Scleroderma
| Scleroderma is a kind of skin disease of connective tissue caused by sclerosis of the skin. It is divided into two types: localized and systemic types. Generally, it undergoes through three stages, red swelling, sclerosis and atrophy. At the advanced stage, the affected skin will be adhered to the deep tissue and produce functional disturbance of corresponding organs. This disease is called (scleroderma). Main Points of Diagnosis Localized Scleroderma 1. Skin Lesion: Part of the skin has a sensation of burning heat and itching, then slightly elevated patches in red or purple color. The lesion may be tenioid or elliptical in shape, and its border is clear with purple halos around them. The central part is sunken and then the color of patches will become yellow, brown and pale. The skin will be indurated and adhesive to the subcutaneous tissue, then the cleavage lines will disappear. Its surface is smooth and then will become atrophied and thin, and will lose elasticity. There are branny desquamations and pigmentations on the skin lesion. 2. Symptoms and Signs: At first the patient may have an unusual feeling or a sense of itch, then the skin becomes blunt and insensitive. 3. It often occurs on the head, face, neck and limbs, especially among the young and middle-aged women. Scleroderma which occurs at the terminal end of limbs of the young women, is known as "acrosclerosis." The course of this disease is chronic. Systemic Scleroderma 1. Skin Symptoms and Signs 1) The skin lesion begins in the face or the skin of the distant end of limbs, symmetrical in distribution, then gradually spreads throughout the whole body. Or the skin lesion is generalized from the beginning. It often attacks the face, limbs, neck and trunk, mostly among middle-aged women. 2) At first the skin becomes thick and swollen, its surface is smooth and cleavage lines disappear. The skin shows parenchy-matous edema (at edema stage), then gradually becomes adhered to the subcutaneous tissue and it becomes hard, sallow in color and its border is clear (at sclerosis stage). Finally, the skin becomes atrophied and thin, and the hair may fall off. And sweat obstacle may appear. The skin and muscle will be stick to the bone and become stiff (at atrophy stage). 3) At the beginning, there are unusual, tense and itching sensations locally, and then the sensations become blunt gradually or entirely lost. 2. General Constitutional Symptoms 1) At the beginning, there are such symptoms as general malaise, arthralgia, loss of weight, stiff fingers and spasm of terminal arteries of limbs. The features at the advanced stage are emaciation, weakness with low fever. 2) The face may be involved and looks awkward. The nose will be sharp and the ears thin. The movement of the mouth and eyes and chewing will be restricted. In case thoracic wall is involved, respiration may be limited. In case four limbs are invaded, the joints will become stiff and motions limited. In case the digestive tract is involved, there will be difficulty in swallowing, accompanied with vomiting, nausea, abdominal distention and diarrhea. In case the lung is invaded, vital capacity will be reduced. If the heart is involved, heart failure will occur. If the heart is involved, heart failure will occur. If the kidney is involved, renal hypertension and uraemia may appear. Differentiation and Treatment of Common Syndromes Internal Treatment 1) Blood Stasis Type Main Symptoms and Signs: The skin becomes hypertrophic and elevated or sunken and hard. It may be bright red, purplish red or yellowish red or brown is color. The tongue is light purple with ecchymosis on it. The pulse is rapid. Therapeutic Principle: Promoting blood circulation and expelling stasis. Recipe: Decoction of Four Herbs plus Safflower and Peach Kernel and other ingredients astragalus root red peony root red sage root spatholobus stem dried rehmannia root Chinese angelica root chuanxiong rhizome honeysuckle flower peach kernel safflower pangolin scale earth worm dried body of ground beetle licorice root All the above herbs are to be decocted in water for oral administration. 2) Type of Kidney Deficiency and Blood Stasis Main Symptoms and Signs: The skin becomes thick, sclerotic, or atrophied and thin, accompanied with pain in the knees and waist, tinnitus, vertigo, impotence, premature ejaculation, low fever, spontaneous perspiration, ecchymosis on the tongue and deep and fine pulse. Therapeutic Principle: Nourishing the kidney and warming, promoting blood circulation and removing blood stasis. Recipe: Kidney Reinforcing Bolus and Decoction of Four Herbs plus Safflower and Peach Kernel prepared rehmannia root multiflower knotweed root dogwood fruit eucommia bark epimedium morinda root peach kernel safflower red peony root red sage root Chinese angelica root ligusticum rhizome All the above herbs are to be decocted in water for oral administration. 3) Type of Splenic Asthenia and Blood Stasis Main Symptoms and Signs: The skin is sclerotic and atrophied, accompanied with fatigue, loss of appetite, abdominal pain and distension, loose stool, ecchymosis on the tongue, thready and moderate pulse. Therapeutic Principle: Strengthening the spleen and replenishing qi, promoting blood circulation and removing blood stasis. Recipe: Decoction for Invigorating the Spleen and Nourishing the Heart with additional ingredients astragalus root red peony root red sage root codonopsis root big-head atractylodes rhizome spatholobus stem poria Chinese angelica root aucklandia root tangerine peel amomum fruit longan aril fresh ginger Chinese date All the above herbs are decocted in water for oral use. 4. Other Therapies 1) 10 ml of salvia miltiorrhiza injection with 500 ml of 5% glucose is used for intravenous drip, once a day, The whole course of treatment will be 10 days running and then stop dripping for 7 days. Curative effects can be seen after a month's treatment. 2) Four Worms Pill Ingredients: dried body of scorpion dried body of centipede dried body of ground beetle dried earthworm All the above drugs are made into pills in equal amount each. The size of the pill is the same as that of a mung bean. Take 3-5g each time, three times a day. 3) Pill of Rhubarb and Ground Beetle Ingredients: rhubarb dried body of ground beetle licorice root lactiflora peony root dried ginger rhizome rehmannia root scutellaria root peach kernel apricot kernel gradfly dried leech dried grub All the above herbs are to be ground into fine powder to make pills. 10 grams for each pill. Take one pill each morning and evening. | ||||||
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