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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