31 Diagnostic basis, classification of symptoms, and assessment of efficacy of melon vine tangles
Gourd vine tangle is a skin disease characterized by erythematous nodules on the lower legs, as if the vine is tied around the shins with melons and fruits. It is similar to erythema nodosum.
31.1 Diagnostic basis
31.1.1 The lesions are usually found on the extensor side of the lower leg, with nodules slightly above the skin surface, light red or bright red, then dark red or purplish red, without ulceration, and often occurring symmetrically. The lesions are often symmetrical. The lesions are self-conscious with burning pain. Feng Jianqing, Department of Dermatology, Taicang Traditional Chinese Medicine Hospital
31.1.2 There are often symptoms such as fever, general malaise and arthralgia before the onset of disease.
31.1.3 Prevalent in young women, common in spring and autumn, often recurrent. Patients mostly have a history of rheumatism or tuberculosis.
31.1.4 Increased blood sedimentation, increased anti-“O” titer and serum gammaglobulin, strong positive OT skin test.
31.1.5 Histopathological examination: vasculitis, thickening of deep venous blood vessel wall, intimal cell proliferation, swelling, degeneration, even lumen occlusion, dermal edema, papillary vasodilatation, perivascular inflammatory cell infiltration.
31.1.6 It should be differentiated from peroneal gangrene.
31.2 Classification of symptoms
31.2.1 Damp-heat stasis: rapid onset, subcutaneous nodules, slightly above the skin surface, burning and redness. With headache, sore throat, arthralgia, increased body temperature, thirst, dry stool and yellow urine. The tongue is slightly red, the coating is white or greasy, and the pulse is smooth and slightly counted.
31.2.2 Cold and dampness entering the ligament: Dark red skin lesions, repeatedly lingering. Accompanied by joint pain, aggravated by cold, cold extremities, no thirst in the mouth and no dry stools. Pale tongue, white or white greasy coating, sunken or late pulse.
31.3 Assessment of curative effect
31.3.1 Cured: erythema subsides and self-conscious symptoms disappear.
31.3.2 Improvement: erythema fades more than 30%, and self-conscious symptoms are obviously reduced.
31.3.3 Not cured: No change of erythema nodosum or appearance of new lesions.
32 Diagnostic basis, classification of symptoms, and assessment of efficacy of wind-heat sores
Wind-heat sore is a skin disease characterized by light red patches on the trunk, mostly arranged with skin lines and flaking like furfur. It is equivalent to pityriasis rosea.
32.1 Diagnostic basis
32.1.1 Most of the lesions first appear in the trunk or limbs locally a large round or oval red or yellow-red scaly spot, called the mother spot. A few days after the appearance of the mother spot, most of the red spots of the same size appear on the trunk and extremities, in the form of transverse oval, with the long axis in line with the skin line, with fine wrinkles in the center, with clear boundaries and uneven edges, with a small amount of fine bran-like scales on the surface, most of which exist in isolation. There is no general discomfort.
32.1.2 Prevalent on the chest and back (especially on both sides of the chest), abdomen and proximal extremities. The face and lower legs do not usually occur.
32.1.3 The lesions appear in batches and are often inconsistent in color, ranging from bright red, brownish-yellow, or gray.
32.1.4 Prevalent in young adults, common in spring and autumn.
32.2 Classification of symptoms
32.2.1 Wind-heat skin: The onset is rapid, with round or oval light red patches with fine wrinkles in the center and a small amount of fine bran-like scales on the surface, accompanied by irritability and thirst, dry stools and slightly yellow urine. The tongue is red, the coating is white or thin yellow, and the pulse is floating and slightly counted.
32.2.2 Wind-heat and blood dryness: bright red or purple-red patches with more scales and more itching, accompanied by scratch marks and blood scabs. The tongue is red, with little coating, and the pulse is stringy.
32.3 Assessment of curative effect
32.3.1 Cured: complete regression of skin lesions.
32.3.2 Improvement: The skin lesions are more than 30% regressed.
32.3.3 Not healed: lesions recede less than 30%.
33 Diagnostic basis, classification of symptoms and assessment of efficacy of white H
White H is a skin disease characterized by red patches on the skin, covered with multiple layers of white flakes, and punctate bleeding when the flakes are scratched away, which is equivalent to psoriasis.
