Common skin diseases caused by “Wetness-heat of skin”
(常見”皮膚濕熱”引起的皮膚病)
Acute “hepatophilic virus” infection causes some patients to have polytypic dermal lesions early in infancy and childhood with manifestations like erythema, papules, vesicles, erosions, exudations, desquamations and crusts which may be termed infantile eczema, urticaria, urticaria pigmentosa, popular urticaria etc. Some pediatric patients, if not treated in time with effective systemic TCM therapy, would have relapses frequently and the disease might turn into the chronic persistent type. Clinically, there are dryness of skin, pruritus, desquamation or even coarse ichthyosis-form dermal changes. These patients are susceptible to sudamina (痱子), infantile diaper dermatitis, hidrotic dermatitis (汗性皮炎), seborrheic dermatitis (脂溢性皮炎) or mycotic stomatitis (鵝口瘡). Recurrent eruptions and dryness of skin may persist to childhood and adult age, the latter being prominent at the lower limbs and over the abdomen where the skin is coarse, pruritic, desquamating, fissuring and ichthyosis-form or even presenting neurotic dermatitis and psoriasis, the symptoms of which aggravating in winter. In young people, there is close relation between skin lesions like obstinate acne, measles, eczema, warts and chronic hepatitis. In the adult age, patients with wetness-heat vaporization form of chronic hepatitis, irrespective of sex, would have active sebaceous secretion on the face and become vulnerable to acne, alopecia and also pruritus (搔癢), pigmentation and hyper-sensitivity of skin between the brows, around the ear, and over the chest and back. If there is the retention of heat and stagnation of liver, the virus evil would become the pathogen and cause measles, eczema, neurotic dermatitis, psoriasis, herpes simplex, herpes zoster, lesions of lip mucosa and repeated multiple ulcerations of oral cavity. Prolonged scratching due to pruritus would induce dermal hyper-trophy, lichenification (苔蘚化), localized pigmentation and desquamation.
From the statistical computer data of our centre, it is shown that there are 2654 cases of “abnormal area of percussion dullness of liver”, in which 512 individuals occupying 19.33%, are patients with several clinical forms of skin disease. Among these patients, acne (痤瘡) is the most common form, amounting to 202 cases, occupying 7.63%; eczema and generalized sweat stains, both having the same number, 91 cases, 3.44%; measles 74 cases, 2.79%; herpes simplex 37 cases, 1.4%; psoriasis 17 cases, 0.64%. Some of these cases visited the clinic because of the above skin diseases, but it was only in physical examination that the abnormal area percussion dullness of liver was discovered.
From the above data, it is shown that chronic hepatitis patients with wetness-heat of skin are liable to have several forms of skin diseases, the more common ones being acne, eczema, measles, herpes, psoriasis and neurotic dermatitis. Here, we introduce some typical cases of skin diseases to elucidate that chronic hepatitis patients with skin diseases, when given simple systemic TCM therapy, can show improvement or disappearance of “skin wetness-heat” symptoms and that this is a clinical proof of the relation between skin illness and liver disease. It also demonstrated that after treatment of hepatophilic virus infection with TCM drugs, the effect on the area of liver dullness and healing of skin lesions is unanimous. This, from another point of view, gives evidence of the correctness of TCM classification in chronic hepatitis and of the curative effect of systemic TCM therapy.
Introduction of cases
| Case 3
Ho (code number 2109) male, age 28 years. His first visit was on April, 2000, complaining of recurrent skin diseases since childhood. In the recent two years, he had itching of skin which was diagnosed by WM and TCM physicians and specialists as eczema, but oral drugs and local therapy were ineffective. He also had prolonged tiredness, recurrent common cold attacks, yellowish urine, wetness-heat stools, abdominal pain and diarrhea. In 1991, he suffered from type A acute hepatitis. He took western medical drugs and received type B hepatitis preventive injection. His clinical manifestations of multiple system involvement indicated typical chronic hepatitis.
Physical examination revealed dryness and coarseness of skin, localized dermal hypertrophy and lichenification, conglomerated and scattered eruptions over hypochondria and lower extremities and generalized multiple skin lesions (macular or popular eruption, erosion, pigmentation). Also, there were desquamations and multiple scratching marks. There was percussion tenderness over hepatic region; the liver enlarged to 3 cm; splenic dullness was present. After 3 parcels of TCM drugs, the liver returned to normal.
During the administration of TCM therapy, there was repeated wetness-heat abdominal pain and diarrhea; bowel movements were two or three times a day, the amount large and the color yellowish. After 3 weeks of TCM treatment, the splenic dullness was more clear. The pruritus and dermal exudations were markedly improved, showing reduction of the affected area and clearer appearance of the edge of skin lesions. The stools were loose and large in amount; there was anal pruritus and yellowish urine. The continuation of TCM therapy caused subsidence of all skin lesions, remaining only some dryness of the skin and pigmentation. Some desquamation and generalized sweat stains can still be seen. Systemic TCM therapy lasted for 8 weeks and treatment was stopped at the attainment of clinical cure.
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Written by WONG Kwok Hung
published on 16th October 2001
(translated by Professor ZHENG Hua En in 2003)