Cutaneous Pruritus
From
Contents |
Definition
Persistent and severe cutaneous itch with clinically normal skin. It features episodes of itchy skin with secondary damages such as scratches, blood scabs, and pigmentation and becomes lichenoid over time.
This condition can be presented as a symptom of a number of systemic disease states or just a limited local pruritus.
Causes and Pathological Mechanisms
- Wind Heat and Blood Heat: blood heat Constitution with invasion of external Wind
- Liver Fire and Wind: emotional disorders cause liver qi stagnation which transform into Fire and Wind
- Damp Heat: Improper Diet: (rich, greasy, deep-fried and spicy food and alcohol) causes damp-heat accumulation in the Spleen and Stomach
- Qi and Blood Deficiency and Wind: qi and blood deficiency due to various reasons (old age and long-term illness etc). Wind evil invasion or wind generated internally (blood deficiency generates wind), skin lacks nourishment.
Patterns
Wind Heat with Blood Heat
- Symptoms: Mostly seen in young patients, short history, severe itch and worse when it is hot, scratches with blood scabs, vexation, dry mouth, dry faeces and constipation and yellow urine.
- Tongue: Pink or red tongue with thin yellow coating
- Pulse: Floating and Rapid
- Treatment strategy: Dispel wind, clear heat and cool the blood
- Formula: Xiao Feng San and Si Wu Tang with modifications: for blood heat, add Mu Dan Pi, Zi Cao; for itchy skin at night add Chan Tui and Mu Li
- Acupoints:
- Symptoms: Persistent and severe pitch, scratch and weeping, dry and bitter mouth, chest and hypochondriac distension, dark yellow urine and constipation.
- Tongue: Red tongue with yellow and greasy coating
- Pulse: Slippery and Rapid
- Treatment strategy: Clear heat, drain dampness and relieve itch
- Formula: Long Dan Xiao Gang Tang
- Acupoints:
Blood Deficiency with Liver Yang Rising
- Symptoms: Mostly seen in old age patients, long history, very dry skin, blood scratches, dizziness and blurred vision, insomnia with many dreams.
- Tongue: Red tongue with thin coating
- Pulse: Thready or Wiry and Rapid
- Treatment strategy: Nourish blood, moisturise dryness, dispel wind and relieve itch
- Formula: Dang Gui Yin Zi with modification. For the old and weak add Dang Shen and more Huang Qi; for itchiness add Di Gu Pi, for thickened skin with scales add E Jiao and Dan Shen
- Acupoints:
References
Articles
Books