33.1 Diagnostic basis
33.1.1 The skin lesion is initially a pinpoint to lentil-sized inflammatory red papule, often with a punctate distribution, rapidly increasing in size and covered with silvery white multilayered scales, like mica. After the scales are peeled off, the film phenomenon and sieve hemorrhage can be seen, with basal infiltration and isomorphic reaction. The old rash can be coin-shaped, disc-shaped, map-shaped, etc.
33.1.2 It occurs on the scalp and extensor surfaces of the extremities, mostly on the elbow surfaces, and often generalizes to the whole body.
33.1.3 In some patients, nail lesions can be seen, with dotted depressions in mild cases and thickened nail plates and loss of luster in severe cases. It may be seen in the oral and pubic mucosa. In those with scalp lesions, bundles of hair can be seen.
33.1.4 Slow onset and easy recurrence. There are obvious seasonality, generally heavy in winter and light in summer.
33.1.5 There may be a family history.
33.1.6 Histopathological examination shows hyperkeratosis and hyperkeratosis of the epidermis. There is an accumulation of neutrophilic polymorphonuclear leukocytes in the stratum corneum and thickening of the spinous layer. The epidermal protrusions extend downward in a regular pattern, the dermal papillae are edematous and rod-shaped, the blood vessels within the papillae are dilated, and there is inflammatory cell infiltration around the blood vessels.
33.2 Classification of symptoms
33.2.1 Wind-heat and blood dryness: the lesions are bright red, the rash keeps appearing, the erythema increases, the shiny film can be seen by scraping away the scales, dotted hemorrhage, with isomorphic reaction. With irritability and thirst, dry stool and yellow urine. The tongue is red, with yellow or greasy coating, and the pulse is smooth or counted.
33.2.2 Blood deficiency and wind dryness: The skin lesions are pale, partially faded, with more scales. With dry mouth and dry stool. The tongue is light red, with thin white coating and slow pulse.
33.2.3 Stagnant skin: The skin lesions are thick and infiltrated, dark red in color, and do not subside after a long time. Purple tongue or petechiae or petechiae spots are seen, with astringent or slow pulse.
33.3 Assessment of curative effect
33.3.1 Cure: complete regression of skin lesions, or more than 95% regression.
33.3.2 Improvement: The skin lesion is more than 50% regressed.
33.3.3 Not cured: lesions recede less than 50%.
34 Diagnostic basis, classification of symptoms, and assessment of efficacy of regenerative sores
Regenerative sores are skin diseases that occur on both sides of the neck and are characterized by rough, thickened skin and intense itching. It is comparable to neurodermatitis.
34.1 Diagnostic basis
34.1.1 The skin lesions are like the skin of a cow’s neck, hard and stubborn, scratching like dead wood and itching intensely.
34.1.2 Preferably on the neck, followed by the eyelids, extensor side of the limbs and waist and back, sacrum, hip and other parts, symmetrically distributed, or in a linear arrangement. It can also be generalized throughout the body.
34.1.3 Most commonly seen in adults with emotional and mental disorders and restless sleep at night. The duration of the disease is long.
34.1.4 Histopathological examination shows hyperkeratosis of the epidermis, hypertrophy of the spinous layer, and prolongation of the epidermal protrusions, which may be accompanied by mild sponge formation. Capillary hyperplasia in the dermis with lymphocytic infiltration around the vessels. The dermal fibroblasts may be proliferated and fibrosis may be seen.
34.2 Classification of symptoms
34.2.1 Liver stagnation and fire: red skin lesions, irritability, insomnia, dizziness, palpitations, bitterness and dryness of the throat. The tongue is red at the edge and the pulse is stringent.
34.2.2 Wind-damp skin: The lesions are pale brown flaky, rough and thick, with severe itching, especially at night. The coating is thin or white and greasy, and the pulse is moist and slow.
34.2.3 Blood-deficiency and wind-dryness: The skin lesions are grayish, scratching like dead wood, thick and rough like cow skin, palpitations and palpitations, insomnia and forgetfulness, and women’s menstruation is not withered. Pale tongue, sunken and thin pulse.
