2 Eczema cases


Case 1 :
Femal, 52y
Clinical manifestations: ten days before the first consultation, the patient had been caught in the rain. The following day, her legs felt heavy and the medial aspects were itchy. Red papules and vesicles 2-3 mm in diameter appeared locally after scratching, and the itching became worse. Exudation occurred in the areas where the skin had been broken by scratching. Gradually, the whole body was involved. The patient, who was overweight, could not sleep because of the itching. Accompanying symptoms and signs included a bitter taste in the mouth, irritability, short voiding of reddish urine, and difficult bowel movements. Examination revealed erythema with surface exudates and crusting present in two locations on the medial aspect of the legs, the largest patched being 3-5 cm in diameter. Discrete 2-3 mm papules vesicles were also found on the legs, scalp, face, and trunk. The exudate was yellowish-white in color. The tongue body was red with a yellow and greasy coating, the pulse was slippery and rapid.
Diagnosis: Acute eczema ( feng shi chuang ) Pattern: exuberant damp-heat
Treatment principle: dredge wind, clear heat and benefit the movement of dampness
Acupuncture : quchi and xuehai ( 1 to 1.5 cun ), yinlingquan ( 0.5-1.2 cun ), with manifu;ation by the lifting and thrusting reducing method for one minute after insertion. The needles were retained for 30 minutes. Treatment took place daily.
Outcome: after 2 days of treatment, itching was reduced, after three further treatments, some of the papules and vesicles had been dispersed, after another four treatments, crusts fell off, and after nine more treatments, the itching had stopped, the papules and vesicles had disappeared, and the skin had recovered its normal appearance.

Case 2:
male, 34y
Clinical manifestations: two weeks previously after drinking aclcohol, itchy papules and vesicles with watery exudates appeared all over the patient’s body, causing him considerable discomfort day and night. Accompanying symptoms and signs included a bitter taste in the mouth, nausea, abdominal distension, loss of appetite, lassitude, dizziness, and loose stools. As the condition persisted, erosion and exudation worsened, with the patient using one roll of toilet paper a day to try to dry up the lesions. Examination revealed papules and vesicles distributed over large patches of edematous erythema on the trunk and limbs with significant erosion and exudation. Crusting and scaling could be seen in a few areas. The tongue body was pale with a white and greasy coating, the pulse was wiry and slippery.
Diagnosis: subacute eczema ( jin yin chuang ) Pattern: damp-heat accumulating internally with dampness predominating over heat
Treatment principle: clear the spleen, eliminate dampness and clear heat
Prescription : baizhu 10g, zhike 10g, yi yi ren 30g, chifu ling 15g, dang gui pi 15g, dong gua pi 15g, bai xian pi 15g, kushen 15g, che qian zi 15g, zexie 15g, yin chen hao 30g, huangqin 10g, zhi zi 10g, liu yi san 30g( wrapped) one bag a day was used to prepate a decoction, taken twice a day.
External treatment: a decoction was prepared with ma chi xian 30g, and huang bai 30g, and applied warm t the affected areas as a damp compress.
Outcome: after 3 bags of the decoction, eduma had been reduced and there was less exudation. Since itching had improved, the patient was able to sleep for a few hours. After another 4 bags, itching disappeared, erosion gradually diminished and exudation stopped. The patient was told to drink another 7 bags, after which the symptoms had disappeared, leaving a small amont of scaling over the lesions.

end

From:
Xu.Y, 2004.Dermatoloty in Traditional Chinese Medicine. Donica Publishing