Anal eczema is a common allergic skin disease characterized by pruritus, exudation of secretions, polymorphic rash, and easy recurrence. It can occur in people of any age. In Chinese medicine, it belongs to the category of renal cystic wind, rheumatic ulcers, and stubborn dampness, also known as Zha Xia Fu. A. Etiology According to the ancestral medicine, anal eczema is caused by damp-heat injection, blood deficiency and wind, mostly due to dirty poisonous turbidity down, wind-heat and dampness, urine and fecal immersion, food accumulation and insect disturbance or diet disorder, spleen loss of health, internal damp-heat and attack. In the “Medical Zong Jinjian – The Essentials of Surgical Technique”, it is written: “This evidence is initially like corn, but itchy and painful, broken flow of yellow water, immersion into pieces, can be born everywhere. It is caused by the heat of the spleen and stomach and the external wind evil, and it becomes.” If the wind is more than itchy, the warmth is vile and flowing, the wind and dampness are intertwined and develop into a wind-damp ulcer. If the dampness stagnates over time, depleting the yin and blood, skin loss of nourishment, then see the skin thick as leather, dry and cracked, the hair for the tenacious wet. In short, acute eczema is mostly due to damp heat guest in the skin and become, chronic, it is more blood deficiency wind dry or spleen deficiency caused. Modern medicine believes that the cause of anal eczema is complex, common factors can be summarized as follows: (a) allergic reactions: this is the main cause of the onset of both intrinsic and extrinsic factors. Such as focal infections, allergenic food, etc., so that the skin sensitivity effect, plus the influence of extrinsic factors, such as heat and humidity, cold, clothing, topical drugs, dyes, etc., can induce the disease. (ii) Disease factors: In the course of the disease, the patient’s sensitivity to allergens increases and is easily triggered, such as indigestion, nutritional disorders, gastrointestinal diseases, intestinal parasites, anal fistula, hemorrhoids, anal fissures, prolapse, etc., which are also common triggers. (iii) Neurological dysfunction and endocrine dysfunction: the disease can often be triggered by excessive fatigue, mental tension, depression, insomnia, etc. The symptoms and diagnosis of anal eczema are divided into acute and chronic: (a) acute eczema: the onset is rapid, at first, the affected area is hot, flushed, itchy, swollen, symmetrical distribution, unclear boundaries, can gradually spread to healthy skin, called erythematous eczema. This is followed by the appearance of scattered or dense small grains of large papules that form a patch, called papular eczema. If the inflammation continues to develop, the papules are filled with plasma and become papules or blisters, called blistering eczema. When the blisters become infected with pustules, the inguinal lymph nodes may become inflamed and swollen, and folliculitis, boils or fever may also appear, called pustular eczema. After scratching, the pustules or blisters rupture, plasma or pus flows out, the sore surface is moist and vesicular, and the exudate often has a fishy odor and is painful to touch, called vesicular eczema. When the exudate dries, an adherent scab forms, called crusty eczema. After treatment, the inflammation of each type of eczema gradually reduced, the affected area covered with fine white chaff-like flaking, known as phosphoric eczema, subacute eczema. The above types of eczema, often 2 to 3 coexist, but there must be a major symptom, so as to deal with accordingly. Acute eczema, short duration, usually a few days or 2 to 3 weeks, can be cured, but easy to recur. (B) chronic eczema: acute eczema does not heal over time, can turn into chronic eczema. Characterized by edema and reduction of inflammation, dry and thickened skin, brownish red or with gray, skin elasticity is reduced or lost, anal edge with chaps, itching, the skin is tinea-like changes, the course of the disease can stretch for months, or even years. Whether acute or chronic eczema, the diagnosis of eczema can be made based on the polymorphism, diffuse, thickening and infiltration of the disease pattern, itching, etc. (3) Treatment (a) Internal treatment 1, the acute phase (rheumatic ulcer): where there is perianal skin flushing, red papules, oozing, erosion crust, obvious itching or itching pain, tongue coating thin white or white greasy, pulse string slippery number, evidence of damp-heat injection. The treatment is to clear heat and dampness, cool the blood and remove wind. If dampness is heavier than heat, it is advisable to add or reduce De-Dampness and Stomach Ling Tang; if heat is heavier than dampness, it is advisable to add or reduce Gentian Diarrhea Liver Tang. 2, chronic period (persistent dampness): where there is thickening of the perianal skin, purple color, peeling or cracking of the epidermis; intolerable itching or alternating episodes of itching and pain, distress and insomnia, white tongue coating, sunken thin or sunken string pulse, the evidence is blood-generated wind, damp-heat cohesion. The treatment is to nourish blood and remove wind, strengthen the spleen and relieve dampness. Commonly used in the selection of prescriptions: 24 grams of shouwu, 10 grams of atractylodes, 15 grams of plantain, 10 grams of zedoary, 10 grams of white moss peel, 10 grams of peach kernel, 10 grams of peach kernel, 10 grams of pollen, 10 grams of angelica, 10 grams of cicada molasses, 10 grams of stiff silkworm, 10 grams of wind. If the spleen is deficient, with loss of appetite, loose stools and weakness, ginseng lingbaijusan is added and reduced to strengthen the spleen and resolve dampness. In addition, antihistamines and non-specific anti-allergic therapy can be used together; if the condition is severe, corticosteroids can also be used as appropriate. (2) External treatment: 1. For local redness, swelling and erosion, and more exudate, use 30 grams of Amaranthus, or 10 grams of rawhide nitrate, 20 grams of Atractylodes, and 20 grams of Phellodendron, decocted in water and applied externally with chloroxylate oil, or 3-3% boric acid solution wet compress. 2, for swelling, exudate is not much, can be used externally Pulian cream, flourohydrocortisone ointment and traditional Chinese medicine eczema cream topical. 3. For those with thickened skin and rough scales, use fumigation rolls to smoke the affected area once or twice a day for 15-30 minutes each time, at a temperature that the patient can tolerate. Then apply topical Pulian cream or cortisone ointment, also can apply topical furo distillate oil ointment or black bean distillate oil ointment. Prevention It is important to prevent anal eczema by removing all suspected causes, avoiding re-stimulation of allergens, avoiding local hot water and soap, avoiding scratching and rubbing, not eating irritating food, and actively treating anal fistula, anal fissure, intestinal parasites and gastrointestinal diseases.