34.3 Assessment of curative effect
34.3.1 Cured: all lesions and symptoms have disappeared, or residual pigmentation or pigmentation has disappeared.
34.3.2 Improvement: lesions become thinner and less flaky than before. Self-perceived itching is reduced or the lesions fade by more than 30%.
34.3.3 Not healed: lesions remain the same, or less than 30% receding, no significant improvement in self-conscious symptoms.
35 Diagnostic basis, classification of symptoms and assessment of efficacy of stubborn dampness
Dampness is a skin disease characterized by solid gray-brown nodules on the extremities with itching due to internal dampness and external wind and poison or insect bites. It is equivalent to nodular itchy rash.
35.1 Diagnostic basis
35.1.1 The lesions are hemispherical elevations, firm to the touch, scattered and isolated, dark red or gray-brown in color, with paroxysms of severe itching.
35.1.2 It usually occurs on the extensor side of the extremities, especially on the extensor side of the lower legs.
35.1.3 Most often seen in adult women, with a slow course.
35.1.4 Histopathological examination shows hyperkeratosis of the epidermis, hypertrophy of the spiny layer, irregular proliferation of epidermal protrusions into the dermis, formation of pseudoepithelioma, non-specific inflammatory infiltration in the dermis, and obvious hyperplasia of neural tissue.
35.2 Classification of symptoms
35.2.1 Damp-heat accumulation: The rash is hemispherical and elevated, red or gray-brown in color, scattered and isolated, firm to the touch, and itchy at times. The tongue is red, with thin white coating and smooth pulse.
35.2.2 Blood stasis and wind dryness: The rash is nodular, purple-red or purple-brown in color, with thick, dry skin and itchy bouts. The tongue is purple and dark, with thin coating and astringent pulse.
35.3 Assessment of curative effect
35.3.1 Cured: The skin lesions are more than 80% receding and the symptoms disappear.
35.3.2 Improvement: More than 30% of skin lesions recede and light itching.
35.3.3 Not healed: skin lesions as before, or less than 30% remission, itching is intense.
36 purpura diagnosis, classification of evidence, efficacy assessment
The skin of purpura is a skin disease characterized by purplish red flat rash, itchy, can occur in all parts of the body, often involving the mouth and lips. It is equivalent to lichen planus.
36.1 Diagnostic basis
36.1.1 The lesion is a purplish-red patch, flattened slightly above the skin surface, tough and dry, with a smooth, glossy, wax-like surface and a central depression with mucosal involvement. Or vesicles, reticulated streaks, severe itching.
36.1.2 Mostly on the skin, mucous membranes, a few can invade the finger, toenail and hair, sometimes in a linear arrangement.
36.1.3 Most often seen in young people and adults, with a long duration of disease.
36.1.4 Histopathological examination shows hyperkeratosis, thickening of the granular layer, irregular thickening of the spiny cell layer, liquefied degeneration of the basal cells and banded infiltration of the upper dermis.
36.2 Classification of symptoms
36.2.1 Wind-heat obstruction: The rash is purple-red, with smooth surface and central depression, often polygonal in shape, with paroxysmal itching and dry mouth and desire to drink. The tongue is light red, with thin white coating and smooth pulse.
36.2.2 Rheumatic skin: The rash is warty and fused into patches or stripes, purple-red in color, with severe itching, restless sleep at night, and dry mouth without desire to drink. The tongue is dark red, with thin white or slightly greasy coating and slow pulse.
36.2.3 Void fire on inflammation: Mucous membrane rash is milky white, or vesicular with reticulated streaks. There is often dizziness, dreaminess and poor memory. The tongue is red at the edges, with thin white coating and sunken and fine pulse.
36.3 Assessment of curative effect
36.3.1 Cured: The skin lesions fade more than 80% and the self-conscious symptoms disappear.
36.3.1 Improved: the rash subsides more than 30%, and self-conscious itching is reduced.
36.3.3 Not cured: No significant change in the rash, or less than 30% remission, still itchy.
37 Diagnostic basis, classification of symptoms, and assessment of efficacy of leukoplakia
Leucoderma is a skin disease characterized by whitening of the skin in various shapes and without itching and pain. It is equivalent to vitiligo.
