What does TCM differentiation of skin diseases mean?

In life, everyone will inevitably suffer from some diseases. Some diseases involve the internal organs of the human body, and some diseases are related to the human skin. After all, the skin is exposed to the outside for a long time and is easily affected by external factors, including polluted air or bacteria, viruses, etc. There are many types of skin diseases in life, so what does TCM syndrome differentiation of skin diseases mean?

1. Subjective symptoms and syndrome differentiation

Subjective symptoms refer to the symptoms that the patient feels subjectively. The main symptoms are itching, pain, numbness, burning and so on. Subjective symptoms often vary due to different pathogenic factors or inducing causes, disease conditions, and individual sensitivity. Some skin diseases only cause itching, while others, such as shingles, are mainly painful.

1. Itching

Itching (itching pruritus, also known as itch) is an unpleasant sensation that makes people want to scratch or rub. It is a common systemic or localized symptom. It is seen in many diseases such as pruritus, eczema, contact dermatitis, drug rash, urticaria, seborrheic dermatitis, dermatitis herpetiformis, lichen planus, scabies, diabetes, uremia, leukemia and lymphoma. Modern medicine believes that the mechanism of itching is not fully understood and is related to multiple factors. Mechanical stimulation, plant thorns, animal cilia and stings, allergic reactions, and metabolic abnormalities of the body can all cause itching. Certain chemical mediators, such as histamine, endopeptidase, papain, tissue proteases and blood-borne enzymes, can be itch mediators. Among them, histamine still occupies a central position, and endopeptidase seems to directly cause itching. Traditional Chinese medicine classifies pruritus into wind itch, heat itch, damp itch, insect itch and blood deficiency itch.

⒈ Wind itch is characterized by itching that is not fixed in place, wanders around, and occurs all over the body. Because wind rises in nature, it is most common on the head and face. The skin lesions are dry, the tongue is red or light red, the tongue coating is thin, and the pulse is floating. Such as pruritus, urticaria, etc.

⒉ The clinical characteristics of heat itch are red rash, swelling, hot itching, aggravated by heat, alternating itching and pain, red tongue, yellow coating, and rapid pulse. Such as purulent skin diseases such as folliculitis, impetigo, furuncle and erysipelas.

⒊ Damp itching is characterized by papules, blisters, erosions, exudates, and infiltration into patches, which are lingering and difficult to heal; because dampness tends to move downward, it is more common in the perineum and lower limbs; the tongue is pale red or red, the tongue coating is greasy or yellow, and the pulse is weak, such as aspiration dermatitis, eczema and contact dermatitis.

⒋ Insect itch is manifested as itching like the worms moving around, with random locations and unbearable itching, especially at night, such as scabies.

⒌ Itch caused by blood deficiency is manifested by dry skin, desquamation, and itching, which is lighter during the day and heavier at night. It is caused by insufficient Qi and blood, malnutrition of the liver, dryness of the skin, and wind caused by blood deficiency. The tongue is pale or has tooth marks, clear tongue coating, and a deep and fine pulse, such as senile pruritus.

(ii) Pain

Pain is the painful sensation caused by disease or trauma, and is the sense of distinguishing the intensity of stimulation that harms the body. Painful dermatological diseases include herpes zoster, corns, gonorrhea, erythromelalgia and dermatomyositis. The nature of the pain can vary and may be burning, stabbing, cutting, throbbing, sharp, dull, or electric-like. The intensity of stimulation that causes pain in the human body is called the pain threshold, which can be divided into the pain perception threshold and the pain tolerance threshold.

Traditional Chinese medicine believes that pain is mostly caused by stagnation and blockage of Qi and blood. Fixed pain is mostly due to blood stasis; pain that is not fixed in a certain place and worsens or eases with mood changes is mostly due to qi stagnation. The differentiation of pain is as follows.

⒈ Pain caused by cold and fear of cold, skin temperature is not high, pain is relieved by heat, and pain is relieved by warm medicine and hot compress, such as frostbite.

⒉ Heat pain is painful and burning, the skin color is bright red, the pain is relieved by cold, and the pain is relieved by cold medicine and cold compress, such as purulent skin diseases such as erysipelas.

⒊ The clinical characteristics of rheumatic pain are that the pain is located in an irregular location, occurs suddenly, and moves rapidly.

⒋ The characteristics of deficiency pain are mild pain, no feeling of bloating or stuffiness, and preference for warmth and pressure.

⒌ Pain of fullness is characterized by acute pain, fullness and pain, refusal to press and preference for cold.