“Wetness-heat” and skin diseases
(濕熱與皮膚病)
Traditional Chinese medicine considers that the invasion of virus evil upon the humane body would certainly produce “wetness-heat manifestations. The retention of wetness-heat or residence of wetness-heat in the lung and stomache, all can cause heat to pass along the Yang Ming channel and to penetrate and spread out through the skin, forming various kinds of skin disease. Clinically, there are confirmative evidences that after virus infection of the humane body, irrespective of the kinds of hepatitis virus, eruptive virus, and hemorrhagic virus infection, there might be contemporary inflammation of the liver, associated with abnormality of area of hepatic percussion dullness (enlargement or shrinkage) and various degrees of injury of the skin and mucosa.
The dermal lesions we encounter everyday are various, some infections are formed by direct contact, like verruca (verruca vulgaris, condyloma latum, condyloma accuminatum, verruca plantaris, infections molluscum contagiosum), hand-foot-mouth disease and infections erythema. Furthermore, some “eruptive virus disease, not considered to be caused by Hepatophilic virus disease, not considered to be caused by Hepatophilic virus before, like herpes, varicella, measles, rubella (German measles) and “virus hemorrhagic fever” (like infections hemorrhagic fever, dengue fever) have characteristic dermal lesions and now are demonstrated that patients involved might be complicated by persistent hepatic pathologic changes. More commonly seen are the chronic hepatitis cases with subsequent immunologic system abnormality leading to allergic skin disease (such as eczema, urticaria) connective tissue disease (like lupus erythematosus), dysfunctional neurodermatosis (neurodermatitis, prurigo) and dysfuctions between visceral organ, leading to the occurrence of erythematous, herpetic, squamous and dyspigmental dermatosis. When chronic hepatitis disease had evoked endocrinalogic and metobalic dysfunction of the body, there may also occur, clinically, various dermal lesions (such as acne, xanthoma, gout stones, diabetic dermatosis). Therefore, in treating skin disease patients, one should be alert on the presence or not of hepatophilic virus infection. If it is confirmed that the diagnosis is chronic hepatitis or abnormal percussion dullness of hepatic region is present, the first choice in treatment is to use effective systemic TCM therapy that is established for chronic hepatitis. It is only when the clinical cure of chronic hepatitis is attained that the obstinate skin lesions would be cured and the dermal wetness-heat could be terminated.
In addition, because the immunologic ability in Hepatophilic virus disease patients is lowered, the diseases caused by dermal infection of bacteria, fungus (including monilia) and insects (scabies) are extremely common, especially disease like generalized tinea versicolor, facial ringworm, tinea corporis, tenea cruris, pustular dermal lesions, monilial paronychia and vaginitis. When clinical cure is obtained in chronic hepatitis, the skin disease caused by bacteria and fungus are more easily managed and cured.
The incidence of dermal disease in clinical practice is high and its kinds are many, and although their manifestations are various, the association of abnormal percussion dullness of hepatic region should be given attention because it might be the result of abnormality of immunologic response in hepatic disease. Many cases show that during the treatment of liver disease with effective systemic TCM therapy, the dermal lesions often times regress or heal completely.
Introduction of cases
| Case 1
Lau (code 548), female, age 49 years. She had a history of positive hepatitis B anti-bodies and 3 years of hypertension, requiring daily intake of hypotensive drugs. Her first visit was on April 1996, with the complaint of suffering from eczema and pruritus for four years and repeated treatment was of no avail. Physical examination: puppy, (++), edema of lower extremities, blood pressure 140/90 mmHg, abdomen soft, liver enlarged to 3 cm, skin of left calf and back showing multiple localized lesions, the skin hypertrophic, desquamating, ulcerative with secretions and scratching marks. The diagnosis was chronic hepatitis associated with eczema and hypertension. Nineteen parcels of TCM drugs were taken and the liver returned to normal. During the course of treatment the skin lesions subsided gradually; the ulcerations improved and formed crusts; pruritus also decreased. TCM drugs were continued to maintain the blood pressure at 120-130/80 mmHg. Finally, the skin lesions as well as pruritus disappeared and the healed places left only some pigmentation. The lower extremities still showed (+) pitting edema. Treatment was stopped after administration of 33 parcels of TCM drugs and at that time clinical cure was obtained.
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By WONG Kwok Hung
published on 25th September 2001
(translated by Professor ZHENG Hua En in 2003)