37.1 Diagnostic basis
37.1.1 The skin lesions are white in color, or spots or dots, of different shapes, without pain or itching.
37.1.2 It can occur in all parts of the body, with the limbs and head and face being the most common.
37.1.3 Most often seen in young people with internal injuries.
37.1.4 Histopathological examination shows a marked lack of melanocytes and melanin granules in the epidermis. The basal layer is often completely devoid of dopa-staining positive melanocytes.
37.2 Classification of symptoms
37.2.1 Qi stagnation and blood stasis: white spots on the skin, or with Qi stagnation and restlessness. Pale tongue or petechiae, thin white fur, slow pulse.
37.2.2 Liver and kidney yin deficiency: white spots, with tiredness and fatigue, soreness and weakness of the waist and knees, or irritable heat in the five hearts. The tongue is red, with little coating and a sunken pulse.
37.3 Assessment of curative effect
37.3.1 Cured: The skin lesions disappear and the skin color returns to normal.
37.3.2 Improvement: More than 30% of the lesions have normal skin color, or pigmented spots in depigmented spots.
37.3.3 Not cured: No significant change in skin color.
38 Diagnostic basis, classification of symptoms and assessment of efficacy of sallow spots
Sallow spots are yellowish-brown or grayish-black patches occurring on the face, not higher than the skin, commonly on both sides of the back of the nose. It is similar to chloasma.
38.1 Basis of diagnosis
38.1.1 The facial lesions are black spots, flat on the skin, like dust and dirt, light brown or light black, without itching and pain.
38.1.2 It often occurs on the forehead, eyebrows, cheeks, back of nose, lips and other facial areas.
38.1.3 Most often seen in women, with a chronic course of onset.
38.1.4 Histopathological examination shows hyperpigmentation in the epidermis and more pigmentation of melanophilic cells in the dermis. There may be a few lymphocytic infiltrates around blood vessels and hair follicles.
38.2 Classification of symptoms
38.2.1 Qi stagnation and blood stasis: yellowish-brown patches on the face, soreness and weakness of the waist and knees, or impatience and irritability, and pain and distension in the chest. Dark tongue, thin white fur, sunken pulse.
38.2.2 Yin deficiency of liver and kidney: brownish-black macula, with soreness and weakness of waist and knees, tiredness and weakness, and thin body. Red tongue, little coating, sunken and thin pulse.
38.3 Evaluation of curative effect
38.3.1 Cured: normal skin color on the face.
38.3.2 Improvement: Skin lesions fade by more than 30%.
38.3.3 Not cured: no significant change in skin lesions or less than 30% remission.
39 Diagnostic basis, classification of symptoms and assessment of efficacy of crab foot swelling
Crab foot swelling is traumatic or spontaneous. It is a skin disease that appears on the skin as a hypertrophic, firm patch in the shape of a crab’s foot. It is equivalent to a keloid.
39.1 Diagnostic basis
39.1.1 The lesions are hard, flat elevations with a nearly smooth surface and a pale red or normal skin color, sometimes with dilated capillaries or dendritic hyperplasia visible on the surface. The lesions are pruritic or tingling.
39.1.2 Preferably on the chest, or on the scapula, back and extremities under pressure. In severe cases, multiple lesions can be seen, depending on the individual’s constitution.
39.1.3 Often secondary to trauma or after surgery.
39.1.4 Histopathological examination reveals hyperplasia of connective tissue, reduction of elastic fibers, and atrophy of the adnexa due to compression.
39.2 Classification of symptoms
39.2.1 Qi stagnation and blood stasis: The lesions are hard, with light red or normal skin color, or with itching and pain. The tongue is dull, with white and greasy coating and sluggish pulse.
39.2.2 Blood stasis blocking the ligaments: the lumps are highly convex, dark and stagnant, mostly occurring at the joints, swollen and painful, affecting movement. There are stasis spots on the tongue, thin coating and thin pulse.
39.3 Assessment of curative effect
39.3.1 Cured: The scar is flattened or disappears, and the self-conscious symptoms subside.
39.3.2 Improvement: The scar is reduced by more than 30%, or becomes softer and flatter, and the conscious symptoms are reduced.
39.3.3 Not healed: no change in the scar, or less than 30% reduction.
40 Diagnostic basis, classification of evidence and assessment of efficacy of rosacea
Rosacea is a skin disease that occurs on the nose and both sides of the nose and is characterized by skin flushing, papules, pustules, and even enlargement and thickening of the nose.
