Dermatology with Dr Fitz II Psoriasis Shingles Herpes simplex – Flashcards
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Distinct borders Thick silvery scales Candle waxing Auspitz sign (pinpoint bleeding when scales brushed away) loc: Yang areas, belly button, genitals, but crack, scalp, nose Heavy genetic component
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Psoriasis
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Long term use of corticosteroids can lead to
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thin skin. Irreversible.
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When you see excoriations from itching, could it be psoriasis?
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unlikely. more likely to be eczema.
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psoriasis nails
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oil spots pitting nail separates from nail bed (onycholysis)
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psoriasis that develops n childhood is known as X. It appears as small red spots on skin, usually on trunk and limbs.
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Acute guttate psoriasis
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Psoriasis type with yellow deep seated pustules on palms or soles that turn into dusky brown reddish crusts
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Palmoplantar pustulosis
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What phases does Chinese Medicine use for chronic plaque psoriasis?
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Acute phase - lesions red, may be itchy, burny Progressive/resting - thick scales, transitioning Static phase - darker, thicker scale, dry
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Three core psoriasis herbs - for erythema
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Sheng di huang Chi shao Mu dan pi
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Acute psoriasis herbs
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Tu fu ling 30 Bai xian pi 30 Cao he che 30 Da Qing ye 15 Shan dou gan 10 Ren dong teng 15 hu zhang 10 Bai hua she she cao 15 jin yin hua 10 Dan shen 15 Lian qiao 15 Sheng di 10
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Herbs: If erythema with swollen glands
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Jin yin hua Niu bang zi Da Qing ye Xuan Shen
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Static phase (cool blood, nourish yin and blood)
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sheng di 30 dan shen 15 xuan shen 15 ku shen 10 huo ma ren 10 shan dou gen 10 dang gui 15 Tao ren 10 bai xian pi 12 mu dan pi 15
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Herbs: darkening lesions, thick, less head. Elim blood stasis
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Sheng di 30 tao ren 10 hong ua 6 chi shao 15 chuan niu xi 10 mu dan pi 15 dan shen 15 zhi ke 10 bai xian pi 30 e zhu 10 ji xue teng 15
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Herbs: palmoplantar pustulosis - clear blood heat and fire toxicity
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Bi xie 15 huang qin 10 huang bai 10 ma chi qian 20 zi hua di ding 20 jin yin hua 12 bai jiang cao 18 tu fu ling 18 bai xian pi 15 bai ji li 15 mu dan pi 12 chi shao 12 gan cao 6
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herbal prescription for 35 yr old man with guttate psoriasis. Thick tongue fur and swollen glands.
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Cang zhu 10 Shen qu 15 fried maya 15 shan zha 15 sheng di 30 mu dan pi 10 chi shao 10 dan shen 15 niu bang zi 10 jin yin hua 20 xuan shen 10 da qing ye 15
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herbal prescription for patient with forehead psoriasis that was worse in summer
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sheng di 30 dan shen 15 xuan shen 10 xing ren 10 mudanpi 10 sheng ma 6 shi gao 30 zhi mu 10 jin yin hua 15 lian qiao 15 niu bang zi 10 huo ma ren 10
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What disease? coin shaped plaques composed of papules and vesicles on erythematous base. Well defined. Chronic. v Itchy with staph aureus present.
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Numular eczema
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Difference between eczema and psoriasis
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psoriasis has vesicles, less itching
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Herbs for Herpes zoster/shingles (heat, damp wind)
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jin yin hua (push out) jing jie feng fang da qing ye lian qiao (push outward) gan cao mu dan pi chi shao bai xian pi long dan cao chai hu (if on head)
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Herbs: Shingles with more heat
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(10g unless noted) Huang qin chai hu da huang 6 jin yin hua 15-20 lian qiao 15-20 mu dan pi chi shao mu tong fu ling 20 deng xin cao long dan cao (drying vesicles)
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Herbs: shingles with bleeding
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bai mao gen >15 di yu mu dan pi sheng di
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Herbs: shingles in retreat. Dusky, vesicles dry up leaving crust. Continued pain.
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Go-to formula: Xiao feng san (avoid Cang zhu when lots of heat) Damp: ku shen, cang zhu, mu tong Wind: chan tui, fengfang, jingjie, niubangzi Heat: shi gao, zhi mu, sheng di Blood: dang gui, hei zhi ma
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Herbs: Herpes zoster/shingles stage 3. Still has scars, sl red around area, pain
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dang gui chuan xiong chi shao mu dan pi hong hua, tao ren zhi ke yan hu suo da huang jin yin hua ru xiang mo yao
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For erythema, red, maybe scaly skin (not oozing)
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Purple cloud: zi cao & dang gui Zi cao gen 30 Dang gui 30 Tao ren 15 Hong hua 15 Gan cao 15 Bai zhi 30 Da huang 15 Di yu 30 Sheng di 30 Heat in sesame oil (1L) Nb if adding vitE or wheatgerm oil, add once cooking complete and before adding wax.
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Herpes Simplex 1 - mouth, face
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External contracted wind heat JJ 10 FF 10 Pu gong ying 30 Ye ju hua 30 Da qing ye 30 Ban lan gen 30 Zi hua di ding 16 Chi shao 10 Yi yi ren 30 Gan cao 3
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Herpes simplex 2 - genital with heat
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Long dan cao 10 Huang qin 10 Sheng di huang 30 Mu dan pi 10 Dang gui 10 Ban lan gen 30 Zhi zi 10 Fu ling 16 Chen pi 6 Gan cao 6
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Herpes 2 genital- yin xu w/ internal heat
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Sha shen 30 Shi hu 30 Xuan shen 30 Sheng di huang 30 Ban lan gen 16 Lian qiao 15 Jin yin hua 15 Yi yi ren 30 Che qian zi 10 Dang gui 10 Hong hua 3 Zhi gan cao 6
