Clinical Manifestations
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Common
Psoriasis
- The skin eruptions may appear on any part of the body.
Most likely on the scalp, outer side of the limbs and
the lumbo-sacral area.
- At first the eruption is in the form of red papules
or maculo-papular, the size of a grain of rice or a soybean.
It gradually grows bigger and merges into one another.
- The distinct edges may appear as dots. The area is
shaped like a coin and covered with multi-layered scales.
- When the scales are removed, a thin translucent membrane
can be seen (membrane phenomenon).
- When the membrane is removed some bleeding in the form
of dots is seen (dew-drop phenomenon).
- The skin eruptions on the scalp is dark red and covered
with thick, grayish white scales.
- The hair is often bundled up due to the adhesion of
the scales, but does not shed.
- There may appear tiny concave dots on the nail when
they are affected.
- The onset is acute in most cases and the course is
protracted with likely relapses.
- The symptoms worsen in winter and become less severe
in summer.
- For some patients the seasonal nature may be the reverse.
There three stages associated with the eruptions:
- Active stage: new eruptions emerge while the old ones
grow larger and thicker. There is clear inflammation
surrounded by areolae. Eruptions occur on a skin wound
or around a sty. (isomorphic reactions)
- Resting stage: The condition stays unchanged.
- Extinctive stage: The eruptions become flat and smaller
until they disappear
Articular Psoriasis:
- In addition to the Common Psoriasis type eruptions,
symptoms similar to rheumatoid arthritis appear (fever,
arthralgia).
- The severity of the arthritic symptoms vary with the
changes in the eruptions.
- Most often small joints are involved, but occasionally
large joints are involved.
- In protracted cases, the joints stiffen and deform.
Pus-Pocket Psoriasis:
- This type tends to attack the palms of the hands and
soles of the feet.
- In severe cases it can attack any area of the skin.
- It manifests as tiny pus-pockets on the surface of the
erythema.
- If the area affected is large, the patient may experience
aversion to Cold, fever and arthralgia
Erythroderma Psoriasis:
- This type usually stems from the Common Type with flushing
or purplish redness of the whole body.
- The area is moist with a large amount of desquamation.
- Only a small portion of the skin remains normal as patches.
- It is accompanied by fever, cornification of the palms
and soles, and thickening of the nails
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Treatment
Principle |
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Herb Formulas
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Points
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- DU-14, LI-4, LI-11, SP-10, SP-6
Face: LI-20, DU-25
Upper extremities: LI-4, LI-11, SJ-6, GB-20, SP-10, SP-6
Lower extremities: SP-6, SP-10, ST-36, LI-11, SJ-6
- DU-9, GB-34, SJ-6
- UB-13, UB-16, UB-17, LI-11, SP-10
- Bleed UB-40
- LU-5, SP-10
- Cupping:
A. DU-14, UB-12, UB-18
B. DU-12, UB-13, UB-20
- Plum blossom + moxa: Wash lesions with warm water,
tap until small beads of blood appear, moxa roll allowing
the smoke to enter the lesions, sprinkle the ashes onto
the lesions
- For Wind-Heat: SJ-5 + LI-4, GB-20, DU-14, DU-16, LU-11, LU-10, LU-5, UB-13, UB-12
- For lesions on the back: DU-14
- For lesions on the head: DU-14, Sishencong
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