40.1 Diagnostic basis
40.1.1 The nose or both sides of the nose are mostly erythematous papules. Generally, there are three clinical stages: the erythematous stage is mainly flushed capillary dilation; the papular stage is based on the flushed appearance of scattered rice-grain-sized papules or mixed with small pustules, but no acne; the nasal flap stage is the late stage, the tip of the nose appears nodules, hypertrophic hyperplasia, the surface is uneven as nasal flap. Generally, there is no self-conscious discomfort.
40.1.2 Five-point division is common on the face, namely, the tip of the nose, between the two eyebrows, the cheeks, the jaw, and the nasolabial folds.
40.1.3 Most often seen in people with high facial oil secretion, often with constipation habits.
40.1.4 Histopathological examination mainly reveals dilated capillaries and hyperplasia of sebaceous glands. Or, hyperplasia of connective tissue and sebaceous glands may be seen.
40.2 Classification of symptoms
40.2.1 Heat in the lung and stomach: Erythema mostly occurs on the tip of the nose or both wings, and the color fades when pressed. Often addicted to alcohol, constipation, uncontrolled diet, dry mouth and thirst. The tongue is red, with thin yellow coating and slippery pulse. Mostly seen in the erythema stage.
40.2.2 Heat toxin in the skin: Acne-like papules and pustules appear on the erythema. Capillary dilatation is obvious, with local burning, dry mouth and constipation. The laminae are red-red with yellow coating. Mostly seen in the papular phase.
40.2.3 Qi stagnation and blood stasis: hyperplasia of nasal tissue in the form of nodules with enlarged pores. The tongue is slightly red and the pulse is sluggish. Mostly seen in the nasal flaccid stage.
40.3 Assessment of curative effect
40.3.1 Cured: The skin lesions disappear.
40.3.2 Improved: partial reduction of skin lesions, or disappearance of more than 30%.
40.3.3 Not cured: No change in lesions or less than 30% remission.
41 Diagnostic basis, classification of symptoms, and assessment of efficacy of acne
Acne is a skin disease characterized by papules, pustules, and nodules that can sometimes squeeze out white rice-like powder. It is comparable to acne vulgaris.
41.1 Diagnostic basis
41.1.1 It begins at the mouth of the hair follicle and presents as a small rice-sized red papule, which may evolve into a pustule. It can then form a hard nodular whitehead or blackhead acne, or in severe cases, a hard nodular cyst.
41.1.2 Most often occurs on the face and chest and back of adolescent males and females, often accompanied by seborrhea.
41.1.3 Most often triggered by poor diet, excessive consumption of fatty, sweet and thick flavors, or exposure to external evil.
41.1.4 After puberty, most of them can be reduced naturally.
41.1.5 Most women have irregular menstruation.
41.2 Classification of symptoms
41.2.1 Wind-heat of the lung meridian: red papules, or itching and pain. The tongue is red, the coating is thin and yellow, and the pulse is floating.
41.2.2 Damp-heat accumulation: red, swollen and painful rash, or pustules, bad breath, constipation, yellow urine. The tongue is red, the coating is yellow and greasy, and the pulse is slippery.
41.2.3 Phlegm-damp agglutination: The rash is cystic, or there is dullness and loose stools. The tongue is pale and fat, the coating is thin, and the pulse is slippery.
41.3 Assessment of curative effect
41.3.1 Cured: Skin damage subsides and self-conscious symptoms disappear.
41.3.2 Improvement: Significant reduction of self-conscious symptoms and more than 30% reduction of skin lesions.
41.3.3 Not healed: no change in skin lesions and symptoms or less than 30% remission.
42 Diagnostic basis, classification of symptoms and assessment of efficacy of facial wind
Facial wind is a skin disease that occurs mostly on the face, characterized by oily or dry skin, yellow crust or white flakes, and itching. It is similar to seborrheic dermatitis.
42.1 Diagnostic basis
42.1.1 The lesions are mostly light red or yellow-red coin-like patches covered with greasy scales or scabs. Dry seborrheic overflow, mostly seen as dry flaking patches. Self-perceived pruritus.
42.1.2 Prevalent on seborrheic areas such as the head, nasolabial folds, behind the ears, axillae, upper chest, shoulders, umbilicus, and groin.
