As the weather gradually becomes colder and winter comes, cold erythema multiforme occurs more and more frequently. Nowadays, most families install air conditioners and the temperature difference between indoor and outdoor is large, so the vascular endings of children’s limbs such as hands and feet, cheeks and auricles are less regulated and have inflammatory reactions, making them prone to purple-red papules. Cold erythema multiforme is a common skin disease in winter. When the body is under certain conditions, a reactive inflammatory manifestation occurs to a variety of causes, cold is the main trigger; infection, drugs, food can also trigger or aggravate the symptoms. According to Chinese medicine, this disease is due to the deficiency of Wei-Yang, the couples are not solid, the evil of cold and dampness invade the muscle surface, resulting in the disharmony of Ying-Yang, blood flow is not smooth and stagnation. The cause is cold and the root is stasis. The main treatment is to warm Wei-Yang, dispel cold and dampness, and resolve stagnation.
Clinical manifestations
There are slightly more female than male patients, with a male to female ratio of about 1:1.5. The youngest is 2 years old, the oldest is over 60 years old, and most are 11-35 years old. The shortest duration of the disease is 2 days and the longest is more than 20 years. Recurrent attacks for more than 2 years account for about 41% to 54%. In addition to the face, ears, distal exposed parts of the extremities including the flexors of the fingers (toes) and palmoplantar areas, it is also seen on the ankles, knees, buttocks and waist. The lesions are edematous papules and edematous purple-red spots with blisters in the center, or mild hemorrhagic erythema; iris-like erythema with blisters in the center and vesicles may occur. It may or may not be pruritic (especially if the itching is aggravated by preheating).
Diagnosis
1. It occurs in winter and spring when it is cold.
2. The lesions are mainly erythema multiforme-like, papules or even blisters and petechiae.
3. The lesions are usually found on the face, both ears and distal exposed parts of the limbs, and may also involve the buttocks, both hips and waist.
4.It can be relieved by itself after the temperature rises.
5. Skin lesions are often accompanied by itching.
Differential diagnosis
1, the disease is distinguished from general frostbite, the latter is mainly dark purple red swelling, plaques, nodules, can break, often limited distribution, damage persists throughout the winter. Cold erythema multiforme lesions are slightly more numerous, scattered edematous papules or edematous purple-red spots with blisters in the center, and the coexisting general frostbite still exists after fading.
2.Differentiated from erythema multiforme, erythema multiforme has prodromal symptoms, no poor peripheral circulation performance, rash polymorphic, with typical iris-like damage, patients can be accompanied by arthralgia, spring and autumn onset, after acute, about 2~3 weeks self-healing.
3, polymorphic sun rash with light exposure and seasonal relationship, pathological changes in the upper dermis edema although similar to superficial frostbite, but the infiltrating cells are often mixed with histiocytes, and polymorphic, erythrocyte spillover is more common.
Western medical treatment
Treatment may include:
1. oral vitamin E (600 mg daily) or topical vitamin E ointment (20 mg of vitamin E per gram of ointment).
2.Orally take Guilizine, 50mg for adults, 3 times a day, reduce the amount for children, for 2~4 weeks.
3.Orally, one tablet per day of kairetan.
4.Thunderbolt preparation.
5.Frequency spectrum therapy instrument treatment.
6.External application of Xylitol ointment or Qingpeng ointment.
Chinese medicine treatment
According to its clinical manifestations and its prevalence in winter, it is generally not difficult to make a diagnosis. Chinese medicine pathogenesis and identification: Chinese medicine believes that the disease is due to the Yang Qi does not reach, repeated cold invasion, Qi and blood does not run smoothly, the meridians blocked, Qi and blood stagnation skin. Chinese medicine diagnosis: Yang Qi does not reach, cold attack, Qi and blood stagnation.
Dry ginger, angelica, chuanxiong, peach kernel, safflower, hyssop, fangfeng, wu hua, cypress, etc. can be used to effectively solve the itching, redness and pain of the skin of hands and feet. Externally, you can use optional Tuhai San to soak hands and feet or Chinese medicine Er Gan Tang, that is, 9g each of Gan Sui and Gan Cao, add water 1500~2,000mL, boil for 10 minutes, then smoked and then washed the affected area, each for 10~15 minutes, once a day, 4~10d for effect.
Prevention
1, actively participate in physical activities to accelerate the flow of Qi and blood.
2. Pay attention to cold and warmth during the cold season.
3, clothing and footwear should be loose and dry.
4.For those who have recurrence year after year, you can gradually develop the habit of washing face, feet, body and bath with cold water in summer to improve cold tolerance.
5, winter fear of cold can eat more hot cold food, such as mutton, dog, venison, pepper, ginger, cinnamon, etc..