dampness-heat downstream injection, stasis and toxicity blockage, treatment proposed to clear heat and dampness, blood circulation and detoxification method, the formula selected licorice laxative heart soup combined with the four wonderful Yongan Tang plus subtraction, it should be raw baked licorice 15g, Huanglian 6g, Scutellaria baicalensis 20g, Qing half-summer 9g, dry ginger 3g, honeysuckle 30g, forsythia 12g, Xuanshen 20g, angelica sinensis 12g, mudanpi 15g, red peony 20g, dilong 10g, cypress 12g, saffron 10g, Radix notoginseng 20g, Sangdi 20g, Sanqi 10g, and the two vein thrombosis. Shengdi 20g, Panax notoginseng powder (punch) 1g. 1 dose per day, decocted in water and divided into 2 times to take. Methylprednisolone 40mg/d sedation, 10 days later changed to oral prednisone 50mg/d, urokinase 250,000 units/d sedation at the same time with subcutaneous injection of low molecular heparin calcium 5,000 IU/d, 7 days later discontinued the use of urokinase, plus oral warfarin 2.5mg/d, 3 days later discontinued the use of low molecular heparin calcium, every 3 days to test the coagulation series, and sedation of clearing the heat and removing the toxins, cooling the blood to invigorate the blood of the Chinese patent medicines extracts and antibiotic treatment. The ulcerated calf was alternated with gentamicin and rhubarb oil gauze every day. The other half-monthly static cyclophosphamide 0.8g/time. One week later, the venous ultrasound of both lower limbs showed that the thrombosis of left external iliac vein and common femoral vein was basically recirculated. The treatment was effective. The traditional Chinese medicine prescription is slightly adjusted, go to clear half-summer add fried gardenia 12g, curcuma 12g. before discharge review coagulation series: D-DI/3 0.28μg/ml, PT-INR 1.76↑, PT-sec 20.8↑, PT-percent 48↓, PT-Ratio 1.58↑, APTT-sec 42.8↑, Fib 4.26g/L, TT 15.4, Fib-sec 11.3, Fib-sec 11.3, Fib-sec 11.4, Fib-sec 11.3. Fib-sec 11.3, TT-Ratio 0.91, ESR 25mm/h↑, CRP 6.3mg/L. The ulcers on both calves improved significantly, and his diet and spirit were good, so he asked to be discharged from the hospital, and was told to continue to follow the doctor’s instructions and to be rechecked after half a month. Press: The patient had recurrent mouth ulcers, vulvar ulcers, skin lesions (erythema nodosum, papular pustules, skin ulcers of the lower extremities), deep vein thrombosis, etc., and the diagnosis of leukoaraiosis was clear. It should be noted that the patient had recurrent deep vein thrombosis of the lower extremities, and was treated with thrombolysis several times in the local hospital, but due to the failure to recognize the primary pathogenesis of leukoaraiosis, the condition was not controlled. The focus of this hospitalization is firstly the treatment of thrombus, timely thrombolysis, anticoagulation; secondly, the application of glucocorticoids in sufficient quantity, the patient has a long course of disease, ESR, CRP inflammatory indexes are high, diet, sleep and spirit are poor suggesting that the disease is more serious, so it is necessary to timely and sufficiently apply glucocorticoids in order to control the primary disease; again, the selection of immunosuppressants, the application of cyclophosphamide, thalidomide (later because of the emergence of thalidomide after the use of thalidomide). (later discontinued due to tiredness and malaise after taking thalidomide). Traditional Chinese medicine believes that the onset of this case is related to the addiction to spicy, fat and sweet, the feeling of dampness and heat of the external evil, the physical quality of the vegetative deficiency and other factors. The pathogenesis is due to the dysfunction of the internal organs, the liver and spleen, resulting in dampness and heat accumulation, hidden in the internal, in summer and summer external dampness and heat, internal and external combination of evil, dampness and heat toxicity, stagnation of the blood, the formation of dampness, heat, toxicity and stagnation of each other’s situation. Damp-heat toxic stasis junction is not resolved, in-depth meridians, attacked in the viscera, qi and blood inversion, the evil flow through the meridians, on the smoked mouth and orifices, then see the mouth and tongue sores, ulceration, not healed; flow of injection into the joints meridian, joints swollen and painful; injected into the vulva and the lower extremities, then the scrotum and calves vesiculoblasts; damp-heat affects the operation of the bloodstream, it is stagnant blockage of veins and collaterals. Therefore, Glycyrrhiza glabra diarrhea heart soup combined with Si Miao Yong An Tang plus subtractions, with raw roasted licorice to strengthen the spleen and stomach and detoxification, Huang Lian, Scutellaria baicalensis, Qing Hanxia, Huang Bai to clear heat and remove dampness, honeysuckle, Forsythia, Xuan Shen, Radix et Rhizoma Ginseng, Angelica Sinensis, Mudanpi, Radix Paeoniae Lactiflorae, Rhizoma Dillonii, Rhodiola Saffron and Panax notoginseng powder to clear heat and cool the blood, activate blood circulation to resolve stasis and resolve toxins, and a slight accompaniment of Ginger with Glycyrrhiza glabra to prevent the cold from being too strong. Taking into account both dampness, heat, toxin and stasis, the therapeutic effect is quite good.