42.1.3 Most of them have mental excitement, abnormal sebum secretion or partial eating habits.
42.2 Classification of symptoms
42.2.1 Heat in the lungs and stomach: acute onset. The lesions are red in color, with oozing, erosion, crusting and itching. With disturbed thirst and constipation. The tongue is red, with yellow coating and slippery pulse.
42.2.2 Spleen deficiency and dampness: slow onset. The lesions are light red or yellow with grayish white scales, accompanied by loose stools. The tongue is pale red, with white greasy coating and slippery pulse.
42.2.3 Blood deficiency and wind dryness: dry skin. There are furfuraceous scales, itching, and dry hair without shine, often accompanied by hair loss. The tongue is red, the fur is thin and white, and the pulse is stringent.
42.3 Assessment of curative effect
42.3.1 Cured: lesions recede and self-conscious symptoms disappear.
42.3.2 Improvement: Skin lesions fade by more than 30% and self-conscious symptoms are reduced.
42.3.3 Not cured: No change in symptoms, or less than 30% improvement.
43 Diagnostic basis, classification of symptoms and assessment of efficacy of gonorrhea
Gonorrhea is a sexually transmitted disease mainly caused by gonococcal infection, with the main clinical manifestations of frequent urination, urgent urination, stinging pain in the urethra or pus overflowing from the urethra, and even difficulty in urination.
43.1 Diagnostic basis
43.1.1 History of extramarital sex, or homosexuality, or spousal infection.
43.1.2 Burning pain when urinating, urgency, frequency, redness and swelling of the urethra, and overflow of pus. Women have increased purulent leucorrhea, back pain, lower abdominal pain, redness and swelling of the cervix, erosion of the ectocervix, purulent discharge, and may have redness and swelling of the vestibular gland area with overflow of pus.
43.1.3 Males can be complicated by prostatitis, seminal vesiculitis and epididymitis. In women, it may be complicated by tubal inflammation and pelvic inflammatory disease.
43.1.4 Smear of urethral orifice in men and cervical orifice in women: Gram-negative diplococci are found in polymorphonuclear leukocytes. Culture is positive for gonococcus.
43.2 Classification of symptoms
43.2.1 Damp-heat toxicity (acute gonorrhea): redness and swelling of the urethral orifice, urgency, frequency, painful urination, dripping, cloudy urine like grease, and pus overflowing from the urethra. In severe cases, the mucous membrane of the urethra is edematous and the nearby lymph nodes are red, swollen and painful. In women, the cervix is congested, painful to touch, and there is purulent discharge, and there may be redness, swelling, and heat of the vestibular gland. There may be fever and other systemic symptoms. The tongue is red, the coating is yellow and greasy, and the pulse is slippery.
43.2.2 Positive deficiency of toxicity (chronic gonorrhea): poor urination, shortness of breath, incontinence of dripping, lumbar soreness and weakness, irritable heat in the five hearts. It is easy to occur after wine or fatigue, with little food and poor appetite, and women with excessive discharge. Pale tongue or teeth marks, white and greasy coating, sunken and weak pulse.
43.2.3 Influx of toxic evil (with comorbidities): swelling and pain in the prostate, refusal to press, cloudy urine or dripping and dripping, soreness and falling sensation in the waist. Women have vague pain in the lower abdomen, pressure pain, vulvar itching, leucorrhea, or low fever, etc., and general discomfort. The tongue is red, the coating is thin and yellow, and the pulse is slippery.
43.2.4 Heat toxin entering the ligament (gonorrheal sepsis): burning and stinging urine, red and astringent urine, pain in the lower abdomen, headache and high fever, or chills and fever, indifference, puffiness of the face, pain in the joints of the limbs, palpitation and boredom. The tongue is red and vivid, the coating is yellow and dry, and the pulse is slippery.
43.3 Assessment of curative effect
43.3.1 Cured: disappearance of symptoms and signs, elimination of comorbidities. Urethral discharge smear, prostate and massage fluid culture negative for gonococcus three times.
43.3.2 Improvement: Symptoms and signs completely disappeared, and gonococcus was still present in the smear of urethral discharge or culture.
43.3.3 Unresolved: No change or worsening of symptoms and signs. No change in laboratory tests.